It isn't actually about costs. The thing about Americans, culturally, is that we hate other Americans. As a society, we would gladly pay $5 more to ensure our neighbor doesn't get $1 we don't think they deserve. See: drug testing of welfare recipients.

Right, when you have a system working as more of a cohesive hole incentives are realigned such that preventative care, reasonable drug prices, and less middlemen, lobbying $$, etc, are part of the process.