And who makes that decision? A doctor, or an insurance clerk?
But my previous post was just about the inequality or rats. Insurance companies should pay the same amount for the same doctor and procedure as everyone else pays.
That would raise my cost since I have group insurance, and it would lower the poor guy who doesn't have insurance. It would reduce costs overall by making insurance billing simpler.
Should Sam's Club pay the same prices for merchandise as Mom & Dad's Local Market?
There are some legitimate reasons for price discrepancies between what insurers pay and what individuals pay, though there are many dubious ones as well. A bigger problem is that insurance is only a small part of what most 'health insurance' companies really do.
To use a rough analogy, would it be reasonable for someone to buy "oil change insurance" for an automobile? To be sure, some people do buy automotive service plans which include oil changes, but would anyone call such a plan "insurance"? Insurance is based upon the notion of protecting people from unexpected events. By contrast, many if not most of the payouts by "health insurance" companies are for things which are entirely expected.
If some employees need medicines that cost $50-$250/month, an employer that helps cover such costs may boost employee satisfaction by doing so. The notion that such a thing is "insurance", however, is ludicrous. If an HMO can act like Sam's Club and use quantity discounts to save more on medicines that it spends distributing them, that's fine. But that doesn't mean it's "insurance".