Paying upfront is different from having transparent pricing though--even if you pay first and insurance reimburses you later, you still might not know the price

Paying upfront is different from having transparent pricing though--even if you pay first and insurance reimburses you later, you still might not know the price until you get the bill. In the end the two systems differ only in liquidity requirements, and perhaps counterparty risk (if insurance stiffs you). Otherwise the costs are the same, and since liquidity requirements affect primarily low-income people and those with little to no savings, it would disproportionately affect them.