I just have to chime in to disagree with this comment. The U.S. does not a have a free market system in place because of Medicare/Medicaid. IE Government 'competition'
Hospital's are a business. Businesses in a free market will try to make the most profit possible, so using the simple economic laws of Supply and Demand prices will naturally gravitate towards efficient sustainable pricing. Discerning patients will shop around for the price they are willing to pay.
Currently, the system resembles this:
Hospital: Okay, we have this procedure, it costs $100 to perform. Tack on other expenses of hospital overhead and we can make a 10% profit by charging $200. "Will you pay $200 for this procedure?"
Uninsured Patient: "Wow, I can afford that."
Insurance Company: "Yes, that is great. A pleasure doing business with you!"
Government via Medicare/Medicaid: "Yes."
Same Hospital: We can make a 300% profit by charging $700. "Will you pay $700 for this procedure?"
Uninsured Patient: "Ouch, no, I can't afford that."
Insurance Company: "Are you serious? We'll have to raise our rates for us to remain profitable, but if that's what it costs..."
Government via Medicare/Medicaid: "Yes."
Same Hospital: We can make a 1000% profit by charging $2000. "Will you pay $2000 for this procedure?"
Uninsured Patient: Crickets chirp as the empty chair spins slowly to a stop.
Insurance Company: "What? There's no way we can afford to remain in business if we pay that. We'll have to come up with an exclusion clause for this procedure..."
Government via Medicare/Medicaid: "Yes."
Obviously that's an exaggeration, but what sane business owner would not jack prices up if they will be paid regardless? What happens if you take the government 'competition' out of the picture?
Hospital A: We can make a 10% profit by charging $200. "Will you pay $200 for this procedure?"
Uninsured Patient: "Wow, I can afford that. I'll be sure to come back if I have another problem!"
Insurance Company: "Yes, that is great. A pleasure doing business with you! We'll refer our customers to you."
Hospital B: We can make a 300% profit by charging $700. "Will you pay $700 for this procedure?"
Uninsured Patient: "No thanks, I'll keep looking."
Insurance Company: "Only if it's an emergency, otherwise we will refer our customers to Hospital A."
Hospital C: We can make a 1000% profit by charging $2000. "Will you pay $2000 for this procedure?"
Uninsured Patient: "Ha ha ha ha ha," as the patient walks out the door to find a different hospital.
Insurance Company: "Ha ha ha ha ha," as the man walks out the door to find a different hospital for his customer.
Hospital C goes out of business due to poor management.
Hospital B struggles until it decides to lower prices to be competitive.
Hospital A's business is booming with record 'sales' and demand is starting to out pace supply. To meet demand, Hospital A buys the closed Hospital C building and expands.
That's the kind of Health Care system I would like to see. Take the government out of the industry and the free market corrects itself. Health care expenses go down until demand equals supply. Insurance premiums drop to a much lower level because the Insurance Companies can now afford to undercut competition. The working (poor?) uninsured can now afford insurance if they want, and those that choose to remain uninsured don't have to file bankruptcy after finding out what their medical bill is.
It's not a perfect system, but it is much harder to game a free market business than it is to game the government.