with or without AI you'd be shocked at how much of a medical bill can disappear if you just ask. Ask for an itemized bill, then ask what programs they have available to help. The real fact is that the hospital barely knows what they did to you, has no idea what it should cost overall, has a foggy idea of much you'll pay vs your insurance (but only a foggy idea because of all of the constantly-shifting backroom deals that insurers and providers make with one another), and then whatevertf price they arrive at with all of this gets an arbitrary number tacked onto it designed to mitigate the fact that a lot of people just don't pay their bill at all and it's not like the hospital can reach into them and claw back their $80 tylenol if they don't get paid, so they just bill it forward and hope that most people will look at their bill as the final word on the subject and pay it despite the fact that they're being badly overcharged. Combine this with the "reject all claims and hope they don't follow up" model of insurance and you can see where this all clearly needs to burn to the ground so that something that works can grow in its place, but also where a lot of people get really rich doing it this way and no one gets super rich when services are provided at a reasonable price so there's no real will to unruin this system. So what we end up with is a system where we pay a lot more than everyone else in the developed world and, for our money, we get to die earlier, which may or may not be preferable to dealing with the american healthcare system. When I was figuring out what I actually owed for my 4 days in the hospital for diverticultitis I strongly considered just dying next time.