It's no secret. The people who cannot afford to pay drive prices up for those who can. That and the occasional frivolous malpractice lawsuit are why your hospital popsicle costs $4. Hospital administrator is considered a high stress job due to the financial aspect.

But the bigger point is what you're choosing to ignore. Health care is an emergency most of the time. That's when the whole economic system falls apart. How can the hospital tell when a guy is having a heart attack whether or not he can pay? They can't make that determination in the time it takes the patient to die. So they're out the cost of that service if yhey treat him and he cannot pay.

Then their choices are 1) go out of business or 2) inflate the cost of services to others who can pay (happening for decades now) or 3) deny service to anyone dying, except to the people carrying gold bars/bricks of cash to pay.