Kendall Regional charges the uninsured at 920% markup, putting it in top 50 markups in US. (xpost from all over)

From one of the other threads:

Lawyer here. This is less about "overcharging" and more about transferring costs. Two factors are in play here: (1) the arms race between hospitals/providers and insurers/Medicare/Medicaid and (2) lawsuits. Say you're an indigent wage laborer with no insurance and no assets. You're on the way to your minimum wage job and you get hit on the highway. You're going to need to go to the E/R just like someone who has insurance. At the E/R you are just like any other patient in one important respect: you can sue a hospital or doctor who fails to provide you with adequate care even if you have no assets and no insurance. The hospital, fearful of lawsuits, is going to go ahead and give you an MRI, a series of x-rays, maybe a CT scan, to rule out spinal cord injury or broken bones. If you happen to have a herniated disk in your back or actual broken bones, the hospital will offer you care, possibly including fixation surgeries, in order to avoid any malpractice claims. Now in the scenario above, you can't pay the hospital back, but there's a good chance you'll have a lawsuit against the person who hit you. The hospital knows that if you ever get paid on that suit, it would have to pursue collections actions against you for your outstanding bills owed to them. In any collections action they are going to incur costs and likely settle the claim for less than the outstanding bill. What actually ends up happening most of the time is that the plaintiff's lawyer for the injured person clears medical bills and liens by settling out with the providers, for a discount out of the settlement funds paid by the at-fault party's insurance company. Hospitals thus know that they are going to get whacked on their bill no matter what: either the indigent person stiffs them outright, or the bill gets paid at a discount settlement via a collections action, or the bill gets paid again at a discount out of the proceeds of any potential settlement. For every ten indigents to whom the hospitals provide care, the hospital might recover payment (usually via the third option above) one time. They are typically not allowed (by law) to deny care to people who walk in, although they might try to ship them off somewhere else. Ultimately someone is going to provide that care. This is simple math. If you only get paid one out of ten times, functionally, then you need to charge 10X the normal rate in order to break even. You need to charge ALL TEN people 10X the normal rate, because you're only going to get paid once, and you need that one payment to make up for all the other non-payors. All of this adds up to a great argument for some kind of blanket health insurance. I don't care if it's government supplied, mandated through private insurers (which is Obamacare), or some kind of hybrid. As long as every person who walks through the doors of the E/R has some financial backing and means to pay, then the hospitals can stop playing this shell game and begin to charge each individual 100% of what they owe instead of 1000%. Now that we are making baby steps towards universal insurance coverage, the next step is to begin putting pressure on the hospitals to change their billing systems to reflect their actual payment rates. Over time, in theory, we should see charges begin to drop as the rate of recovery for outstanding bills improves as more and more people are covered by some form of insurance. There are a lot of ways to bring that pressure (including, in my profession, allowing defense lawyers to discuss insurance coverage and fair market value with juries, which is currently outlawed by something called the collateral source rule in many jurisdictions, thereby bringing down overall lawsuit values and relieving runaway verdict pressures on the insurance system). Tl;dr: 1000% charges are a symptom of hospitals getting paid 1 time out of 10 and the solution to this shell game is some form of universal insurance coverage.

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