It's not just insurance companies that are a problem, and that's a common but annoying oversimplification. Other countries (such as Japan, Germany, and Switzerland) integrate private insurers without the massive cost overruns of the American model. It looks to me like there's a systemic feedback loop somewhere that leads to price inflation. And if private insurers aren't the root cause of that feedback loop, then getting rid of them won't solve the problem.

Example: I suffer from a rare chronic illness (respiratory papillomatosis, aka warts on my vocal cords) that requires regular laser surgery treatments to control - two to four times a year. Until recently, treatment consisted of going to the specialist's office, where he had the laser and endoscopy camera. He conducted the operation with two assistants - a laser tech and an ordinary nurse. I was in and out in an hour.

But my most recent treatment was different. This time, I had to go to their "surgical center", wear a gown, get wheeled to the room, and there were a half-dozen assistants that were mostly not doing anything. I had to wear a blood pressure cuff, which kept retriggering when I wiped away tears during the treatment (it HURTS and tears of pain happen). I complained to the doctor about this, and he didn't like it either, and said flat out he thinks they do this to charge more money.

This isn't a dangerous surgery. It's as unpleasant as it sounds, but... it's wart removal. I'm not under general anesthesia. I'm not going to stroke out. He can't kill or even seriously injure me with that laser. The old, simple office-based routine was better for patient and for doctor - and a lot less expensive, I'm sure. And that's the point there, isn't it?

So there's your feedback loop, maybe. Insurance companies can be hit on to cover even unnecessary work, so providers tack on unnecessary work, which raises premiums, which means more money is available, so...