As in the rest of the United States, health-care costs in Massachusetts continue their rapid climb, even though most prices in the United States are falling because of the deep recession. But unlike elsewhere, Massachusetts taxpayers guarantee medical coverage to all residents. And so they have a right to know why an MRI of a knee costs $1,100 at Children’s Hospital in Boston but only $490 at Boston Medical Center.

In a Nov. 29 editorial, “Celebrity health care” spawned by The Boston Globe’s superb Nov. 15 expose, “A health-care system badly out of balance,” we commented on this, but it deserves more elaboration because it affects so many people in so many ways.

There seems to be no medical reason for such pricing disparities. It’s all about empire building by some powerful Boston hospitals, using the proceeds of special deals they’ve wrenched from insurance companies and Americans’ obsession with celebrities –– be they individuals or institutions. If Massachusetts is to be the model for a national health plan, as proposed by Sen. Edward Kennedy, then let it start here by slowing the spiraling costs of medical care.

Some of the big-name Boston teaching hospitals that have managed to extract higher insurance payments include Children’s Hospital and the members of Partners HealthCare, a group including Massachusetts General and Brigham and Women’s. As a result, they may be paid two or three times more than a community hospital for the same procedure.

And while patients may think they are getting better care at a famous teaching hospital, that is not necessarily the case. On the contrary, the doctor at the teaching hospital may be an intern, while the cardiologist working the 2 a.m. shift at a local hospital may have 20 years’ experience. Some very specialized care is best delivered at famous hospitals, but 85 percent of medical procedures — for such things as delivering babies and treating pneumonia — can be easily done anywhere. Indeed, Brigham and Mass General do not get the best mortality ratings, according to The Globe’s analysis.

In addition to helping raise the average Massachusetts family’s premiums by 78 percent since 2000, the 800-pound-gorilla hospitals are using their enhanced profits to expand into the suburbs and take business from smaller hospitals. For example, Partners has built a $43 million outpatient clinic in Foxboro, not far from Caritas Norwood Hospital. The objective is to drain day-surgery patients from Caritas, which because of its lower insurance reimbursements, is $4 million in debt. Caritas asserts that were it paid the same rate for delivering babies as the Partners hospitals, it would have lost no money in the third quarter.

What we have in Massachusetts is a grand play by some big-name hospitals to enrich themselves and put lower-cost competitors out of business. The ultimate bill, of course, goes to anyone who pays for health coverage in Massachusetts — companies, individuals and, increasingly, the taxpayers.

In response to these revelations, Governor Patrick has proposed having state insurance regulators stop excessive premiums. And he has convened a panel to embark on cost-containment steps in Massachusetts, something that is long overdue.

Vigorous action is needed, for the good of Massachusetts taxpayers and to make the Massachusetts insurance program a better model for America.