Our system is broken.
It is teetering at the tip of a butte separating two paradigms.
It will either tumble into full out socialism, or to competitive capitalism.
One or the other.

Think about it.

We now have a system of, as you surmise, "consumer choice".
That sounds like a capitalistic model.
It isn't.

Usually, such a system would entail competitive mechanisms to draw consumers. Competition drives cost down and quality up. Regulation and government interference ensures that is not so much the case here though.

For example, our system establishes that the best orthopedic surgeon on the planet cannot not charge any more for a hip replacement than a new grad from from the least favorable training program in the country. Only difference is the former is booked out for 6-9 months. Just stupid!

Our system establishes that an outpatient clinic run by a physician must operate entirely off of the physician's earnings. Rent, salaries, equipment, supplies, insurance, etc. must all be funded by returns on the MD's fee alone. However, if that MD cedes control of his clinic to a hospital, the hospital can bill a separate 'facility fee' and make a ton of money. Meanwhile the MD can keep all of his own earnings for himself. In other words, the government is willing to pay twice the fee in the latter situation for identical care. Again, just stupid.

Interestingly, hospitals tend to run such facilities less efficiently than an onsite owner. So while quality suffers, costs are driven upward.

In our system, Stark Laws establish severe restrictions on physicians' "self-referral" even when such self-referral could save major money. However, there are virtually no such restrictions on hospital systems. So hospital administrators with zero medical background are free to make personal "business decisions" directing referrals for nonclinical reasons.

The consumer is blinded to any of this. His/her post-insurance costs (deductibles) are often identical.

I could go on for pages, but suffice it to say those consumer choices you reference are rarely what they should be. They certainly have limited impact on the cost equation.