Yes that’s where I was headed with this line of questioning. I can see individual plan insurers and self insured businesses, as you say taking an active role in this, and in fact they already do to a great extent. I’ve had conversations with my own doc about it and he admitted that insurance companies hold the cards on this.
Rather than trust my insurance provider (public or private insurance), who is only concerned with immediate pay out costs on THEIR part I would gladly trust a single agency to work on that behalf, like is done in England for instance. Yes, it has it’s share of complaints but does have an appeal system built into it, albeit a bit weak from what I understand.
Transparent pricing can help a little with this issue but it requires a certain amount, too much IMO, of self diagnosis.
Administrative costs for all would come down as well on the side of insurers and of providers, IMO.
Like many, I believe that the manifold problems inherent in our existing health care system almost require a single payer entity, mainly for controlling the system in a way that leads to more effective care at lower costs. Right now I see no entity that is tasked with that role and that’s one of the biggest problems in the current system.
BTW, do you have any evidence of this happening in the United States? “ As more of the private market adopts this fierce customer style, they force healthcare providers to adapt”