It is most likely that the hospital didn't pocket all of that fee. Insurance companies have contracted fees with hospitals. In spite of the shortcomings of our health care system, it is still among the best in the world, especially when compared to socialism. A friend of mine was vacationing in Italy several years ago, and became very ill. The hospital couldn't treat him even though many of the docs attended med school in the US. He ended up hiring a medi-vac jet home, was treated for bac spinal meningitis. Saved his life. Would have died in Italy.