Cutting out insurance companies and letting govt do it in the style of the Veterans Administration Hospitals could be much more efficient. But when they tried Hillary Care the response of the opposition was very well funded. Thereafter until Obama Care, people thought health care was the third rail of politics.
Negotiated prices for drugs is a step in the right direction.
We know what needs to be done. This is mostly a political issue with very strong support for our current system which some find very profitable–in spite of its flaws.