You have monopolies especially in pharma, very tight restrictions crossing national borders for anything, caps on how many doctors get licensed (did you even know they do this?), alternatives are choked out (example midwives), insurances get semi-monopolies because there are rules in place on who can do business in what state (literally government limiting the competition for them)...
Just one example to prove my point: https://www.openhealthpolicy.com/p/medical-residency-slots-congress
Instead on focusing on supply (Reagan's approach macro economically to fire up the economy was supply oriented, and it worked!!!), they focused almost entirely on demand, like government bureaucracies tends to do, like socialists (the political left) tend to do.
Guess who created this system? Government bureaucracy and a bunch of more left leaning politicians who pandered to the insurance companies, doctors, hospitals and pharma so they don't face resistance.
Instead of leaning on pharma, insurance, doctors and hospitals, they basically just restricted the care “you” the consumer gets. Of course that is NOT going to fix the problem with rising costs, and that too was predictable even as the MSM cheered on Obama care (anything Obama did was awesome according to the US MSM. He could have farted, and the MSM would have reported about the sweet summer smell of flowers).
The solution is not to lean on the cost drivers by imposing cost caps/mandates (more communist thinking). The solution is to create a truly competitive market.
For health care, bring on market force:
1. Break most hospitals into two highly competitive entities.
2. Convert other hospitals into real estate leasing entities with competing surgical suites and nursing wings.
3. Separate out drug coverage so hospital systems can run care coverage systems and cut out insurance company overhead and meddlers.
4. Create interstate drug plans that don’t have to pay what the drugmaker wants for every drug. To qualify for exchange listing and federal subsidies, they would have to most (~80% or more) in all important types (large volume recombinant, small volume recombinant, breakthroughs under patent, etc.). Group and exchange plans to offer time-limited vouchers at plan set amounts for out-of-formulary drugs. Voucher plans would have variable premiums. Plans without minimums (or vouchers) could be vended directly to individuals and families.
5. These plans would be all the doctors (and AI) prescribe for formulary drugs with co-pays equal to manufacturing cost
6. Have drug patents limited by government sourced product revenue and overall domestic government health care spending and not by time [so drug companies have an incentive to minimize government health care funding].
7. Require Kirchoff patent collapse to a single entity upon FDA marketing approval of a covered entity.
8. Reform medical education, breaking down medicine and dentistry into simpler chunks and start it in the first year of college
9. Replace most primary care doctoring with AI.
(Insurers would pay human doctors to confirm AI diagnosis, orders for expensive tests[MRI, genetic], prescribe radiation imaging[CT, PET, X-ray]/treatment, and voucher/government co-pay drugs. Other human doctor care would be private pay.)
10. Radioisotope-related care would be at international airport centers