RT Journal
A1 Magee B
T1 HOspital services in the united states and canada
JF JAMA
JO JAMA
YR 1998
FD August 19
VO 280
IS 7
SP 599
OP 600
DO 10-1001/pubs.JAMA-ISSN-0098-7484-280-7-jbk0819
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-280-7-jbk0819
AB 
In Canada, with universal coverage and a single payer, there is little reason for charges to vary significantly from revenues. In the United States, however, cost shifting is an intrinsic part of the system. Few pay "retail"; rather, charges are an elaborate way of using the many different payers to cross-subsidize each other and those who cannot pay. Most hospitals' revenues represent discounts from charges, some of them quite substantial.