Power of collective bargaining drives the price down.
The AMA and other collectivizations of providers drive the price up (cartels). That's why becoming a doctor in the USA is such a long and hard ordeal, relative to other countries. And also why litigation is so high.
Oh and of course... THE PATENT SYSTEM causes the USA to pay for most of the innovation that scientists in the redt of the world are prevented from building upon with open source.
It's fascinating, and kind of horrifying too. I've of course been a patient, and I saw the initial bill for a neck injury that led to no treatment other than Tylenol - $16,000. My HMO paid about half that, I believe. I was not on the hook for the difference. This is negotiated by contract between the HMO and the hospital. The high bill is the beginning of negotiations between two large and powerful organizations.
Here's the thing - lacking access to good health care in the US is even worse than not being able to pay the bill. It means you get stuck with the higher bill, and no pre-negotiated contract or negotiators to knock it down. I've talked to people who work at hospitals, and they say their billing department may knock it down a bit, but it means that the person not represented by an HMO or similar gets hit not with an $8,000 bill but one much closer to $16,000.
I know I'm supposed to hate my HMO and everything, and they can be irritating, but there's no way I'd want to experience the US medical system as an "independent".
As you said, you're already dealing with a Monopsony. It's worse, because you don't know what they're charging, whether it's important, whether it should be done, none of it. And it is run by something closely resembling a cartel, the AMA and hospitals simply do not operate in anything remotely resembling a free market. I guess my HMO is my government backed cartel. I pay through the nose for the insurance (well, my employer "pays" some of it, but it's all through the employer, so what does it matter the portion that is added to and then deducted from my actual paycheck vs the part that never makes it to my paycheck and is paid on my behalf?). But as a result, I have a powerful cartel on my "side".
When I describe the AMA as a cartel, people often think this means I oppose occupational licensing entirely. No, not necessarily. That's an interesting discussion, but there is plenty of room to criticize the AMA (and other professional and trade licensing bodies). while supporting some limited form of occupational licensing (actually, you could support substantial licensing and still be appalled with the AMA and ABA).
Power of collective bargaining drives the price down.
The AMA and other collectivizations of providers drive the price up (cartels). That's why becoming a doctor in the USA is such a long and hard ordeal, relative to other countries. And also why litigation is so high.
Oh and of course... THE PATENT SYSTEM causes the USA to pay for most of the innovation that scientists in the redt of the world are prevented from building upon with open source.