I'm getting that most people don't know the sticker price is fraudulent (e.g. the overlapping "master procedure" and component codes) and/or are so relieved to have the charity out that they agree to it without any further questions. But OP points out that the charity out is just further fraud, victimizing tax-payers.

the medical insurance industry and the hospitals do this whole song-and-dance charade where they pretend that they are charitable, public-protecting institutions who serve noble goals of helping sick people.

in truth, they are doing nothing but racketeering.

The hospitals and insurers are locked in a Red Queen Race. The hospital bills for 10x actual market value. The insurer touts they are getting you a 90% discount. The individual who got sick or injured gets crushed in the middle.

Where are the class action law suits?