Insurance companies provide a few things that providers can rely/bank on....quantity and certain payments. I agree with the point about "usual and customary" charges....they are way overinflated in many regards. Keeping this pool-related, I sort of liken it to the pricing strategies of certain cuemakers....overinflating a "retail price" but then they turn around and allow any paying customer to negotiate down to a "wholesale price". Why bother with having a retail price...
Seriously, most of the time if you are uninsured and a cash payer, a health care provider will negotiate a payment with you....oftentimes at a substantial reduction, even close to what some insurance companies would pay.