You think over years and a number of bills that cents wouldn't start adding up?

It's 100% noticeable. If it weren't, then it wouldn't matter to people like the c-suite who are so focused on making money for themselves.

The numerator might so up but so will the denominator, so it effectively cancels each other out. More to the point, I feel like this argument is over relative vs absolute. It might be noticeable" to a single person, but given that we're talking about the healthcare system as a whole, it's fair to say that it's not "noticeable".