I think part of the problem is the blurred lines between routine healthcare and emergencies. You are right, if you are having a heart attack insurance should step in to help you front the unexpected large cost. But for expected care like dentist visits you can and absolutely should shop around.

I like your point about insurance getting to decide but I think it’s important to note you can still get treated even if insurance doesn’t pay. Or you can sue them if you feel they should pay. You make some good points though.