> There is no one area that is the cause. It's death by 1,000 papercuts.

Yup. A few minutes (of unnecessary) oxygen in an ambulance cost my insurance company about $500. A single oral dose of generic Keppra while in the hospital cost more than the cash price an entire month’s supply from CVS. The room I stayed in was billed at about $7300/day, but hey, it did include unlimited room service.

In fact, the only clearly reasonably priced item from my hospital stay was the generic Tylenol, I assume because it’s common enough to generate complaints.