I'm of a similar mindset... even though I'm very libertarian in mindset... I think that all the current spending between Medicare/aid, VA Medical, Federal Employees and other programs would be better served by a govt backed non-profit insurance corporation, maybe a little more self-goverened than say the USPS. If federal employees and politicians had to deal with the same "plan" as everyone else as a baseline option, that would provide for better competition. Full negotiating power would also be necessary.

This should be combined with a 50% domestic production and at least dual sourcing requirements for all FDA regulated medications and devices. Both for strategic security, as demonstrated during the pandemic and necessary given political shifts. It would also have the side effects of requiring licensure of medical patents as well as at least some more open knowledge.

Blocking pharma ads would help a lot as well. Unfortunately, pharma is the single biggest advertiser as well as one of the biggest political donation blocks by a wide margin.