Not ideological, I'll try to explain better.

>Insurance or the individual pays the bill, that is no different than it ever has been.

Strictly speaking this is true. I agree with this statement.

However, our current insurance industry based system (colloquially known as the ACA or Obamacare) has caused "health care" to pivot away from providing medical treatment to individual patients, and toward a system of "health care" companies charging insurance companies for services provided to a 3rd party (the patient).

The patient is no longer a customer, the insurance company is. There is effectively no health care provider in the US that caters to a patient as a customer, especially if we're talking about hospital level medical care.