Hospital charge masters are designed to bring in revenues at a level the hospitals feel to be warranted. Similarly, physician charges seem to be more arbitrary than derived from an understanding of cost of inputs (labor, supplies, capitalization expense for technologies, indirect costs, etc.). Fee-for-service reimbursement hasn’t been based on what it costs to do the service, or to produce the desired health outcome. There is a healthcare cost crisis, in part, because we have no way to associate actual costs of producing the service with what is charged. Not surprisingly, the uninsured are punished the most by this billing design. We have an illogical and irrational system that the Affordable Care Act seeks to change.