[s_m_t]

How is that legal? What is stopping the hospital from charging 200 million dollars for the rabies shots?

If I hired someone to fix my plumbing and they wouldn't give me an estimate and then decided to charge me $20k/hr I don't think a court would honor that contract.

[1letterunixname]

It's legal and legitimized because of corruption.

Whoever has the most money in America captured the regulators and politicians through money conveyed to them by lobbyists.

You live without plumbing by making different arrangements but you can't live with a fatal lyssavirus.

[akomtu]

I'm not sure about that. Hospitals use the fact that patients have no choice. Amoral business is the most profitable. A pipe in your house has burst, you called a plumber and he arrived in 1 hour (other plumbers were even further). He looks at your situation and says "sign here, my rate is 5k/hr plus unexpected expenses up to 50k" and when you try to negotiate, he calmly looks at water flooding the second floor in your 2mln house and answers nothing. You both know that very soon the repairs will cost you 100 thousands of dollars. I doubt any judge would agree that the plumber owes you work at a rate convenient for you.

[s_m_t]

Sure the plumber is free to only offer outrageous rates but I'm not sure they would be able to markup a roll of teflon tape they used in the repairs as 50k and say that is covered by "plus unexpected expenses up to 50k".

To me it just seems like fraud. Forget about patient choice because in this situation the patients conceivably could have shopped around for rabies shots, AFAIK you aren't going to die because you got your rabies shot a few hours later the you needed to. The problem seems to be that even if they were able to shop around and find the lowest price apparently the hospital can just charge whatever they want regardless of the expected or quoted cost.

Going back to the example of the plumber; Imagine if my house is flooding and I get into contact with two plumbers, one tries to price gouge me and quotes me $5k/hr and one is seemingly honest and quotes me $80/hr. I go with the plumber that quotes me less but then he ends up charging me $50k for the teflon tape he used anyways. We can see this isn't a breakdown in being able to shop the market and the normal competitive dynamics that arise from that, the breakdown occurs because of the fraud.

[1letterunixname]

It's the gambit of brinkmanship + Vito Corleone.

[fxd123]

Hospitals are required, under federal law, to list all their prices publicly.