This is something that only people like us can see. The rest of the world doesn’t care about the problem, and even if they did, they have zero incentive to fix it.
Healthcare has one of the lowest payment collection rates of any consumer industry. And as of a couple years ago, medical debt under $500 can no longer go on your credit report even after going to collections. States have passed even more consumer-friendly versions of this law, like NY where no amount of medical debt can affect your credit score.
So actually medical billers are directly hurting themselves with their incompetence in this and many other departments.
Send someone an official looking piece of paper telling them they received $394 worth of in office medical laboratory service from Tristate Medical Partners Inc in August last year, that insurance paid $374 and that they just owe you a $20 copay, and I think a lot of people will just go to the online bill pay site and hand over the money.