[duk3luk3]

You seem to be implying that the providers set the prices, but isn't it true that insurers can pick and choose which providers they cover, and because of the large amount of patients they insure, they have a huge amount of negotiation power to exert downward pressure on what providers charge?

[tptacek]

No, that's not true. All the market power is with the providers, which is why they're responsible for something like 9x total health care spend in the US than all health insurers combined.

Medicare is better than private insurers at regulating prices (to wit: when Anthem tried to adopt Medicare's rules for anesthesiology comp, they were excoriated, and the governor of New York proposed a statute preventing them from doing it). But they still wildly overpay for services; in fact, what they pay is not really materially different from what private insurers do (it's less, but not by that much).

[inferiorhuman]

  to wit: when Anthem tried to adopt Medicare's rules for anesthesiology
  comp, they were excoriated

For everyone in the back: that's not what happened. BCBS tried to place arbitrary limits on anesthesia payment. Medicare does not do this. Physician complaints with Medicare payments revolve around the hourly rate. Physician complaints with BCBS revolve around arbitrarily setting a hard limit for the amount of time a procedure is allowed to take. One is limiting cost, the other is limiting care.

[duk3luk3]

> All the market power is with the providers

How does that work? Do the providers have cartels that set prices?