[chimeracoder]

> $41.1 billion = 5% of total revenue. A few orders of magnitude would mean the shortfall is greater than all of their income combined.

You're not comparing apples to apples. $41 billion is the aggregate of the bills for which they cannot collect; that doesn't mean they don't receive any money from them, and it doesn't mean $41 billion is the amount they've actually lost.

I know you "don't trust" GAAP accounting, but understanding the basic terminology and concepts makes it a lot easier to follow what's going on here.

[Retric]

"U.S. hospitals provided $41.1 billion in uncompensated care in 2011, according to the latest data from the AHA's Annual Survey of Hospitals. That's $1.8 billion more than in 2010. The total includes "bad debt" (services for which hospitals anticipated but did not receive payment) and charity care (services for which hospitals neither received nor expected payment because they determined, with help from the patient, the patient's inability to pay). It does not include Medicaid and Medicare underpayment."

So, no this is not all 'underpayment' but I agree it's relative to charges not costs.