My view as far as healthcare is that we should either go totally private, with no insurance companies involved, where people just pay out of pocket (but because of the way the free market works, the cost of healthcare services is very low), or we should go to a universal single-payer healthcare system (which, again, would result in lowering costs and creating more efficiency, like in Canada or Scandinavia).
Problem is that the only way you lower costs substantially in the US is to ration end of life care the way those nations do, AND lower the earnings of the health care professionals, the way they do. My nephew is a doctor in Sweden; he makes an upper middle class wage, no more. Same for nurses and med techs. This is lucrative here, and if you change that, prepare to have talented people leave the system.
So, the binary choice of “pure market or single payer” has already left the barn. Those two options are closed to us.
So, we’re stuck with managing the inefficiencies, not getting rid of them. They’ve become built into the system, in many cases.
Right now, private insurance premiums get jacked up because doctors cost-shift their medicare/aid losses to the patients with private insurance. If private insurance goes away……no place to shift those costs too. Premiums skyrocket across the board.
The “middle solution” is to nickle and dime more efficiency where you can get it, and get health cost inflation down to equal the COLA. Then we grow into the problem over time.
Devil is in the details, of course. Easy to say, hard to do.