[AnimalMuppet]

It's actually worse. Not only does insurance function as a clerk, but it acts as a clerk whose job is to find ways to not pay. This means that medical offices also hire clerks, whose job is to jump through all the hoops that insurance comes up with so that the medical office gets paid. You could make things much more efficient by getting rid of clerks on both sides. (I mean, you'd still need some clerks. Far fewer, though.)

[gremlinsinc]

Make your local hospital -- be your primary hospital, this is ALSO you're insurer. They tell you what doctors to go to, etc...but they pay for things when you're traveling too...so its in other hospitals' best interest to have okay rates so they all pay about the same and not crazy.

The hospital benefits because: Nearly guaranteed and predictable MRR based on monthly premiums (income based maybe 4% or something)...a lot less billers all around, etc.