The economy of it is probably the worst in the world. The issue isn't people neglected into mass preventable deaths, the issue is sucking the maximum amount of money out of everyone. Even the people who are somehow too young, healthy, and wealthy for government insurance while also not insured through work and encountering major medical debt are likely to just have most of it forgiven once the system has figured out the maximum amount of blood they can squeeze from the stone. It isn't poor care, it isn't lack of access, it's just the money that's the problem.
All of this- every last step- could be solved by single-payer healthcare. It would be massively cheaper, since people would be less discouraged to seek care early on during an illness, with less-expensive preventative care rather than far-more-expensive treatments later in a disease, and also with the government's far stronger ability to negotiate prices.
Would you like to know who we have to blame for a great deal of the high cost of hospital care in the United States?
Ronald Reagan.
He signed EMTALA (the Emergency Medical Treatment and Active Labor Act) into law, dictating that hospitals could not turn away patients because of an inability to pay. While this seems like a humane course on the surface, EMTALA does not grant any sort of compensation to hospitals for this, meaning that they must absorb the costs incurred by that patient if they are unable to pay.
And what does a business do with higher costs? It passes them on to everyone else. This is where you get $1,400 bottles of aspirin from- the hospital is trying to recoup costs so that it doesn't go out of business. It's an indirect tax on everyone in the country who needs medical care.
And this, too, could easily be remedied by single-payer healthcare. But Republicans, for
decades, have been against that- and while they say that it's because SPH is a slippery slope to communism, the real root is a sadistic belief that the poor deserve to suffer for being bad people, ignoring the fact that those poor people are the entire underpinning of the American economy.