There are A LOT of reasons for this. For example fentanyl probably took quite a bit off it, considering over 200,000 people are dead at this point from it.

So does the obesity crisis.

Now - I think we are probably more in agreement than not, I think there are huge issues with the US healthcare system, the entire fentanyl crises WAS created by the healthcare system, but still - I don't think the root issue, or problem to be solved is private vs public. Switching to public would just mean another set of problems.

For the record, I'm not from the US, and I mostly use private healthcare, despite there being so called free healthcare available in my country. It's just terrible. So it's almost the same as the US - rich people get healthcare, poor don't.