Hospitals hire increasingly ferocious collection companies because plenty of people skip out on the (insane) bills. People choose not to pay these bills because they are frustrated by their enormously confusing health insurance. The insurance companies profit, the hospitals profits shrink, and everyday citizens are caught in the middle.

A while back hospitals, schools (public and private), and governments decided in order to survive they needed to operate as a for-profit endeavor instead of as public services.