Another approach would be that a hospital actually has to take responsibility for the doctors and all other care teams working inside. Legislation to this effec

Another approach would be that a hospital actually has to take responsibility for the doctors and all other care teams working inside. Legislation to this effect would work, but in some cities there is enough competition that a marketing campaign along the lines of "guaranteed no out of network bills!" would catch my attention. I'd happily drive an extra hour for that piece of mind. And the reality is that a large number of ER visits are not true time-critical emergencies. Many times the standard admission procedure starts with reporting to the ER. I spent 4+ hours before a small outpatient procedure at a local hospital trying to find out if the anesthesia group and surgeons were in-network. I never got a straight answer -- no one knew the answer and I was forced to roll the dice. Hospitals are currently more like co-working spaces where each room (ORs, radiology, etc.) is rented out. The support staff is included, but everyone else is their own small business.