A Major factor in spending Pyschology is People must pay Upfront and then get reimbursed. On OutPatient stuff.
The US Market Unhinged in the Early Sixties from getting Insureds to pay doctor x-rays then get reimbursed.
The TOTAL Balance of Medical cost between Inpatient and Outpatient is exactly Opposite 30-70
People Go To Physicians for Litle things that would be skipped if it had to be Paid then reimbursed.
30 Years ago when I lived in Chile They Privatized Social security and their UK style Health Scheme! It is functioning quite well.
price discovery
patient physically and fiscally involved in the process