Health insurance is almost pure wealth capture. The provision of services is actually rationed acutely.

Public healthcare is wealth creation. There a trickle-out effect as private sector "insurance taxes" are reduced. But access is also increased, which creates jobs in frontline health care services.

There's a limited role for private industry in health R&D innovation, overlapping with public funding of original research. But provision is most economically efficient and productive when it's state-managed.

What it isn't is politically efficient. Wealth capture is political capture, and dilution of one creates dilution of the other.

This is not a popular idea in some quarters.