I think the problem is that hospitals can use the price of procedures as a bargaining chip. They can jack up the price for the uninsured (on paper) then lower i

I think the problem is that hospitals can use the price of procedures as a bargaining chip. They can jack up the price for the uninsured (on paper) then lower it if they're actually going to bill a person. Then they take the jacked up number and use it to negotiate with insurance companies, and insurance companies can likewise point to the number and say "look what will become if you if you don't stick with us!" The first step should be disallowing this negotiation. That should massively lower the on-paper prices, or let insurance companies at least make the tough decisions about what procedures are actually worth it, which is supposed to be one of their functions anyway. If that isn't their function, I'm not sure what their function is.