Fuzzy Numbers: U.S. Hospital Accounting Since the 1930s

This chapter argues that U.S. hospitals have used accounting in a distinctive, paradoxical manner to secure generous reimbursements and favorable regulatory terms from third-party financiers, both public and private. By presenting inexact, unreliable cost calculations as “objective” accounting products, hospital leaders could more readily inflate treatment prices, charge patients widely divergent rates, and conceal internal operations from third-party payers seeking data to design efficacious cost containment methods.