benefits programs by and large are now "self insure" programs for companies...and the providers handle the paperwork. However, doctors have gotten used to (and medicare is a HUGE factor in this) having these providers lowball payments to doctors. So the doctors must hike rates hugely to make their return.
Take for example my recent dentist visit. Billed over $200 and she will get $60 for it.
Until this process is forced onto people in a very visible manner, it won't change. Making it "government" healthcare won't help...they're as much the problem as any private insurance company.