One can always craft some excuse, which is how the terrible system continues to perpetuate itself. Doctors cannot even tell you how much they themselves will charge for anything. The problem I'm describing originates completely with them - no escaping blame here.
(And "might take years" lol. How about eliminate whatever flagrant regulatory capture is allowing providers to create and enforce post-facto and downright fraudulent bills in the first place, and watch the system reform itself overnight)
Feel free to blame doctors if that makes you feel better but the reality is that in most cases they literally have no way to accurately calculate a patient's out-of-pocket cost in advance. Like there's just no technical way to do it.
If you have specific suggestions for fixing the regulatory capture problem then you can submit a petition for rule making under the Administrative Procedures Act.
https://www.govinfo.gov/content/pkg/USCODE-2011-title5/html/...
You keep misinterpreting "how much [a doctor] themselves will charge for something" as "patient's out-of-pocket cost". I'm certainly not asking for the doctor to get involved between the patient and their health plan [0], but rather what the doctor charges, regardless of who might pay. In other words, the straightforwardly-legible prices that exist in every other market - even markets where insurance companies often pay (eg auto repair).
I don't know the specific legal details that allow doctors to make up these post-facto bills (often fraudulent) and send them to patients, but I feel it's probably at the state level rather than federal. Also the big problem with regulatory capture is that businesses paying off politicians makes that kind of citizen feedback meaningless.
[0] in fact I think another good angle of reform would be "if a patient has a health plan, providers are prohibited from billing the patient directly". Any copays, outstanding balances, etc should flow through the health plan.
Are you perhaps unfamiliar with existing price transparency rules? Patients paying cash already have the right to demand a Good Faith Estimate in advance. Those using a commercial health plan can see the negotiated rates for every participating provider.
https://www.cms.gov/medical-bill-rights/help/guides/good-fai...
https://www.cms.gov/priorities/healthplan-price-transparency...