Is it fscked for physicians and various healthcare professionals (e.g., paid higher wages than other countries with different systems). Is it also fscked for wealthy patients who do not really care about costs.
It's an underappreciated point. The US healthcare system is one of the largest wealth transfer systems ever invented. It's a heavily protected cartel that plunders wealth from the top 2/3 and lines the pockets of a few million employees in the system.
There is an excess cost bounty of $1.2 trillion (or more) being plundered and redistributed every year to the healthcare cartel.
There are millions of people working artificially high paying jobs in the healthcare cartel in the US courtesy of the hyper inflated costs in the system. From nurses to doctors to pharma sales reps to scientists to management and everything inbetween.
Nobody ever talks about the need to slash the pay of nurses & doctors though, it's far too unpopular of a subject, it's downright taboo. Just a notch below slashing the pay of teachers. They'd all go on strike tomorrow morning if a serious attempt were made to bring their pay in-line with other developed nations.
The US has to remove a minimum of $1.2 trillion in cost from its healthcare system (which would produce an end cost structure still far above that of eg Britain). Only about 10-15% of that can come from slashing costs out of the pharma drug price side. The bulk of it has to come out of inflated salaries of millions of workers in healthcare across the board.
When politicians talk about universal healthcare in the US, they always, without exception, go far out of their way to dodge this epic scale problem of inflated salaries in healthcare and of where to find $1.2 trillion in costs to slash (they primarily focus on high drug prices as a matter of political convenience; that segment by itself won't remotely cut it though). This is why every time a state decides it's going to look at doing universal healthcare, it immediately runs away after the cost study is completed, it's impossible until you remove a dramatic amount of cost from the system. Now someone go tell all the nurses and doctors in California they get to make 25%-35% less money (good luck).
Studies like this [1] led me to believe that massive rises in administration costs and inefficiencies due to insurance structure are bigger culprits than doctor/nurse salaries. But I am admittedly not very well informed in this area.
The people mentioned specifically in the comment are of more concern; sales, admin, etc. salaries in this field are also inflated compared to other industries.
There would be some overhead for single payer but it would be much more efficient and simple.
Massive insurance company dissolution might also be an unpopular reality for folks to come to terms with as well though