It’s a complex question but the problem is that _everyone_ that points out one reason or another is usually right - we disagree upon which factor is the biggest. Malpractice, bloated administrations in insurance and hospitals (just like our educational and corporate systems), a dysfunctional market leading to profiteering, bad / outdated regulations, Medicare being unable to negotiate costs, bad patient health across the country, and so forth. What I will argue against is that we have the best healthcare - maybe only if you exclude the outcomes for our poor, but even the outcomes for our wealthy are no better than the middle class in other developed Western countries.