The fundamental problem is no body knows the cost of anything beforehand. Neither insurance company not doctors tell the cost of the care. Its really frustrating ! The first step to fix the problem is getting the cost of the care transparently. Without this i am not sure how any of the scheme works whether it is done by govt or private insurance companies !
This also translates to the cost for labor. How much your company is paying for insurance seems to have little correlation to how good your insurance is, so Company A could be paying an extra $5k per employee because they don't have a good HR department.
It also means that every job offer has to be examined not only for salary and culture, which are usually pretty easy to see; but also benefits cost. I've had offers that were an over 20% raise which would have all been eaten by insurance costs. I've looked at my "benefits cost breakdown" at similar companies only to see that one is paying $90k for me and one is only paying $70k, on similar salaries of around $60k.
These insurance costs are not something usually shared outside the company, and they are hard to get until the last stages of your job offer.
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.
