Why is it that insurers in the US are seemingly the only industry where the person paying the bill can a) negotiate it after services are received; and, b) just

Why is it that insurers in the US are seemingly the only industry where the person paying the bill can a) negotiate it after services are received; and, b) just decide not to pay it if they don't want to? Hospitals should set a price for a procedure. There will be some variability of course as people need more or less anesthesia, identical surgeries can take longer to perform (=== more OR/surgeon time === more money), etc. But a $22-102k like in the article is absurd. Insurance companies should be required to pay whatever the hospital price is provided it can be justified. There should be specific courts to handle these disputes until the industry realizes it isn't special. Regardless, the onus shouldn't fall on the patient. Outcomes should be limited to: 1) Insurance company pays without complaint; 2) Insurance company doesn't pay, is sued by hospital, and is ordered to pay by the court; 3) Insurance company doesn't pay, is sued by the hospital, prevails in court, and hospital adjusts accordingly, eating 100% of that loss. But, we'll likely just stay where we are now where people pay $100 for Tylenol PM and insurance companies get out of paying claims because one person out of 12 in the OR were out of network and they're all contractors.