This is something that really bugs me about the socialized medicine debate in the US. We've had socialized medicine since the law was passed in 1986 that said ERs couldn't turn people away. Everything since then has just been a debate about how to socialize it and how to pay for it.

I would say the current rules are not socialized in any sort of good faith method. Certainly not in a way that provides transparency of costs and effectiveness. Nor in any way how a socialized universal healthcare system would approach it.

> Medicare pays cost based rates (for all services) to small rural hospitals in part to ensure this. "Critical access hospital" is the keyword if you want to read more.

They pay extra to small hospitals that don't receive enough privately-insured patients to break even on standard Medicare reimbursement rates. For other hospitals, they pay rates that are below-cost, and hospitals charge private insurers extra to make up the difference.