Insured price $2,758, cash price $521

Let's disrupt some stuff here:

First, it is EXTREMELY rare for a physician to be paid a million dollars. You can easily look at most state's open records (California, Texas, Florida) and search the online databases and see that it's usually only several in an entire state and these are people of extreme qualification or unique talent. The Dean of a large/famous medical school (a CEO essentially), a very famous chair of a department (they helped invent some special technology or are well-known leaders in their field), or are simply prestigious to the institution because of notoriety (imagine an Atul Gawande or an Oliver Sacks).

Second, the costs of healthcare have been sliced and diced by countless experts and the numbers tell a different story than your theory--most analyses place physician payments at 10-20% of the total cost of healthcare depending on who is doing the study.

Third, there's no way you received ONE bill that wasn't itemized. Typically you receive two bills--one for the 'facility' and one for the 'professional.' It's usually obvious which is which because an ER might charge $1000 or more for that quick visit, while the physician probably would've charged in the $100-200 range. When you hear about those scary $50,000 bills for a night in the hospital and a $30 box of tissues... that's the hospital bill. It's extremely high because of many complicated reasons... most of which have to do with the fact that it NEEDS to be that high or insurance companies won't pay the negotiated rate of about 40% or less of that--it's an arms race that needs to stop.

I'll give you that there are complicated price gouging issues that come up on the physician side (out-of-network billing, surprise bills, etc) that may be unethical and some states are dealing with this... but it's usually a tenth or less of the total of what is coming from the facility in the same scenario.

So anyway, you could literally pay doctors nothing and you would save maybe 10-20% on all those bills. Does that sound like a viable setup?

You can Google some articles and read studies, but I'll save you the time and give you something to think about that should convince you that the physicians can't possibly be the primary problem:

Many (most?) physicians are now wage earners. They increasingly own less and less of the infrastructure (capital) of healthcare and are less independent than ever (consolidated, hospital owned groups, VC and publicly owned groups like Envision and MEDNAX).

In this kind of capitalist setting, where would your profits go? To your doctor workforce? No! It goes into C-level administration, shareholders/investors AND reinvestment/M&A.

Hospitals and Insurance companies, Drug companies, Device companies.... these are the real power players and their influence in seen all the time as they negotiate sweetheart deals (Medicare Part D for example), continue to consolidate ownership, and literally price gouge from consumers (EpiPen, insulin, etc, where a cheap drug is inflated in price for no reason).

I'm truly sorry for the state of the system in the US, but the fix has to come from Congress. If tomorrow every doctor was perfectly ethicall and paid 50% of what they earn today, all that savings would just end up as dividends for the capital owners and NOT as lower hospital bills.

I have experience of single player (UK) and private insurance based but properly managed by the government (NL) and can tell you that single player is much cheaper to run. When I moved to NL about 15 years ago the UK was spending the same per capita on the NHS as The Netherlands spent from the central government to cover the shortfall to the insurers.

In 2019 there isn't as much difference: a significant amount of providers in the UK have been privatised which increased costs whilst at the same time the NHS budgets have been systemically strangled in real terms - something like annual 2% budget increases against annual 15% cost increases thanks to demographics and lifestyle choices.

So in short: single payer is great but the second the Republicans (or whatever the "don't tax the rich" party is at the time) get to touch it they'll ruin it.