Health insurance companies beat the doctors and hospitals up pretty bad on pricing. I don't see how it can be done better.

One place the doctors get back at them is by not accepting that insurance in rural areas. Eventually those people with that insurance coverage end up in the emergency room or that doctor's office, and guess what they aren't paying the negotiated rate. They stick it to them right up the ass. What's to keep doctors from doing the same to the national insurance carrier. If I'm a small hospital and there is no competition around why take the universal health insurance that pays me less than the cash price? F-em those patients are gonna end up in my emergency room eventually. These are just some of the problems you are gonna have to solve. Doctors are smart, I could tell you a million ways they beat the insurance system to put more money in their pocket. When they find a loophole they tell all their friends, it gets around.