Consider that the average healthcare consumer pays an insurance company a premium and a co-pay so that the insurance company can reimburse a doctor whose rates

Consider that the average healthcare consumer pays an insurance company a premium and a co-pay so that the insurance company can reimburse a doctor whose rates are higher to offset the cost of administrative salaries for assistants to deal with the insurance companies. If you think about it, it's basically a form of racketeering which happens to be legal because the doctors and the insurance companies aren't formally colluding to needlessly increase the administrative complexity of the system, and because there is no legal response, the insurance companies are incentivized to raise administrative complexity and cost over time (since inelastic demand has no effect on preventing revenues from rising from pure cost increases).