I disagree, I don't think payer-side things are why healthcare is expensive, but payee-side things (hospitals, pharmacy benefit managers, docs, and the choices that flow from them) + obesity/T2D. I think this is pretty clear from where the money goes and why people in the US need so much healthcare in the first place, and that hamming about insurance is 95% a canard.

If you think you can replicate the healthcare success of [pick your model country] without also replicating their obesity rates, doctors salaries, amount of testing and prescriptions, etc, you will find that who pays for it all is the least of your concerns. As Americans consider it, we probably have too much "healthcare", not too little.

Others have spent far more time than me on this if you're interested: https://randomcriticalanalysis.com/2020/01/31/i-created-a-pr...

The US is pretty close to a lot of the rest of the OECD in obesity rates (in particular, UK/Australia/NZ) https://data.oecd.org/healthrisk/overweight-or-obese-populat...) while costing twice what other systems pay for healthcare.

The stuff about pharmacy benefits and doctor salaries are artifacts of our weird way of paying for things. I'm not sure why you're portraying them as separate, isolated issues.

Or we could fix medicare and medicaid and make them actually efficient. No need for medicare for all.

We just need to fix billing, end price fixing, and massively deregulate - certificates of need, bans on telemedicine, pay for procedure etc. This will actually fix it. Medicare and Medicaid are incredibly expensive and inefficient.

> Medicare and Medicaid are incredibly expensive and inefficient.

This appears to be, at the very least, debatable:

https://www.healthaffairs.org/do/10.1377/hblog20110920.01339...