You don’t even need there to be conscious corruption. If the system churns out incorrect bills through simple error (perhaps because the hospital never bothere

You don’t even need there to be conscious corruption. If the system churns out incorrect bills through simple error (perhaps because the hospital never bothered to drag its accounting system out of the 1970s), and an overcharge is just as likely to be paid as a correct bill¹, then the bad system will stay in place without anyone twirling his mustache and sneering about his obscene profits. ¹Which is to say: Consumers in bad financial situations will dispute or default on overcharges, but they’ll do the same for correct bills. Insurance companies will occasionally dispute an overcharge, leading to six months of paperwork back and forth until they agree on what to pay, but they’ll put correct bills through the same wringer.