There is an "Adam ruins everything" about that
In short if you have insurance you pay the real price, the rest is bloated to make it seem like the insurance is really necesarry. If you don't you pay the real cost and the bloated extra
So it went crazy in both directions the bloating got out of hand and the insurances got more costly and very specific (pay for the operation but not the aftercare, ...)
In at least some countries, there is also a serious component related to legal requirements on privately funded institutions to provide significant care first and only after determine how - and if - the patient or their heirs, if any, can pay.
Thus, it is legally impossible to legally comply, stay in business, AND only charge those patients who can pay enough to cover their own care plus a moderate profit, because then providing significant care for patients who cannot pay - which cannot legally be turned away at the door - would then drive the hospital out of business.
IF the hospital is required to balance their cash flow so they take in at least as much as they spend, THEN either they need to determine the patient's total ability to pay up front (including insurance, government spending, etc.), OR they have to be able to compensate for patients they have provided care to who cannot or do not pay. Plus the edge cases of people who lose the ability to pay, refuse to pay, etc.
Don't get me wrong - like every other large human enterprise, there's a lot of inefficiency, corruption, greed, and so on. Hospitals and health care often has a lot of regulatory overhead as well, which has a lot of expenses - some of it is truly for patient safety, some of it is self-inflicted by lobbying for barriers to entry to prevent smaller organizations from competing, some of it is inflicted by politics, some of it is out of date or poorly thought out... but it's there, nonetheless, and once in place, it's very difficult to change overall - and no single hospital or hospital system has any real say other than "comply minimally", "comply more than minimally", or "fail to comply".
There are also other layers involved based on regulation, such as being required to pay for large hospital management software systems that are legally compliant and/or regulatorily approved, which both cost enormous amounts (those people want to make money too) and introduce costs all their own in terms of "Nope. You can't do it that way anymore, you have to do it our way. Don't like it? Don't use our software! Oh, wait, it costs tons of money and years of time to change. So, do it our way [which we chose because it's what we happened to code first/it was easy for us]"
Alternately, of course, in some places the hospitals have no requirement to collect fees and may be funded by an outside source, at which time they are resource-limited in a way that may or may not not scale with the amount of resources they use providing care, which gives a different set of financial incentives for greed and corruption, and a different set of options that work long-term within that environment.
tl;df In addition to greed, corruption, and other issues internal to hospitals and hospital systems, there's entire sets of major issues that are either partly or completely outside the hospitals control that still have to be dealt with one way or another, since they don't exist in a vacuum.
So, bringing it back to this story, I think Ordis found the hospitals were charging - coincidentally - exactly the same as they would have if they'd provided ALL the care, which is clearly fraudulent, since they were not providing all the care. Now, they absolutely have the same right to charge for what they actually provided the patient as under any other case, and they have the right to charge for what they provide Amy - nurse assistant, etc., but charging coincidentally the same as for a triple bypass operation they never performed, that's pure greed.
