Yale economist Zack Cooper argues that the real driver of soaring U.S. health costs is not insurer denials but hospital prices. He points to a 320 % rise in premiums over 25 years that mirrors a three‑fold increase in hospital charges, a trend that outpaces inflation and drug costs for patients and policymakers alike.

Cooper cites hip‑replacement bills: U.S. hospitals earn an average of $29,000 per procedure under private insurance, compared with $9,400 in Germany. With over 1,300 mergers since 2000, many U.S. hospitals now operate as de facto monopolies, pushing prices up while offering little improvement in outcomes for patients and care providers alike today and investors in.

The public’s fury over premiums—some families pay more than $27,000 a year—has focused attention on insurer practices. Yet reforms that curb denials or lower out‑of‑pocket costs will do little without tackling the monopoly power that lets hospitals set steep prices and pass them to policyholders for patients and investors who depend on stable coverage today.

Congress faces a choice: let unchecked mergers continue, fueling job losses and widening income gaps, or impose price caps based on Medicare or competitive benchmarks. Only decisive action against hospital price inflation can curb premium growth, protect low‑wage workers, and restore confidence in America’s health‑care system for future growth and prosperity for all citizens today.