Medical care is the one service that you generally don't have an option to "shop around" or even make your own decision about which services you will purchase and which you will forego. Once you present yourself, the MD tells you what you will buy but almost never tells you what it will cost until you receive the bill 
Au contraire, Once I had been diagnosed by Mayo, (after seeing about 30 different doctors here in Chicago trying to findout what I had, so call that 30 different 2nd opinions.) I went and talked with two different Oncologists here about treatment options. With option 1 always being "Do Nothing".
Which is why there is insurance. Insurance is suppose to transfer and cover risk, not be a welfare program. You buy it prior to needing it. No one sells you car insurance AFTER you had an accident. (They might, but it won't cover the accident you just had.)
And yes, you can negotiate fees for services, if you pay cash. That's precisely what insurance companies do. They tell the hospital "We'll pay $X for Y procedure." The hospital can take or leave it. If they take it, they are "In-Network". If they don't, they are "Out-of-Network." When I went to out-of-network Doc's I would negotiate prices if I hadn't meet the OON and/or Max Family Out of Pocket. Every single one gave a discount for cash. Like any other purchase, you just have to be a informed consumer. Most people aren't because they expect real life to be like "House" or "ER" or "Grey's Anatomy". Those shows don't show the business side of Healthcare, just the Drama and Docs as all seeing, all knowing, all powerful healers of any and all aliments. Which like everything else on TV is a load of crap.
The problem with health care costs is being driven by the providers, doctors, and hospitals.
Their cost structures are ridiculously high, and there is no accountability.
Insurance companies now are just trying to use their size to negotiate discount rates for services.
Neighbor's son just had back surgery last week.
His surgery was to fix screws that were installed incorrectly during the last surgery.
The surgery should be no charge, as it was not done correctly the first time, but he will be charged the full ride.
This is bullshit, and is devoid of accountability.
He also is fighting a nasty infection that he got in the hospital.
He is also being charged for these costs, which is bullshit, as he did nothing wrong.
This is also devoid of accountability for the hospital.
In both these incidents, there would be no charge if is was a car going back to the shop who did the original work.
My belief is that is we can correct these kind if problems, force accountability to doctors and hospitals, make them fix their screw-ups for free, that the cost of health care would drop dramatically, and employers and people would be able to afford that was reasonable priced.
ETA - Bottom line is to fix the problem on the front end, not the back end.
1) Insurance companies have been using their size for years (with help from the .gov) to drive down their costs.
2) When you say "installed incorrectly" what exactly do you mean? Put in the wrong place? (Right foot instead of the left). Put in upside down or backwards? Or did it not heal the way the doctor expected it to. (It's amazing to me the number of people who think that if they don't do exactly what the Doc's, nurses, therapists tell them to do that they will still get "all better" and then are shocked and want to blame the Healthcare Provider(s) when they don't. Have him check his warranty card and see what his options are. Oh, that's right. Humans are not cars. You don't come out of the hospital with a 12 months/12,000 miles on parts, 3 years/36,000 miles on labor warranty after a "repair". And once something breaks or goes wonky in a human, it's almost impossible to bring ti back to 100%. So unless the doc did something more or less intentional that made things worse, then he did nothing wrong.
3) Last I checked hospitals are not sterile, germ-free environments. Did any visiting family perhaps have dog crap (dried or fresh) on their shoes? How about coughs, cold, allergies? Was he in a plastic bubble during his stay or in an open air room (with perhaps another patient or three? Did he sign an informed consent that told him "We're going to cut you open, you might get an infection."? If so, then he knew the risks. Sometimes, we don't always get the rewards. Someone has to be in that small percentage that the docs warn you about. And he knew he could decline. Medicine has come a long way from Civil War days, when docs used the same instruments on patient after patient after patient. While we have reduced the number of deaths from infections, that number is not 0.
4) The fact is, is that there are far to many variables with the human body (and especially between) human bodies to make medicine nothing more then educated guesses. We can't be hooked up to a voltmeter or oscilloscope and announce "It's a bad fuse or a bad relay" (see several threads where those questions are asked and the variety of answers!). My docs never gave me odds, but told me things like "In 82 of 100 people over several studies this treatment did X, which was good. In 18 out of 100, it did Y, which is bad. Your call."
So you pays your money and you takes your chances. Just like everything else in life, there are no guarantees.
