[dragonwriter]

> And, there are other countries and healthcare systems in which they internally take care of the stats/metrics so that they make a decent amount while you pay a reasonable amount that they tell you before you choose to get the procedure.

That's a difference in the financing system, which hospitals have about as much say in as consumers do.

The insurance companies (including government payers like Medicaid and Medicare) don't just control reimbursement, they control what providers can bill to customers, too. And that includes (by usual and customary charge rules) influencing what they can and need to charge to customers that aren't even being reimbursed by the payer in question.