If you pay cash most places I’ve seen cut the price in half so there’s truth to that. What can happen is the insurance companies want big discounts to be in their network. So in order to accommodate that, providers raise the list price so the middle managers at the insurance companies can show their bosses how much they “saved” the company. It’s a game.

Another problem that drives up costs is underpayments. We have laws on the books that any hospital that takes any federal money has to see everyone through the ER regardless of whether the person can pay or not. And they can’t just release someone to the streets after treatment. So many hospitals have agreements with local motels to set people (usually homeless) for 1 night to release them “safely”. Those costs can add up. Our medical tort system which is very litigious runs up the insurance costs of providers, especially certain specialists like obstetricians. Ironically one of worst payers in insurance is the Federal Government with Medicaid being one of the worst.

While it‘s good that people can be seen, those losses have to be made up somehow. And they do this by having really high list prices.