Getting the people inside the institution to recognize that people don't trust them may lead to them trying to do better.
I'm pretty sure that most people that work in hospital billing have little notion of how terrible a process it is. They just think they are doing the best they can given the situation (nevermind that the institutions have created the situation). For example, I was discussing a bill with someone (I was complaining that it seemed high) and their unimpeachable logic was that I shouldn't care about how much it was because it had already been applied to my deductible. Yes, they actually said something along those lines.
Above I'm alluding to the people inside of them wanting to believe in what they are doing. The average person working in medical billing doesn't actively want to participate in a cluster fuck, they are putting up with it because they need a job.
Mostly, I think the way to fix broken institutions is to dismantle them.
Because a new institution is going to sprout up in its place. Maybe some aspects (e.g., medical billing) will be improved. But there will still be a new institution and it will still have lots of bugs, some new and some old.
Your suggestion is like noticing that a few modules of an XX MLOC code base suck and then deciding to rewrite the entire code base.
You might decrease the code base. But probably not by an order of magnitude.
You might fix some bugs. But you'll sure as hell introduce new ones, too.
You're definitely going to end up spending a shitload of money.
And eventually, assuming your software is actually used by real people, your beautiful new code base will become a cluster fuck for the same reason the old one did.
In most cases, the wise move is to actually identify the problems and solve those, leaving in place the solid components that actually work well.
Just like the XX MLOC codebase, institutions aren't the problem; rather, they are the inevitability. You won't get rid of them by throwing away the ones we have now, and in most cases you're better off fixing bugs than starting anew.
I'm pretty sure that most people that work in hospital billing have little notion of how terrible a process it is. They just think they are doing the best they can given the situation (nevermind that the institutions have created the situation). For example, I was discussing a bill with someone (I was complaining that it seemed high) and their unimpeachable logic was that I shouldn't care about how much it was because it had already been applied to my deductible. Yes, they actually said something along those lines.