The US system works like this * hospitals run as non profits, so they dont pay federal taxes * they still pay local taxes, so they need to generate a large lo

The US system works like this * hospitals run as non profits, so they dont pay federal taxes * they still pay local taxes, so they need to generate a large loss to offset these taxes * insurance companies negotiate huge "discounts" on list prices, and then go back to their customers (large corporations) and boast about these discounts, meanwhile the hospital gets its tax writeoff This entire system is rigged to also grow the number of hospitals/ the overall size of healthcare in america. Pharma companies play this game too, and anyone who doesnt have insurance can quietly get a "coupon" from them to bring down the cash price to the same as insurance. No politician will close hospitals, so at this stage any move to "single payer" will just move the boasting role to the government.