Health insurance is one of the rare services where incentives between consumer and business are well aligned. The vast majority of people are healthy. Healthcare is expensive in the US because the uninsured population continues to rise out of "they're not making me pay for it": There are entire tranches (in the US) also don't buy insurance and use the ER and abuse EMTALA for their primary care (most of this is actually unintentional in my opinion, it's less educated populations in the US who are repeatedly taken advantage of and left to ride on government, which is extremely eye-wateringly bad at spending money). Personal experience here working in an ER.
The real pathway in the US to success is getting those populations onto private health insurance. Obama tried a heavy handed "health insurance mandate" that hilariously somehow passed the supreme court, but was so laughable mis-aligned with American ideals even Biden wouldn't enforce it.
What is apparent though is these populations are completely willing to pay bills like their cell service, gasoline, car payments, etc before investing in the most important thing (their health). This gives me hope there is a way forward by riding these perceived essential services somehow. I'm not really sure what the answer is here, but there is at least opportunity for some creative solutions.
I also think the disagreement here between red vs blue isn't the outcome: both want people to be healthy. Red doesn't want single payer, whereas blue does. Red ignores the fact these systems don't exist, blue ignores the fact that no other country in the world has the diversity of America and there are not functional examples.