The nurse is probably receiving very little of these $49. It's probably an inflated price charged by the hospital that is usually negotiated down to something reasonable by the health insurance provider. Similar to the discussion I had with my product manager recently: she can't expect that consultant to work according to the 100$ per hour that his company charges, because he is likely receiving a lot less.

> The nurse is probably receiving very little of these $49

Yes, that was the point. That the price of healthcare isn't based on the wages of the nurse.

But that's the point, no? If you double the consultant's salary, you won't have to pay double because most of it is just pure margin.

That assumes that the employer is willing to lose part of their margin and doesn't charge it back to their customers. Maybe not on the current contract, but future ones.