> Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high. Exactly. This is the

> Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high. Exactly. This is the hidden secret about US healthcare that very few people are aware of. Even providers usually don't see this anymore, because they're so removed from the billing process (especially now that most providers are salaried and not running their own practices). Medicare and Medicaid are the reasons that sticker prices for treatment in the US are absurdly high. Incidentally - and most people don't know this - if you're uninsured and self-paying, you almost never have to pay the sticker price. Hospitals really don't care, and if you just tell them that you're self-paying and can only afford (say) 10% of what they billed you for, they'll almost always immediately agree to a 90% discount. The only reason they're showing you that bill is that they need to present high bills to private insurers (to make up for the loss on Medicare/Medicaid reimbursements) and they're not legally allowed to present differently-priced initial bills to patients based on their insurance status.