That is the crux of the matter, insurance insulates the consumers from the actual costs leading to an apathetic attitude about the actual accounting.
This is most applicable in terms of office visit charges and prescriptions.
What does the consumer care if the doctor charges $50 or $250 for a consultation if it only costs the patient $15 or $25 either way? In an open market situation where prices are discussed up front (unless the $250 doctor provides some tangible add-on benefit) people would stop going to him.
Same principle with pharmacies. Suppose Eckerds charges $200 for Augmentum and Walmart sells it for $100 (actual case!) and the prescription plan says patient pays $25 for name-brand either way. Consumer has no incentive to shop around, Eckerd pockets an extra $100 bucks (just for being jerks!) and insurance carrier foots the bill. Even in my case where I would pay 30% the $100 difference is only $30 to me. Whereas in most cases the difference is between $10 and $20 dollars, which means big money to full payers but barely worth the gas, time and phone-calls for those with insurance.
Just for your education here are typical charges:
Doctor visit: $40 to $100
Generic drugs: $10 to $200 per month or course
Name brand: $30 to $300 per month or course
ER visit: $200 to $1000
Hospital stay: $800 to $2000 per day
Lab work: $200 to $1000
X-rays/sono's: $300 to $1000
Biopsies: $300 to $500 each
Office surgery: $200 to $500 each
Out-patient surg:$500 to $3000
Surgery: $3000 and up
Neo-natal care: $1000
Birth (natural) $3000 to $5000
Birth (ceas) $5000 to $10,000
My personal experiences, regional differences and inflation do take their toll.