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The “system” needs more than just some fine tuning. It needs government totally out of it, period.

Getting predetermination of costs for a hernia operation, the hospital, surgeon and gas passer charges would have been billed to insurance somewhere in the neighbor hood of $50,000. If I elected to pay cash it came down to something close to $15,000.

Doing some research on private surgical centers, I ended up paying a cash price of about $4200.

The “system” is the problem so long as hospitals and their willing accomplices in the insurance industry depend on the government to keep fleecing the public.

This unholy alliance has been building a public dependency for decades and they are the reason the “system” is broken. They broke it so they could do like any other “program” to be the only ones who could fix it, just like they fix every other damned government “program”.

You raise a lot of good points there. But the government isn't really the problem at all. The problem is that the health care industry is one of the few industries in the U.S. that relies almost entirely on third party payment (government programs, private insurance, etc.) for its existence.

There's no way to "fix" this unless you're willing to turn medical insurance into something very small and aimed at dealing with specific maladies and injuries -- sort of like how homeowner's insurance and auto insurance work. As long as you have a third party involved in a financial transaction that intermediary between a buyer and a seller, you'll always have distorted pricing and financial arrangements that are idiotic on their face.