Earlier quoted context omitted.
It seems like the entire US medical system runs on prices that no one actually pays. I don't really understand what all that extra complexity achieves?
The US healthcare system is a patchwork of policy, local incentives, and unchecked capitalism that barely works, some of the time. You can read intent into it, but it's really just a big mass of inscrutable complexity. That said, a lot of the time, inentionally or not, the answer is "it facilitates the transfer of money to the shareholders of the big private health insurance companies"
Of all the industries in the US Health Care is the MOST regulated. How on earth is that "unchecked"? The problem is the checks are (and always will be) written by the companies.