E.g., my doc listened to my heart. Thought he heard something, so he ordered some tests. A couple of 45-minute hospital procedures, involving only techs, not MDs, totaling about $3363. Nothing found. Lucky me.
Blue Cross hammered the bill down to $567, a reduction of 83%. I owed a $20 copay. I had insurance. Lucky me.
Blue Cross probably still overpaid.
Sorry, but no. At what Blue Cross paid it's unlikely much if any profit was made, and the hospital may have lost money. For $567, you received (by your estimates) 90 minutes of technical care for your testing, and probably at least 30 minutes of physician time (your cardiologist and the doctors doing the official reading of your tests), for 2 hours, at least. So, for a cardiologist visit and the time of two trained technicians you paid ~$283.5/hr. Try getting out of an attorney's office, even if most of your time is with a paralegal, for that much per hour.
Plus that price includes the cost of staff at your docs office, staff at the hospital, the cost of equipment that was used (probably one of your tests was an echocardiogram, so consider the price of the ultrasound console; and whatever your second test was - maybe a treadmill with imaging), service contracts and maintenance for that equipment - plus the time and cost of compliance protocols to make sure they're up to standards, malpractice insurance for all physicians involved - plus insurance coverage for the hospital, facilities costs for your docs office (rental of space etc.) and facilities costs for the hospital, the cost of filing the paperwork for payment (often extensive), electronic medical record keeping - which is now government mandated, the fact that your cardiologist had to review the results and they probably called you to tell you the results, etc. etc.
Whereas I agree that the ‘real’ costs of medicine are very difficult to pin down, and hospitals ‘cost shift’ all the time, providing medical care is not cheap. There are clearly ways to do it better, but if you want expert medical care - and not just whatever Walmart or CVS can provide in some ‘minute clinic’, costs have to be covered and people with many, many years of costly training should be able to make a reasonable profit.
I paid $20 dollars (plus the expected tip) for a ‘trim’ at the barber shop the other day (going basic price in our town). This probably took 10-15minutes. The barber didn't have to worry I was going to sue him.
They know exactly what stuff costs. It’s marked up because of the insurance.