What we have with the affordable care act is government run health care of 80% to 90% of the health care system. The government dictates what is to be written for coverage in the insurance policies. The government dictates what doctors and hospitals will be paid under these insurance policies and at what rates. The patient will pay his co-pay amount.

The insurance companies and hospitals merely act as agents for the federal government.

The other 10 to 20% of the population (high income earners & healthy self pay) who choose to be self pay have a choice of their doctor of choice and hospital of choice without regulation.