This is spot on, the costs of services is clouded from the ultimate consumer and as such market forces are perverted. Some components of healthcare services are harder than others to expose to market forces, emergent services such as stent placement for example. But there are certainly components that you can, it would just require shaking up the major stakeholders that benefit from the current system. Convert Medicare to a HDHP-like public backstop that kicks in at a reasonable annual amount, open up tax advantaged HSAs to everyone, HSA credits for certain income bands, private coverage for services prior to hitting the backstop available if desired, public coverage up to the hd annual for low income safety net. That would expose the most frequently used Rx and medical utilization to market forces and have a backstop for catastrophic events. It would also decrease premiums for private coverage and incentivize savings for future healthcare spending needs. We could even give it a catch name like "Medicare 4 All".