[bobwyman]

At hospitals in the US, every payer is charged a different price. Large insurers and HMO's negotiate large discounts which shifts costs onto smaller insurers who get smaller discounts and thus pay part of the costs of their larger competitors. The non-poor uninsured, who often can least afford to pay, are charged the most -- often 5X, 10X or more than what Medicare or a large insurer would pay. In all states other than Maryland, which has state-wide "all-payer" pricing, what you are charged depends more on who you are and how much negotiating power you have than what was done for you.

The solution is to let the "free market" work. Of course, that means we need to regulate the market to fix the existing "market failure." Free markets are regulated markets. (Although not all regulated markets are free.)

All states should pass laws saying that hospitals are free to charge what they want but that their prices must be posted and apply to "all-payers" without discounting. Additionally, states should develop all-payer databases like those advocated by: http://www.apcdcouncil.org/

Much has been said about Medicare in the comments here that isn't quite accurate. The reality is that Medicare ignores hospital charges (except in Maryland) and pays according to their own calculations of hospitals' costs. In most cases, that means they pay much less than they are charged. However, in some cases, it means that they pay more.

For some additional background on this issue, from a New York perspective, see my PDF on the subject linked to at: http://bobwyman.blogspot.com/2013/04/RFC-FRAND.html