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I have a little experience with the medical billing system for this fantastic country that I'm lucky and unlucky enough not to live in (yes, both lucky and unlucky; different reasons).
It's messed up. There are band-aids in place to keep costs down for charges billed to medicare and medicaid, but that just makes the whole thing worse because it adds a lot of extra complexity and everyone else likely gets fleeced to make up for the new overhead. The medicare 8 minute rule itself isn't that complex, but add modifiers for activities performed by different providers (in therapy, this could be a PT and a PTA providing the same service, for different lengths of time, on the same visit)? It goes NUTS.
Single payer healthcare with optional private coverage would solve nearly everything. The cost to the patient first and foremost, but also the cost to the government itself, due to greatly decreased complexity. And private clinics and private insurance don't have to disappear, they can still provide more high-end services, or shorter wait times, for those who can ACTUALLY AFFORD IT.