We fix the largest problems that we are permitted to touch.
We cannot propose a solution to the ultimate cause, because that would require the representative democracy to elect more scientists, technicians, engineers, and mathematicians to the legislature in lieu of the usual professional politicians, lawyers, corporations managers, and educators.
So we work on what we can reach.
We cannot create a proper healthcare system from the top down, but we can issue bugfix patches and hope they get adopted upstream. That keeps the system limping along, but never getting quite bad enough for anyone to demand the complete overhaul that it needs.
It only looks crazy because the biggest problem any motivated individual can solve is limited either by the amount of investment capital they can attract with their solution, or by the amount of campaign funding they can attract with their solution. So any proposals that threaten profit margins cannot be considered.