If clinics and hospitals do not bill 1k dollars each visit, 100k+ for a simple surgery, and pharmacy does not sell medicine 10x the price, US gov't do not need that much allocation for healthcare.
They get that cash price amount from a tiny amount of people, 70% of that price from private insurers, 30-60% from Medicare, less from Medicaid. Even then, they have to basically litigate the bills through private insurance appeals.
If they had one payer which had a single reimbursement rate, they wouldn't have to do these shenanigans.