Several very important items were left out of this analysis:
The health care payment business model is the only one I know of where the cash customer pays the highest rate, the insurance customer lower rates based on quantity discount which does not exist called a contract, and the government pays the lowest rate which it mandates to itself arbitrarily based on no facts or nothing at all. In all other areas of business transactions the the reverse is true, because cash is king, and the government is a PIA to deal with.
The second item is that the government grants itself a status of arbitrarily setting prices it will pay for most services which in many cases are so low that the medical community ups their rate everywhere else to compensate for the low government rates; in effect the private patients have been subsidizing government patients for decades.
Third, the medical community will not hold their own accountable for misdeeds, creating an environment of coverups, high cost insurance, and very sloppy workmanship at the individual level and institutional level….do you realize in study after study, it doctors literally kill more patients every year than all forms of guns violence many times over, look it up, yet little is done about, look it up and watch what types of medication you are given.
Last, I do not need to go to offices that resemble Taj Ma Halls, I have been sewn back together in more Dr. offices with linoleum on the floor over the years then I care to remember, and have had out patient minor surgeries that did not require a fancy OR in my life, remember, insurance took doctors from being well off to owning the biggest boats at the boat club and owning two vacation houses.