I interact with a lot of engineers moving from Europe and US and it’s never how US politics portray it. German friends talk about paying for private insurance because the public one is so bad.
So yes, Americans love consuming healthcare. Is there any category they aren’t a high consumer of? You can’t measure efficiency only looking at the input side.
As a consequence, insurance companies generally try to sign up mixed-pool, younger, healthier (read: employee plans) over older, sicker, opt-in insurance (read: ACA).
There are ways they can and can't legally do that, but it's always the goal. In the same way that retail order flow is targeted by HFTs.
Urgent care clinics have been big in our region. The primary system is obviously overloaded, and 2 of these have popped up in the last 3 years. It's more expensive per visit than our primary physician, but cheaper than an ER visit, which could easily take half a day anyways.
I don’t have metrics for good/bad. I’m just going off of them telling me it’s bad.
The US government funds most of the resident slots through which the path to become a doctor runs.
The AMA generally (but not always) lobbies against increasing slots too much, reasoning it would decrease the premium doctors (its members) could charge.
As a result, most of the time the US has too low of a supply of doctors, especially in general, highly-demanded areas (family medicine, internal medicine, psychiatry).
Private insurance sucks ass in the US, period. It's just bad, which makes sense because all the insurers are completely uncontested. You don't even get to choose your policy, your employer does.