Since I had wrecked my knee and nothing better to do than pull MedLine articles up and ask him questions about the papers he's written. I got an impromptu anatomy lesson and he went through the whole thing step by step.

Does every patient do that?

No. And not enough will ever do so to ever matter. And even then, I notice that your description of the work and education and questions you put into him doesn't mention price!!! Even as you were educating yourself about him and his skills and the procedure, did you ever bother to research his pricing compared to those of other providers, and figure out whether the cheaper alternative might be a better fit for you.

Because you have no incentive to. However, if your insurance company told you there'd be a discount on your next premium if you picked Hospital A or Provider B you would take notice.

But they're not going to. Not enough people would ever take them up on it to make that worthwhile. The insurer has lots of information about the tradeoffs between price and medical outcome, both generally and for specific doctors - there's no benefit to having all their patients recreate that learning curve.

All this is infinitely better than an unwieldly government driven solution that seizes partial control over a quarter of the nation's GDP (or more).

How do you know? Obviously you have a philosophical belief about it, but there's absolutely no country on earth that has the type of pricing model you are wishing for, and we have no way of knowing at all whether it could work or whether it would have any better outcomes.