When can you charge what you want after the fact and then have collection agencies enforce it?

What is the only industry in which you can charge what you want AFTER services have been provided?

Health care. 

And even when you are enterprising and try to call around hospitals to find out how much an operation would be, the task is impossible.  A Kaiser Health News story describes how a man who broke his leg called and negotiated the fees up front.  Received a 30% discount only to find out that the bill was more than twice what had been negotiated.  "Every doctor does it differently" it quotes a surgeon saying.

In any other industry prices are negotiated up front.  Any increase would be a "change request" that would have to be signed before.  Otherwise the price stands and the service providers have to eat the costs they did not anticipate.  But the health care industry is above it all.

In NJ, the New Jersey Hospital Association has put together a pricing comparison web site. 

What is the only industry in which a price comparison website does not compare prices, only allows you to see "average charges" for one provider at a time after you enter the provider name and the item name separately?  Nothing simple here!  No itemized charges here!

Don't get me started.  Anyway, the "average cost" for an appendectomy (a really simple operation that beginner surgeon students get to do) is an unbvelievable $24,000 at Valley and $37,000 at Hackensack "University" Hospital.  Either hospital does 200-300 such operations per year.  Are these comparisons useful?  Probably not since prices fluctuate like crazy depending upon what insurance you have, what doctor is doing the operation, what nurse is recording the charges, whether there is space in the operating room (or you have to wait a day or two, at expensive hospital rates). 

But can you really expect anything useful from a health care industry player in business to increase the hospital business?