"Perhaps worst of all, billed charges can be perceived as shocking, or even punitive, to the uninsured. As hospitals increasingly raised their charges and set prices by negotiating discounts from their chargemasters, those with the least bargaining power received the smallest discounts. An unfortunate consequence of this system is that self-payers, including the uninsured, were usually forced to accept the charges that hospitals stipulated. This created, probably inadvertently, a rather pernicious outcome in which patients who had the least ability to pay for their health care were charged the highest prices. This has resulted in considerable problems for some patients with very high health care personal debt, aggressive efforts at collection, and avoidance of needed services."
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|title=The Precarious Pricing System For Hospital Services|url=http://content.healthaffairs.org/content/25/1/45.long|accessdate=March 7, 2013|date=January 2006|author=Christopher P. Tompkins, Stuart H. Altman and Efrat Eilat|doi= 10.1377/hlthaff.25.1.45 |volume=25 |issue=1|pages=45-56}}
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Chargemaster
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