Comment by legitster

Some food for thought: More than half of all medical costs are accrued in the last 2 years of someone's life. That means the vast majority of the medical system, including billing and insurance is geared around elderly people with extremely complex medical bills. Young, healthy people who occasionally need to visit the doctor is an afterthought. Which is why you still get a person over a phone.

That said - yes, the system is incredibly dumb. Not only is it insanely regulated, but there is a constant 3-way game being played - not just between insurance and hospitals, but also between hospitals and Medicare/Medicaid. Medicare and Medicaid only pay out a percentage of the list price for any procedure, but unlike private insurance, the payout is non-negotiable. So providers play around with billing codes to cover their costs. They are also cagey about publishing prices because that's ammunition for insurers to negotiate harder.

Some providers try to offer transparent/straightforward "cash" prices (shout out to Zoomcare in the PNW). But this gets them in trouble with insurance providers for some reason.