Health
Hospitals Profit from Exorbitant Markups
By Jazelle Hunt
NNPA Washington Correspondent
WASHINGTON (NNPA) – Hundreds of American hospitals are turning a profit by charging patients exorbitant rates for necessary procedures. And for 50 hospitals in particular, the mark-ups are as high as 12 times the amount it costs them to deliver those services.
This is the revelation from a paper published last week in the Health Affairs medical journal, titled “Extreme Markup: The Fifty US Hospitals With The Highest Charge-To-Cost Ratios.”
“These 50 are outliers, they’re very skewed. But that does not mean all the other hospitals are hidden,” says Ge Bai, assistant professor of accounting at Washington and Lee University, and co-author of the paper. “It’s very difficult to tell [though]. You’d have to ask the question, when you walk in, at the front desk…about the ownership of the hospital.”
The researchers looked at 2012 hospital price lists for nearly 5,000 facilities across the country, and compared them to the Medicare-allowable costs, defined as the most reasonable fees a hospital can expect to spend in effectively delivering any given service to Medicare patients, as calculated by the government. They are not intended to guide hospital charges to patients, and every hospital creates its own price list. These lists are called chargemasters and are often difficult for patients to access and decipher unless a hospital takes the rare initiative to be transparent.
According to the study, most hospitals charge patients between 1.5 and 4 times the Medicare allowable cost. A smaller, but sizable number of facilities charge between 4 and 9 times the cost. The 50 outliers – 49 of which were for-profit facilities – were charging patients between 9.2 and 12.6 times the cost they incurred in delivering services.
The top five hospitals with the steepest mark-ups, all charging at least 12 times the Medicare cost, were North Okaloosa Medical Center and Bayfront Health Brooksville in Florida; Carepoint Health-Bayonne Hospital in New Jersey; Paul B. Hall Regional Medical Center in Kentucky; and Chestnut Hill Hospital in Pennsylvania.
Florida is home to 20 of the 50 high mark-up hospitals identified in the study. The rest are spread across 12 other states – mostly in the South (76 percent are), and mostly in urban areas (84 percent are).
The other states were Alabama (which had five of these facilities), Arizona (one), Arkansas (one), California (three), Kentucky (one), New Jersey (one), Oklahoma (one), Pennsylvania (seven), South Carolina (one), Tennessee (three), Texas (five), and Virginia (one).
Two publicly-traded corporate hospital systems – Community Health Systems and Hospital Corporation of America – own 38 of these facilities.
Chargemasters vary widely, in general and within this top-50 group. For example, at Orange Park Medical Center in Florida (number eight on the list), if an uninsured person is admitted for one to two days for chest pain, he or she could be charged somewhere between $12,000 and $23,000. About 15 miles away at Memorial Hospital of Jacksonville, the same patient would be charged between $9,000 and $17,000, and that’s with an extra day of care. Both hospitals are owned by the same company, which voluntarily provides its price estimates.
Uninsured people feel the full force of these charges. While the Affordable Care Act has helped millions get coverage, the Centers for Disease Control and Prevention (CDC) estimates that 13.7 percent of Black people are still uninsured as of 2014 and will likely remain so. Many are low-income or below the poverty line, living in states that did not expand Medicare coverage. Half of the states housing the top-50 high mark-up hospitals did not expand Medicare.
Insured people who are “out-of-network” at these facilities are also vulnerable. Insurance companies do not set their terms based on the hospital’s prices – if a policy covers 70 percent of all emergency visits, then the patient is responsible for the 30 percent, whether the hospital charged $100 or $1,000. When a person gets a bill from a hospital that isn’t partnered with his or her insurance company, the company often pays little to nothing of that bill.
People who are both insured and in-network end up paying higher premiums when a hospital with high mark-ups is part of their network. As insurance companies have to cover members who end up in these for-profit facilities, they spread the steep charges among all their members.
“We don’t have price regulations in other industries so people can do comparative shopping. But in the health care market it’s very different. In many cases, we as consumers do not have the time…to compare prices,” Bai says, adding that during treatment, physicians don’t know or are not at liberty to discuss the hospital’s pricing systems. “We as consumers have no options before the service is provided. We just wait there hopelessly…we’re sick and anxious.”
About 30 percent of the hospitals sampled in the study were considered for-profit – Bai says that about half of all hospitals in the country are.
Maryland and West Virginia are the only states with complete health care pricing regulations. California and New Jersey have regulations for what hospitals can charge uninsured patients. Maryland’s system is widely considered a national model, with the lowest mark-ups in the nation (1.5 of Medicare allowable cost). The report recommends a federal system patterned after it.
“We knew these high mark-ups have been going on for a while, at least 15 or 20 years, but this is really over the top,” Bai says. “I think the public needs to understand…there’s a loophole in our system. The market has stopped working. That’s why we need the government to step to help regulate some of these prices.”
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Activism
OPINION: California’s Legislature Has the Wrong Prescription for the Affordability Crisis — Gov. Newsom’s Plan Hits the Mark
Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.

By Rev. Dr. Lawrence E. VanHook
As a pastor and East Bay resident, I see firsthand how my community struggles with the rising cost of everyday living. A fellow pastor in Oakland recently told me he cuts his pills in half to make them last longer because of the crushing costs of drugs.
Meanwhile, community members are contending with skyrocketing grocery prices and a lack of affordable healthcare options, while businesses are being forced to close their doors.
Our community is hurting. Things have to change.
The most pressing issue that demands our leaders’ attention is rising healthcare costs, and particularly the rising cost of medications. Annual prescription drug costs in California have spiked by nearly 50% since 2018, from $9.1 billion to $13.6 billion.
Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.
Some lawmakers, however, have advanced legislation that would drive up healthcare costs and set communities like mine back further.
I’m particularly concerned with Senate Bill (SB) 41, sponsored by Sen. Scott Wiener (D-San Francisco), a carbon copy of a 2024 bill that I strongly opposed and Gov. Newsom rightly vetoed. This bill would impose significant healthcare costs on patients, small businesses, and working families, while allowing big drug companies to increase their profits.
SB 41 would impose a new $10.05 pharmacy fee for every prescription filled in California. This new fee, which would apply to millions of Californians, is roughly five times higher than the current average of $2.
For example, a Bay Area family with five monthly prescriptions would be forced to shoulder about $500 more in annual health costs. If a small business covers 25 employees, each with four prescription fills per month (the national average), that would add nearly $10,000 per year in health care costs.
This bill would also restrict how health plan sponsors — like employers, unions, state plans, Medicare, and Medicaid — partner with pharmacy benefit managers (PBMs) to negotiate against big drug companies and deliver the lowest possible costs for employees and members. By mandating a flat fee for pharmacy benefit services, this misguided legislation would undercut your health plan’s ability to drive down costs while handing more profits to pharmaceutical manufacturers.
This bill would also endanger patients by eliminating safety requirements for pharmacies that dispense complex and costly specialty medications. Additionally, it would restrict home delivery for prescriptions, a convenient and affordable service that many families rely on.
Instead of repeating the same tired plan laid out in the big pharma-backed playbook, lawmakers should embrace Newsom’s transparency-first approach and prioritize our communities.
Let’s urge our state legislators to reject policies like SB 41 that would make a difficult situation even worse for communities like ours.
About the Author
Rev. Dr. VanHook is the founder and pastor of The Community Church in Oakland and the founder of The Charis House, a re-entry facility for men recovering from alcohol and drug abuse.
Activism
Oak Temple Hill Hosts Interfaith Leaders from Across the Bay Area
Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.

Special to the Post
Interfaith leaders from the Bay Area participated in a panel discussion at the annual meeting of communication leaders from The Church of Jesus Christ of Latter-day Saints held on Temple Hill in Oakland on May 31. Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.
Chambers, said he is thankful for the leadership and support of the Church of Jesus Christ Latter-Day Saints’ global ministry, which recently worked with the interfaith congregations of ICAC to help Yasjmine Oeveraas a homeless Norwegian mother and her family find shelter and access to government services.
Oeveraas told the story of how she was assisted by ICAC to the Oakland Post. “I’m a Norwegian citizen who escaped an abusive marriage with nowhere to go. We’ve been homeless in Florida since January 2024. Recently, we came to California for my son’s passport, but my plan to drive for Uber fell through, leaving us homeless again. Through 2-1-1, I was connected to Rev. Ken Chambers, pastor of the West Side Missionary Baptist Church and president of the Interfaith Council of Alameda County, and his car park program, which changed our lives. We spent about a week-and-a-half living in our car before being blessed with a trailer. After four years of uncertainty and 18 months of homelessness, this program has given us stability and hope again.
“Now, both my son and I have the opportunity to continue our education. I’m pursuing cyber analytics, something I couldn’t do while living in the car. My son can also complete his education, which is a huge relief. This program has given us the space to focus and regain our dignity. I am working harder than ever to reach my goals and give back to others in need.”
Richard Kopf, communication director for The Church of Jesus Christ in the Bay Area stated: “As followers of Jesus Christ, we embrace interfaith cooperation and are united in our efforts to show God’s love for all of his children.”
Activism
“Unnecessary Danger”: Gov. Newsom Blasts Rollback of Emergency Abortion Care Protections
Effective May 29, CMS rescinded guidance that had reinforced the obligation of hospitals to provide abortion services under the Emergency Medical Treatment and Labor Act (EMTALA) when necessary to stabilize a patient’s condition. Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.

By Bo Tefu, California Black Media
Gov. Gavin Newsom is criticizing the Centers for Medicare & Medicaid Services (CMS) for rolling back federal protections for emergency abortion care, calling the move an “unnecessary danger” to the lives of pregnant patients in crisis.
Effective May 29, CMS rescinded guidance that had reinforced the obligation of hospitals to provide abortion services under the Emergency Medical Treatment and Labor Act (EMTALA) when necessary to stabilize a patient’s condition.
Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.
“Today’s decision will endanger lives and lead to emergency room deaths, full stop,” Newsom said in a statement. “Doctors must be empowered to save the lives of their patients, not hem and haw over political red lines when the clock is ticking. In California, we will always protect the right of physicians to do what’s best for their patients and for women to make the reproductive decisions that are best for their families.”
The CMS guidance originally followed the 2022 Dobbs decision, asserting that federal law could preempt state abortion bans in emergency care settings. However, legal challenges from anti-abortion states created uncertainty, and the Trump administration’s dismissal of a key lawsuit against Idaho in March removed federal enforcement in those states.
While the rollback does not change California law, Newsom said it could discourage hospitals and physicians in other states from providing emergency care. States like Idaho, Mississippi, and Oklahoma do not allow abortion as a stabilizing treatment unless a patient’s life is already at risk.
California has taken several steps to expand reproductive protections, including the launch of Abortion.CA.Gov and leadership in the Reproductive Freedom Alliance, a coalition of 23 governors supporting access to abortion care.
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