There will be NO cost limits or controls until you get the third party out of the middle and put the transaction of service/cost back in the hands of the doctor and patient. We should shop our health care services just like we shop every thing else in our lives - compare price and service between different providers and MAKE THEM COMPETE!  If you are willing to turn your most basic life decisions over to some faceless gov't agency then you get what you deserve but you will never get what you are paying for.