Sure, and that's one of the reasons I like Belk's site: he tries to explore more facets of the overall US health care clusterfuck than most other researchers an

Sure, and that's one of the reasons I like Belk's site: he tries to explore more facets of the overall US health care clusterfuck than most other researchers and journalists. For the hospitals' portion of the mess, he finds that despite an overall decline in hospital stays [1], the amount that hospitals bill over what they actually collect has grown dramatically [2]. This in turn is caused by differences in incentives between Medicare/Medi-Cal and private insurance companies; private insurance companies are less motivated to drive down costs, and even have some incentives to pay hospitals more than Medicare/Medi-Cal would for the same services. Hospitals likewise have had steadily growing profits overall (in the 5% to 8% range) over recent decades, although most US hospitals are non-profit business entities. (This doesn't mean they don't make money, of course.) This really funky interplay between governmental health insurance, private health insurance, and hospitals is the main driver of the shocking, headline-grabbing bills people receive. They aren't the prices the hospital is expecting to actually collect, they're the prices that hospitals have invented in the hopes of collecting 30% of it from Medicare, and private insurance companies are playing along because it gives them a justification for raising their pricing for coverage. In a sense, a lot of what people are arguing about is phantom prices. Unfortunately, uninsured and under-insured get caught up in all this absurdity and that ends up driving around 60% of bankruptcies [3]. And while there are often arguments that hospitals have to charge more because there are more people unable to pay their bills, the number of uncollected bills hasn't really changed for a long time [2]. Thus a lot of the discussion around this issue ends up coming back to "greedy insurance companies" because they really are a major contributor to the problem. Prescription drug pricing likewise affects a disproportionate number of fixed-income people (whether retired or disabled). I'll try to keep yours and ~rayiner's different positions in mind in the future. [1]: http://truecostofhealthcare.org/admissions_data/ http://truecostofhealthcare.org/admissions_data/ [2]: http://truecostofhealthcare.org/hospital_financial_analysis/ http://truecostofhealthcare.org/hospital_financial_analysis/ [3]: http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/index.html http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bill...