[sparklingmango]

Medical patients are not really "consumers" in the normal sense of the word. A patient may be unconscious when they arrive at a hospital and doctors will just start to treat them (as they should). A patient's doctor may refuse to change where they'll do the operation even if it'll save their patient a lot of money. A patient may decide they're going to have a procedure done at a surgery center, a facility that is typically much cheaper than a hospital, but they can't predict if they'll have a complication that will drastically change the cost of their procedure. Patients can't just walk up to a menu and decide that because they have chest tightness they want a stent put in. That's not how medicine works. The doctor typically sets the treatment plan and there's very little veering off that plan. The doctor really isn't even the one that sets the prices. Insurance companies are heavily involved in that and it varies by health insurance and plan.

The cheapest prices in US healthcare are the prices paid by Medicare. There are so many people on Medicare so this leads to a lot of bargaining power. Hospitals would never refuse to treat Medicare patients (because there are so many). So, Medicare decides "We're only going to pay $10,000 for a total knee replacement." And hospitals have to say "Okay, sounds good. Can't really say no to 60 million patients." Insurance companies do not have that type of bargaining power. They say "We only want to pay $20,000 for a total knee replacement." And the hospital goes "Nope, we're charging you $30,000." And the insurance company sheepishly goes, "Okay..." and then sets really high premiums, deductibles, and out of pocket maxes so they don't have to bear the weight of the cost.