Part of the issue is that Medicare and especially Medicaid pay providers below cost for services. That money needs to be made up somewhere. Private insurers pay above cost, but they have too much leverage to get squeezed by the hospitals. That leaves uninsured patients to hold the bag. They could try to cut costs, but that puts them at a competitive disadvantage because most patients don't actually care about how much their care costs, they only care about how much they have to pay.

If you're an uninsured patient who isn't in poverty then hospitals are going to squeeze you for as much as they can get away with. It's how they keep the lights on. None of this makes any real sense, but hospitals are just doing what they have to do to survive in the system we've created for them.