[gen220]

There are many complicated reasons that a hospital would charge more than people can afford. One factor is that it looks better on their balance sheet to have uncompensated medical costs. This is exactly why insurance companies never pay the full price, and why nobody pays the difference. It’s accounting magic to make hospitals etc look like nonprofits and claim subsidies.

That being said, there’s been a trend in the US recently, where hospitals have very aggressively gone after unpaid bills of the uninsured, because some administrators see it as money they’re leaving on the table. It’s more prevalent in rural areas, where there’s often only one hospital to go to, and consumers have no choice but to go to the hospital with a terrible reputation.

In some cases, they’ve convinced the judicial system to garnish the uninsured person’s wages, to get “their money back”. IMO it’s clearly illegal and it won’t last much longer, but yeah the system is crazy. :/