Can't tell if you're being sarcastic or not, but yes, there are patients that pay (or are charged) a 1,000% markup, that in turn offsets patients not paying any

Can't tell if you're being sarcastic or not, but yes, there are patients that pay (or are charged) a 1,000% markup, that in turn offsets patients not paying anything. I'm not saying the problem is the patients paying nothing; the problem is that the payment model is broken.