If they had to pay the first $5000, they would demand itemized bills that weren't just based on the fraudulent DRGs the government uses, which were never intended to be used for billing purposes.
The feds released 700 pages of clarification on one of their regs a couple weeks ago. In the next two months they will release a “mega-reg” which is expected to be thousands of pages.
This on top of everything else.
Hospitals have high fees because they have to make up for the regulations, lawsuits, and non-payers. Insurance companies add in a tremendous amount of overhead but they are not the only problem.
Yes people who don’t see their bill do tend to over use services, but that doesn’t impact hospital fees. The hospitals are required to use those DRGs.