In a perfect world, healthcare services would be well-matched to the level of care needed. Standards would be laid out and followed, and effectively priced care delivered.
And then, please don't laugh, if lower cost healthcare was delivered, then premiums would go down. No, no, don't laugh. Okay, you're right, there's no incentive for a local monopoly health insurer that owns the hospitals to pass the money to the consumer. YOU DON'T HAVE A REAL CHOICE. So if you are in buttshit Indiana, you basically get to use Anthem. And they have no incentive to deliver cost savings to the insured.
So of the four pigs, they are all opposed to each other to some degree:
Doctors: hate insurers (who want to lower their salaries/fees/billing) and trial lawyers (who cost them in malpractice insurance).
Drug/Device: hate insurers (who want then to pay less than bloated retail price) and trial lawyers (who sue them in massive class action lawsuits)
Insurers: hate everyone (because they own the money that comes into the system, they attempt to let it go to anyone else, be it drug company, doctor, lawyer, or claim)
Lawyers: hate insurers
BUT, the one shadow incentive they all have is to increase spending on healthcare. So even though the pigs oppose each other on details, they all want people and the government to pay more money for healthcare.
Are you aware of the lack of standards in NP education and training? The American public has no idea how raw of a deal they are getting. This is shrinkflation in healthcare, whereas you might have expected to see a doctor before, now you have to see a PA/NP, where the barrier to entry is extremely low and the training standards are loosely enforced, if at all.