^^^^^^^^

1. Bills get lowered by your insurance company before you pay them. My $42,000 surgery bill was knocked down to $2000 just from negotiations between the hospital and my insurance.

It’s all of the above, really. Health care can’t work like a textbook capitalist system because you don’t have one “consumer” who decides what they need and whether to pay for it. You don’t have a choice about getting sick, and you often have little or no choice in your treatment.