I think there is an important point to be highlighted: We often blame the system for being expensive but in this case an individual doctor was able to say we will not collect. These decisions to charge patients a literal fortune for treatment probably always falls to an individual or small group of individuals. We should highlight this on billing documents, instead of "please pay XYZ hospital" the individual accountable for the largest share of the bill should be named: Dr. X is requesting payment of $500,000.