That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (includin

That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (including nothing at all) you are responsible for. But they also tell you up front what they are going to charge you and you acknowledge that you accept responsibility for making sure they get paid that amount either out of your own pocket or by covering the gap of what insurance pays. The idea that having insurance changes the cost is sort of a misdirection. There's a chance my plan doesn't cover some or all of things that will be billed. So there is always a risk of non-payment or partial payment. Yes, they sometimes do pre-approvals for specific procedures but that doesn't always translate to proper billing/coding that gets covered. The vast majority of healthcare are not ER visits which means people have a chance to review and accept the responsibility of payment. But that would also mean they would know what the hell they would be charged. There's no good reason for a hospital to say "oh you don't have insurance so we're going to basically mark your bill up 3x just to be safe. Marking the bill up 3x, for example, doesn't change the fact that they are really only seeking 1x so the people who can afford to pay 3x are legally required to do so because for some reason this is viewed as a legit practice and not fraud. And the people that can't settle for something less than 3x, usually much less. Maybe 1x...in which case the providers gets what they were after anyway and just indicates further that this is a sort of fraud and extortion.