> And yet, the multiple giant private bureaucracies we have in the US health insurance system seem to perform so much worse (by cost, outcomes, pretty much anything you want to measure) than the big government bureaucracies managing the healthcare systems of just about every other modern industrialized democracy.
Not really. There ARE many things that could be improved, certainly. Outcomes are among the best in the world, however. Costs are high. People point to Canada as a "better" system. There are _some_ advantages, but people very frequently travel from Canada to get healthcare in the US. Those who live in the Canadian system would rather pay US prices and get the US level of care than wait a couple of years and then get the Canadian level of care "for free".
Part of the higher cost is that "you get what you pay for". The other part of high costs is various inefficiencies. Unfortunately, there truly are many different problems, which will require many different solutions. You can't identify THE problem with healthcare in the US, and propose THE solution. To make real progress rather than just scoring political points, you have to identify a problem, fix it, identify another problem, fix it, identify another problem