> If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash,

> If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash, and if patients actually knew what the prices were beforehand there would be actual competition and downward pressure on prices. This implies that there are enough doctors. But current reality is that supply is artificially limited and there are not enough doctors.