Unfortunately, that's what it comes down to in practice.

-----

It really comes down to insurance companies. Some doctors are switching to private pay only (i.e. you pay out of pocket). This allows them to operate much more closely to a traditional business, like auto repair or general contracting. They have easily itemized costs for materials and a standard labor rate.

When insurance comes in, absolutely all of that goes out the window.

* Insurance never wants to commit to exact costs. Doing so removes their leverage to minimize bills.

* You remove the incentive for high efficiency (which simply becomes an issue in every aspect of health care).

* Patients never even attempt to shop around for costs.

* Patient satisfaction scores are completely at odds with billing efficiency. You either do too much to minimize visits or risk loosing money if you choose to tackle something iteratively.

-----

In general, I think the entire health system would be drastically better if health insurance took the approach of automotive insurance. Insurance is only for catastrophic events. Standard care and maintenance is an expected cost that comes out of pocket.