Why Australia hospital prices are lower
Australia sets one hospital price — a DRG, a tariff, or a budget. The hospital takes it. It cannot charge each plan a different secret multiple. In the US the must-have hospital extracts 2–3× Medicare from job plans that cannot walk. The insurer passes that through. It does not set it.
Public hospital as the floor
How it works
Public hospitals run on activity-based funding plus budgets. Medicare posts the MBS fee schedule for doctors. Private extras exist. They do not reset the floor at 250% of Medicare the way a US job plan does.
Why it holds
If the public hospital will do the bypass at a public rate, the private market cannot charge US commercial and keep the volume. That is why iFHP private-plan medians in Australia are the sourced proof, not a model: same operation, a fraction of the US invoice.
The invoices
See iFHP, RAND hospitals, Papanicolas.