"Payment rates for Medicare and Medicaid, with the exception of managed care plans, are set by
law rather than through a negotiation process, as with private insurers. These payment rates are
currently set below the costs of providing care, resulting in underpayment. Payments made by
managed care plans contracting with the Medicare and Medicaid programs are generally
negotiated with the hospital.
Hospital participation in Medicare and Medicaid is voluntary. However, as a condition for
receiving federal tax exemption for providing health care to the community, not-for-profit
hospitals are required to care for Medicare and Medicaid beneficiaries. Also, Medicare and
Medicaid account for more than 60 percent of all care provided by hospitals. Consequently, very
few hospitals can elect not to participate in Medicare and Medicaid."
That quote is misleading because it implies that the cost of care is static, that it's not also heavily influenced by spending choices made by the hospital that don't affect patient outcomes. Or heavily influenced by the consequences of the broken healthcare system, like the overuse of emergency rooms by people who can't afford to see a doctor.
Hospitals could easily afford to provide care at Medicare/Medicaid rates — if they're willing to have less impressive lobbies, marketing materials, corporate facilities and shareholder profits. Citation: all other first world countries.
Do intelligent people ever go to for-profit hospitals? I'd group those with for-profit universities and for-profit prisons as "nope, not touching that, stay as far away as possible and hope they all disappear".
Maybe, but for the same expense I'd rather go to (non-profit) Harvard than (for-profit) Trump University.
All the best universities are non-profit, for the obvious reason that it allows them to keep massive endowments, which are spent on better education instead of being paid out to investors.
It's because in addition to the reimbursement, hospitals are paid a bonus fee by US taxpayers called a DSH to subsidize the subsidies. This serves to incentivize providers not to drop Medicare/Medicaid patients and also covers up the losses incurred.
Hospital participation in Medicare and Medicaid is voluntary. However, as a condition for receiving federal tax exemption for providing health care to the community, not-for-profit hospitals are required to care for Medicare and Medicaid beneficiaries. Also, Medicare and Medicaid account for more than 60 percent of all care provided by hospitals. Consequently, very few hospitals can elect not to participate in Medicare and Medicaid."
Source (American Hospital Association, December 2016): http://www.aha.org/content/16/medicaremedicaidunderpmt.pdf (Sorry it's a PDF)
Edit: updated from 2010 reference to 2016 reference