At least in the clinic a family member of mine owned, regulation was far from the biggest challenge. It was billing, especially interacting with private health insurance companies. Dealing with their labyrinthine systems costs a lot of money and time.
The private insurance companies are a big factor driving the consolidation, too. As the care networks consolidate their negotiating power, it gives them more and more of a competitive advantage over their smaller competitors, who have relatively less ability to negotiate good rates. That, in turn, leads to them having to drop off of the insurers' networks, which then results in patients being directed elsewhere.
I certainly don't want to say that government influence has no influence, but the brand of capitalism that sees government as the source of all evil is more about politics than economics. Economically speaking, cartels and informal cartel-like systems can be just as harmful. You don't get a healthy, well-functioning market by indiscriminately yanking any one lever; you get it by carefully tending the garden, and balancing a lot of competing considerations.
Where do you think these cartels get their power? Does the clinic post their prices online? Do they provide estimates on what care will cost before it happens? If insurance is costly and troublesome can you compete on a cost basis?
Posting prices online is infeasible because the system has been structured such that the price is different for everyone, depending not only on which health insurance company they use, if any, but also on which of that particular company's plans they have. And it's ever-shifting. Maintaining an online price sheet that is even accurate, let alone navigable, would only be feasible for large corporate entities, so expecting something like that to happen would only further advantage the oligarchy and undermine what remains of the free market in this sector.
But what you can absolutely do is call and ask. Assuming you have the time to do so, of course. Urgent care does have a distressing tendency to be urgent.
And it is wise to do so when you can. For a really pedestrian example, it's worth asking your pharmacist about the retail price of a drug before paying. If the retail price is lower than your prescription plan's copay - something that happens quite often - then there's no sense putting it on your insurance. And no, I don't think it's the pharmacist's job to keep track of that. The elephant in the room in this discussion is that American culture already does way too much shitting on service industry workers. We need less of that, not more.
