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“Greed is good” was the 1980s caricature of capitalism, but it could be the slogan of countless hospital executives who work relentlessly to drive up healthcare costs. Hospitals, as the largest share of healthcare costs, are the driving force behind rising insurance premiums. They are shielded from competition and heavily subsidized. And they constantly demand more.

The Washington Post  shows how this works through the example of one woman’s medical bills. After a week of intense headaches, Autumn Daniels was advised by an urgent care doctor to go to an emergency room. She went to the Carle Foundation Hospital in Urbana, Illinois.

She said the ER didn’t seem very busy when she registered at the front desk and was taken briefly to an exam room, where a staffer checked her vital signs and asked whether she had migraines frequently. Then they told her to sit in the waiting room until she was called.

She and her sister waited. And waited. By then, Daniels said, she was vomiting every 10 minutes, a not-uncommon occurrence during one of her serious migraine attacks.

After four hours, with no indication that Daniels would be seen anytime soon, her sister took her to another hospital. There, after a wait of about an hour and a half, Daniels was seen and treated.

Daniels had once before sought treatment at Carle Foundation Hospital and had the same experience, leaving after waiting for hours. At that time, she was not charged. But unknown to her, the hospital had adopted a new policy to charge pretty much anyone who walks through its door. Daniels was billed $410.

According to the Post, Carle Foundation Hospital refused to provide an itemized bill, refused to negotiate, and told Daniels “that even if patients leave without being seen by a provider, they may still be charged, because the hospital is using resources to maintain its staff, space and equipment.”

Wait until grocery stores learn they can bill us simply for being in the store, even if we leave without making a purchase. Electronics shops might bill us for browsing the latest tech. Perhaps malls will charge husbands for sitting on benches while their wives shop. Except that if any such business sent out bills for “staff, space and equipment,” everyone would laugh, leave a nasty review, and their competition would eat their proverbial lunch. Rightly so.

Several policy choices allow hospitals to get away with this. One is reliance on “third-party payers” in American healthcare, where most bills go first to insurance companies or government programs. This lets hospitals hide costs from patients and blame third parties when they refuse to cover outrageous or excessive bills (as happened to Daniels). It also means patients often don’t care (especially if they don’t know) how much is charged for the services they receive. Hospitals are also protected by thick webs of regulation that make it nearly impossible for anyone to compete with them. This is not a free market or capitalist system.

Hospitals routinely charge for basically nothing without any shame, as a policy, and even hire consultants to do it more. This is moral corruption. The institutions and the executives who drive these decisions and this culture deserve the public’s disdain. It also explains why American healthcare is wildly expensive and costs continue to rise.

Read more of Save Our States’ analysis of hospitals’ role in making healthcare unaffordable at HealthcareBetrayal.com and in the affordability section of our website.