Keeping money within its own hospitals sounds more or less what you'd expect, surely? That's the whole point of having their own hospitals? And I expect the executives are paid quite a bit. I'm sure they're not a bunch of angels, but nobody says you have to use them. FWIW, I've used them once in the past, and observed my father doing the same, and we've had no complaints. The premiums seemed reasonable, as well; far from the horror stories one hears from the States.