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From the outside, a hospital seems like one thing; but it's really nothing at all like retail. Some doctors can bill separately, the pharmacy can bill separately, different departments can bill separately, different diagnostics can bill separately. One well-meaning hospital can't fix this; it's baked into everyone's expectations.

Could be driven by Private Equity.

Are the bigger hospitals like Mayo Clinic, university medical schools and MD Anderson like this too? I've only visited Mayo Clinic for the executive checkup plan which has a fixed and upfront sticker price (I'm in Europe).

Some non-profit hospitals have for-profit management companies.

My hospital system, like many others in the US, is owned by the local government. My experience is the same as yours.