A study from the Wall Street Journal using medical pricing data that, until the start of this year, had been confidential has found that people with no insurance are generally charged the highest rates for care, over and above even insurance companies. It found that, in most cases, hospitals routinely charge the highest rates on uninsured patients paying cash, or at least tie with the highest insured rates. For 21 percent of hospitals in the study, this is done for the majority of services versus simply "all." This means that those least equipped to pay hospital bills are those with the highest charges, while insurers get deep discounts for their patients.

For example, at one hospital in Kentucky, uninsured patients who get a heart attack are charged $66,226; Anthem Inc., as a company, is charged $17,895 for the same procedure, with the co-pay likely being far smaller than the discounted cash rate.

Hospitals reacted to the data in a number of different ways. Some questioned by the Journal said the prices were either in error or they hadn't been updated; others said the uninsured get deep discounts of their own, though the Journal said they rarely cover more than 20 to 30 percent of the cost, and this is even if someone qualifies; others changed their rates as soon as reporters contacted them; and a few didn't dispute the facts and were frank about their reasoning.

For these hospitals, they're concerned that if insurers see them charging uninsured patients at a deeper discount than they've received, they might decide to take their business elsewhere. Insurance companies, it seems, fear that if the cash rate is lower than the insured rate, then what's the point of health insurance in the first place? And so, to maintain the reason for their own existence, they pressure hospitals to keep the uninsured rate high, according to the Journal.