Patients and providers should have the ability to shop and negotiate price directly with each other. No 3rd party will
ever be in a better position to negotiate individualized care and prices for 350,000,000 people better than we (or our family) can for ourselves.
Currently, patients cannot price compare anything, not even for the exact same drug from two different pharmacies on the same street! To make it worse, most providers can't even make sense enough of the provider-insurer prices to shop on behalf of the patients.
To improve prices in healthcare, all care must have a price visible to all, paid by patients. Insurance should be required by law to publicly publish their reimbursement rates and immediately (48 hours) reimburse their insured patients for care at approved (in-network) providers.
This would end the current: impossible to self advocate, impossible for providers to advocate on behalf of patients, intractable insurer-provider price web.
Insurers and providers should never negotiate price. Providers should only be concerned with providing good care, how to classify/code it, and the amount they need to charge for that care to be financially viable. Insurers should only be concerned with how much they will pay out for each classification/code, and which providers they authorize as in-network.
Last, since there is a long tail of medical care that doesn't fit nicely into a code box, each plan should have a mandatory minimum coverage of something like 50% all unknown-care costs at in-network providers and pharmacies above $5,000 annually, with some annual cap.
As a society, if we want to further subsidize healthcare for those with lower economic means, and/or those who end up with catastrophic expenses, then that should be done on it's own, as two distinct standalone welfare programs.