If you look at the federal budget, it is easy to see that the federal government is misallocating a significant amount or tax money to purposes that don't really benefit the average American. Interest on the national debt and military spending are the two big ones. There are probably also wasteful spending in most of the other programs as well.

Then there is the issue of too much inefficiency within existing insurance programs. American consumers are not getting a good value for the healthcare dollars that they do spend.

Lastly, I would say that the American education system is too expensive and too inefficient at training new medical staff.