In a truly capitalist system you would have worked out the price for the surgery in advance and could have known the name, medical license number and prior work history of every person involved in the surgery.
See my last lengthy post . . . anytime you get a third party involved in paying the bills (no matter who that third party is), you can expect to have that sort of thing happen all the time.
I think you make several excellent points on the nature of insurance and how it drives (or crashes) health care delivery for both providers and consumers. Would you agree that HSAs are the best alternative to the pvt/public turd party payer schemes (excluding the indigent population)? And would a transitional period would be in order for the vast majority without one, so that people could fund their own care? It certainly redraws the model not only for the industry but of personal responsiblity. But as you point out people are far more likely to take better care of themselves, which will sharply drive down utilization. Perhaps in cases of prolonged or catastrophic illness insurance could be maintained in some way, and not necessarily publicly funded/administered, or people could be fast tracked into a safety net program.
Of course, none of this is feasible until the economy turns around, and that won't manifest until the Marxist is returned to Illinois or Hawaii or Indonesia or Kenya... whatever.