Why France hospital prices are lower
France 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.
T2A — one hospital price list
How it works
Hospitals bill T2A (tarification à l'activité) — a national activity tariff, like a DRG. Doctors bill CCAM/NGAP. Assurance maladie is the payer. The job does not pick a hospital price.
Why it holds
One list. A French hospital cannot bill a second secret commercial rate to a job plan, because the job plan is not in the room. If the tariff is too low, the fight is with the ministry, in public. That is how 38¢ happens without skipping the ICU.
The invoices
See iFHP, RAND hospitals, Papanicolas.