It sounds like in the "free market healthcare" system hospitals are incentivized to get the patient to spend as much as possible. That's aside from other bad incentives of such a system such as hospitals not wanting to be transparent with their prices, insurance companies not wanting to take patients with pre-existing conditions, also wanting to cover as few conditions as possible, Big Pharma being incentivized to as…
Would Medicaid/Medicare be "free market"? Why bother shopping around when someone else picks up the tab?
Insurance companies mostly reflect the costs of the hospital. If the hospital charges you $50 for a bottle of Asprin, so be it. ICD10 and Meaningful Use were designed for billing not really for health care. Those were federal mandates not "free market"
Pre-existing conditions is a lot more tricky than you think. The political ploy is to think of a poor person with a serious illness being turned away by insurance because they don't want to deal with them. When in reality it can be you're obease or someone who just did not take care of themselves period. You can imagine a group pre-existing conditions patients could bankrupt a insurance company. What if to be "fair" you were charged the same as a person with a pre-exiting condition. Say someone that smoked 2 packs a day for 30 years?
ACA was just a big initiative to add more insurance companies to the mix. Now it is mandatory you pay insurance companies.