I have been preaching this for years: The single most important change for lowering the cost of health care is to require transparency so that consumers can comparative shop for services. Nearly every state has consumer protection laws that require grocery stores, retail stores, gas stations, car dealerships, etc. to clearly mark the total price and/or unit price of the items for sale so that consumers know the price before they buy and can comparative shop for a lower price if they so choose.
Prior to Obamacare, health care consumers did not have to comparative shop because most consumers only had to pay a flat co-pay regardless of the actual cost of the service or procedure, which brings me to the second most important change for lowering the cost of health care: Create an incentive for health care consumers to comparative shop by getting rid of the flat fee co-pay. Instead, set co-pays as a percentage of the cost of the medical service or procedure so that the consumer has skin in the game and a reason to comparative shop. Better yet, get rid of co-pays altogether and require the consumer to pay out-of-pocket and seek reimbursement from the health insurer.
The third most important change for lowering the cost of health care is to prohibit health care insurers from penalizing providers for charging consumers less than the negotiated insurance rate for medical care.
Then they make you sign that you’ll pay when you get the bill. If they can decide the amount of the bill ex post facto, then you should get to decide whether to pay in the same manner.