Let say you go and pick up a loaf of bread from the store. You don't pay, however. Instead, you have the bakery send a bill to your "buyer." Your buyer then negotiates the price. One thing about your buyer: the more revenue that flows through them, the more money they get to make. The bakery tells the buyer that the cost for the loaf of bread is $500. However, the buyer wants to keep you happy, so they reject the price, and come back with a lower price: $350. The bakery rejects the $350 price, and eventually, the two parties agree that the price should be $400. (Note, that other bakeries, where you buy directly, charge $4 for a loaf of bread.)

The buyer gets to say they negotiated. The baker doesn't have to look you in the eye when they gouge you.

It gets a little more complicated,though. Instead of just paying $400 for the loaf of bread, the buyer bundles the cost of all the purchases together, and then charges a monthly fee, based on the previous year's overall revenue. They then tack on 20%. So, it turns out, with that extra 20% you're actually paying almost $500 for the loaf of bread anyways.

Is it a scam?

Yes, it's a scam.

The difference is that the customer pays 100% of the entire price. The industry doesn’t have a plan where you pay $0.10 for an eggs benedict brunch, or 10% a year after spending $100, and then get to charge your employer or your fellow citizens massive sums.

And someone can start a competing bakery across the street that doesn't over charge. You can't do that with healthcare.