She was billed $809 for a boot for her broken foot. Amazon charges $80

[NowISeetheLight]

5. I worked in healthcare finance...

… for fifteen years until I had to retire last year. I started in billing, then moved to coding, and ended up as a revenue cycle department manager for a large health system. I agree the healthcare system is a disaster. In the hospital we had the charge master with prices (all inflated). Insurance paid a fraction of the charges while people with no insurance were offered a “discount” of 25% which meant they still paid way more than the insured. Medicare and Medicaid often didn’t cover the cost of care to the hospital. Probably half the years I worked the hospitals I worked for lost money. If we made 2% profit it was a good year. My last year working we had total revenue of over $4b dollars, were in the red, had layoffs, and gave away over $100m in charity care. We wrote off a couple $100m more to bad debt.

What drives the cost are a couple things. First, building hospitals like resorts, pianos in the lobby, healing gardens, fancy architecture, stuff like that. The second (and bigger) problem is material costs. A knee joint from Stryker costs a hospital twice as much in the US as Canada. We all know about drug costs and how expensive they are. An AICD from Medtronic is way more expensive for a US hospital than an EU one. American device manufacturers drive the costs as they are profit oriented.