Not to mention that this is almost completely out of your hands if you're unconscious or otherwise not able-bodied. If you get in a car accident and are unconscious, you're likely to go to whichever hospital the ambulance takes you to, and you're on the hook for that ambulance ride now, too. Before you even get to the hospital, your bill can already be over $1000.
Companies who act as the insurance company and the care provider have an interest in cheaper care. E.g. Kaiser Permanente
They also have an incentive to err on the side of providing less care. Since you still can't meaningfully comparison shop between them and their competitors, I suppose it is exactly like a national single-payer system.
This is only true at the end of a person's life. Before then, ignoring problems does not make them go away, it in fact makes it more expensive for them.
See:
* Why nobody can itemize a medical bill.
* Why a bag of saline may cost the patient $100.
* Why an in-network hospital will bring in an out-of-network independent contractor nurse to assist an in-network surgeon, leaving you with a $200 bill for the surgery + a $5,000 bill for the out-of-network assistant.
* Why nobody will tell you how much a procedure will cost, with, or without complications.
* Why nobody knows how much your insurance will pay for, until the bill is due. Often months after the procedure.
Compared to all of these problems and abuses, HIPAA seems the least of America's problems.
I'd like to contribute to reducing the cost of care, by shopping around for more efficient/more affordable/better dollar for value doctors/hospitals, but I haven't the foggiest idea of where to start. It's like going to a car dealer, saying that you want a Prius, and not knowing what the age of the car, its condition, or how much you will be billed for until after the title is irrevocably transferred to you. Oh, and the dealer across the street will happily sell you one for half what you paid for. Or double. You really have no idea.