Nailed it, buddy. I just went through a bad few months of health issues that required numerous trips to see specialists, in-patient and out-patient care, etc.
Even though I do have supposedly decent insurance which costs about $1K month between my employer and me, the bills just started piling up day after day. Cryptic codes on all of all of them and absurd costs which were reduced by the insurance company and then sent to me. I'd consistently see crazy, clown-world prices like a one-night hospital stay charged for $25K, reduced by the insurance company to $1200, and then billed to me for $500. It's like they just made up the prices as they went along.
And even after doing my best to figure out which bills were valid and which weren't, I still had almost $10K of bills out of pocket, even though I have a deductible for $3K. Turns out the hospital who guaranteed me to be in-network allowed the use an out-of-network anesthesiologist (who billed me twice - once through the hospital where it took place and once through some anesthesiology company).
If any other business or industry played these kind of games they'd be instantly bankrupted as consumers would refuse to play, force their credit card companies to make charge backs, or find alternatives. Any other industry with these type of practices would be instantly sued by the SEC and DOJ for RICO act violations and collusion.
And while I know it's not just doctors causing the issue, they play a huge part. No sympathy from me if their whole industry were nationalized and they were forced to take government set salaries no higher than GS-15.
$25K is the sticker price that someone uninsured would see. Sure, they'll get parts "forgiven," but this markup makes patients feel ripped-off, and it almost looks like an accounting scam. I'd like to see something that the sticker price can't be more than 10% greater than the lowest negotiated price.
I know one medical area where it isn't this way. Dentistry. When I go to a dentist, whatever is the procedure, I can know upfront what are the costs, what I am paying for, and almost always (excluding rare exceptional cases, which usually also are handled by the dentist) which part is out of pocket and which will be covered by insurance. That is before we even start. But if I go into a non-dental clinic - suddenly billing is a riddle, wrapped in a mystery, inside an enigma, nobody can say anything - you just have to wait for the bills to come, and then you'd know.
No wonder it ends up with the state coming in and putting the boot down. And no wonder it will be done in a ham-fisted way state regulation usually works. Because however laissez-faire I am, I cannot but see current situation is completely fubar. I'd prefer medical professionals and insurers and administrators and whoever they are figured it out and proposed me a market-based solution that doesn't make each visit to a doctor a reverse lottery - but that doesn't seem to happen (well, there are a handful of medical establishments with proper predictable pricing, but rare and far between). So, no wonder this is happening instead.