as to private hospitals they only receive a flat fee from the social security institution for every patient they see and are free to charge patients additional costs up to a ceiling fixed at more than the public hospital price this is dampened however by the fact that providers have little incentive to offer the full range of secondary care particularly complex packages of care for patients with the greatest need since the current set of reimbursement codes do not reflect case severity furthermore there is little incentive for public hospitals to contain costs since overspends due to unbudgeted activity may in some cases be compensated with funds from other public hospitals in surplus prices paid by the social security institution however are well controlled and show no evidence of inflation