Straightforward healthcare reform would start with eliminating this unprecedented and nonsensical ability for hospitals to engage in arbitrary post facto billing, require well-defined contracts for non-emergency care, and require providers to publish a uniform all-payer rate schedule for emergency/urgent care. Any deviation should result in a non-enforceable invalid bill, with easily claimable punitive damages if such fraudulent charges end up being mistakenly paid.

When I walk into a grocery store, buy some items, and leave there is absolutely no chance that I will later get a bill in the mail from the cashier for their bagging services. If I were to, it would be laughably unenforceable. And yet, this is precisely what the medical establishment feels entitled to do when they refuse to answer basic questions about prices or "network" status of providers, and then send you multiple bills for a single engagement!

While this would do little to help healthcare affordability for those who truly cannot pay, it is a necessary step to creating a functioning market regardless of who is paying. The point we're at now, where even people with the ability to pay have no clue how exactly the system will attempt to screw them, is utterly untenable.

For what it's worth, this is the kind of reform the Republican party could be loudly and persistently pushing if weren't primarily interested in dysfunction. As it stands the only popular avenue for reform I've seen is to punt the whole thing to the government, which I'm forced to reluctantly support even though it feels like giving up on actually solving the problem and letting the organizational cancer metastasize and feed on taxpayer money.