Ype what I would pay $250 cash for the private insurance company pays maybe $150.
And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?
Usually because there's some perceived value in insurance companies steering their customers toward certain doctors. When the insurance companies only pay $150, the doctors don't complain too much because they know in the future that same insurance company might have a patient that needs procedures that result in a profit.
What they want is Referrals, Volume, Bulk, and the hope of making out better on average. No One can survive extended losses. Regulations that Capitalize on those losses putting Institutions out of business, are nothing more than schemes.