Sol, A lot of the issues you mention are a direct result of government intervention. The lack of transparency and competition is because health care providers are not allowed to advertise prices. Insurance companies can compete only in limited geographies. Government regulations prohibit selling health care insurance plans across state lines.
In the US most products and services other than healthcare compete heavily on price. Why not healthcare? Government regulation.........
Sorry, but I strongly disagree in this case. Government intervention is NOT the problem with healthcare.
Where did the government say that hospitals can't advertise prices? They choose not to advertise because they don't want competition, they want max reimbursement from insurance companies.
Insurance companies can compete in any state they want to, if they follow that state's insurance regulations. Insurance companies are self-limiting when it comes to expansion. The good ones expand. The cheap ones have decided it's more profitable to only play in the most gougiest of markets.
And as for selling insurance across state lines, which has been a staple soundbyte of the GOP repeal and replace effort, Obamacare
already made that explicitly legal! That's right, section 1333 of the ACA was written for the express purpose of encouraging insurance companies to sell across state lines, and five states have already taken advantage. Why not more than five? Because Republicans in Congress defunded section 1333 in order to prevent insurance companies from selling across state lines The hypocrisy here is truly astounding.
So don't come to me and claim the federalis are the problem here. Healthcare isn't competitive because a man who's having a stroke can't ask for quotes before he gets treated, because he's definitionally unfit to make those decisions at the moment when the decision needs to get made. Not because the government dictates which hospital is going to treat him or what care he's going to get, but because he's a totally captive consumer. Prices aren't transparent because hospitals deliberately obfuscate them with a chargemaster that they have lobbied Congress to keep private, and then they deviate from the chargemaster for each insurer, as part of their basic business model. Care is uncoupled from supply and demand because facilities get to charge guaranteed rates by the procedure, rather than by the outcome, so of course it's more profitable to do every test every time (and because doctors are afraid of getting sued).
The UK health system has it's problems, but one of it's great breakthroughs was paying doctors for outcomes. They get government bonuses for things like convincing people to stop smoking, or successfully treating injuries with the minimum number of diagnostics. They've figured out how to align the doctor's financial incentives with the patient's welfare, and overall costs plummeted as patient outcome improved. That solution pretty much requires a single payer system, though, in order to have every doc eligible for the same incentives.