My feeling is that the experience could be improved dramatically right now if instead of ever directly paying providers, we instead always paid the delta to the

My feeling is that the experience could be improved dramatically right now if instead of ever directly paying providers, we instead always paid the delta to the insurance company. My experience with provider billing offices is that they actively weasel and trick you into overpaying the negotiated rates and hope you don't go over the bill. And then they stall and "forget" to refund. Nothing ever makes sense until the explanation of benefits document is generated. In other words--if we're not going to do single-payer, then it should at least be single-payer-per-patient.