Pretend YOU own a medical facility. Pretend there is no insurance, so the only way YOU get paid for services rendered, is if those customer (patients) can afford, and pay, for those services. Now, in this imaginary world, think about what is going to make the most money for yourself? Lower medical costs so that you can hit a larger demographic, thus increasing foot traffic through your door, or higher prices, appealing to the wealthy, and hoping that you can gouge them enough that with even fewer customers, you still have enough mark up on the services to make a tidy little profit. Oh, but hey, there are other guys like you out there, by the way, with THEIR own medical facilities, too, and they get their own choice on what demographic they want to appeal to. So, watch out...if you go too high on your pricing, you might find that the majority of your would be customers, wealthy or not, flock to the guy offering the same, or VERY similar services, at a reduced cost. What do YOU do? Price your services right out of the range of you would be customers, forcing you close up shop due to being in the red every month? Or, do you make sure that, regardless of your overhead costs, you keep prices in an affordable range for your customers, in order to ensure you get all the business you can?
What insurance companies serve to do, is REMOVE those tough choices from hospitals and private practices. You see, with insurance, a customer need never look at an actual bill. You don't see signs on the highway advertising lower cost cancer treatments, because, quite frankly, none are needed. There are enough people with health insurance to invalidate the need for competitive pricing, only competitive quality.
You want to fix health care, which is to say, make it more affordable to people who are paying out of pocket, you have to get rid of insurance companies. And that's the bottom line.