You are basically making the arguments in favour for a single-payer system. If the fee schedules and expected procedures are straightforward, then the opportunities for this kind of manipulation become minimized.US healthcare system is perplexing. It makes no sense to me. The bills are absurdly high but most people aren't expected to pay them unless you volunteer your insurance.
Shortly after returning from Kazakhstan with my third child, he became ill with respiratory distress and hypothermia. We brought him to the pediatric emergency room where they immediately did a massive workup on him because he had heart failure, acidemia, sepsis, etc... We later found that it was all because he got the flu during international travel. He ended up in NICU for a week and transferred to regular care for another few days and the bills have just been trickling in. So far, we're over $190K for just the emergency rescue during the first night with the NICU and regular care bills not here yet, so probably $250K-$300K or something. Our family healthcare caps our financial responsibility at $9K so we're all fine.
The other day, my father in law took a nasty fall and sustained a near skull-deep laceration above his brow. We took him to the ER where they did a head&neck CT scan, found no serious damage, and stitched him up for discharge. Minimal work on their part. We realized something odd at the hospital, which is that they didn't ask for ID or proof of address, essentially meaning that you are whomever you say you are and the bill goes wherever you say. Anyone can fill out made-up info and they'd be impossible to bill. But we didn't. The bill was $5K. My wife called and said that he's uninsured asking if they can discount the bill. They asked for his income and seeing as how he's retired and from a small town in HeiLongJiang, he was well below the threshold for financial aid. They told her it was free, totally free and gratis. My wife said the point is that we want to pay for just our healthcare and not subsidize those who did not pay, making our bill higher. She said we can pay a discounted bill, suggesting maybe $800 or something for just a scan and 6 stitches and they said that's not going to happen because that'll F up their finances. They don't want our $800 when they can send the full $5K to the government for tax deduction as a charitable contribution.
China, Kazakhstan, most other countries, you just go to the hospital, and you pay for the services you order for yourself. The bill is fair, and no one can push costs onto others. It makes sense. American healthcare just doesn't make sense.
Of course the primary con is usually long wait times.
Even in China, you are just looking at primary care, going to see the doctor for more minor things, people just pay for that no problem because it is usually straightforward. Can some poor farmer pay for some major surgery if it comes up? This is why the government implemented it's own insurance system as well. There is corruption too (human nature), the only difference is the punishment is much more severe if you get caught.