The first thing that needs to be done is to stop calling it insurance, it isn't. Insurance is for paying for things that are unexpected not a regularly recurring cost you can't pay. The last time I looked that would be called a loan or going in debt. What we have now is a service that people cannot afford and are essentially using the rob Peter to pay Paul method . It hasn't been health insurance in decades. I hope auto mechanics , carpenters , electricians and more do not catch on or we will be paying premiums for auto repair insurance to have the oil changed. The system has become this entangled mess that nobody really knows how it works.
It is almost like hospitals are just willing to accept that whatever something cost is what it cost. If a hospital needs IV needles and there are only 3 manufacturers of those needles and they all price within a few dollars of each other, then that is the price the hospital pays without questioning why the price is what it is.
In the past if someone made a product and the end result could not justify the cost it didn't matter how unique the product was, the manufacturer would go broke because people would refuse to pay the price. In health care it is like that thinking doesn't apply . They have taken the idea that poor health can lead to death if not managed properly and made it where everything they spend money on can lead to death no matter how trivial so any price is not too high. There is no excuse for something like aspirin costing 10x more in a hospital pharmacy than a retail shelf because the pill in the hospital has to be sold to them from a licensed distributor and the hospital can't purchase the same place as retail.