I don’t have my thoughts compiled well enough at the moment to make a full reply, but I enjoyed reading your opinion. There is much to think about here on the balance of economic benefit and moral obligation.
After one visit to a hospital, we received a bill before our health insurance information was fully received. This bill was significantly lower than the updated one the hospital sent after our insurance was entered, but the immediate out-of-pocket cost to us was lower with insurance.
The fact that the same procedure cost different amounts with and without insurance raised my eyebrows. Perhaps the hospital charges less than market rate (which, as you mentioned, may be somewhat arbitrary) for uninsured patients, compensated by higher costs for insured patients, or perhaps the hospital charges above market rates to the insurance companies, which eventually comes back around to the premiums.