That's because the US has turned into a defacto buyer-coalition system where you have to pay to join a club (health insurance provider) which negotiates rates w

That's because the US has turned into a defacto buyer-coalition system where you have to pay to join a club (health insurance provider) which negotiates rates with health care providers. If you don't join such a club, you get charged rates that can be significantly higher (read 2x or more).