Bill- a well thought out post
Cost control could be cost reduction it could also be cost elimination it could come in different forms as well
Costs can be eliminated. Transportation fees, lab fees, billing fees... the doctor's offices create fees to bill insurance companies for, so they have more billing codes and because the fees are small, they will not get the attention from the insurance company that "large claims" get. My MIL works in large claims at a health insurance company- her job is to track the high cost patients and the bills they receive, and work to pay less on these large claims. Small claims have similar markups, but because its OK for you and me to each pay an extra $35 for this, or $75 fot that, those costs do not get removed or eliminated, where as if the bill is large, those costs are often removed.
In a similar example, In my experience, I had health coverage with an employer in 2007. Call it company A. In 2008 company A was bought by company B and new health care was provided. In 2009 I received a Bill for services which were incurred in 2007. The fees totaled about $500. The insurance decided to change what was covered in 2007 2 years later. This is after my company let all its benefits people go when the 2008 buyout happened- I had no where to go but pay the extra $500 in fees which were covered on the original Bill, but the insurance company audit close to 18 months later decided we had to pay the fees. That type of insurance company bullying needs to stop as a way to eliminate or control costs.