It will always be a challenge to allocate limited healthcare resources. It's an unsettled question why the US accepts such an expensive means (private health insurance) of doing so.
Because we don't have another option. Your job dictates your insurance, not you, and most jobs explicitly search for insurance companies that don't end up costing them much (but cover enough that people still think they have coverage, maybe).
There's stories going around right now about how BlueCrossBlueShield is going to be dictating the amount of time during a surgery that anesthesia will be covered. https://duckduckgo.com/?t=ffab&q=blue+cross+blue+shield+anes...
Of course, these stories are happening after individuals have made their elections for insurance AND after the companies that would be choosing the various insurance companies to pick from would have already selected their projected insurance provider.
This is answering the question with a very narrow focus on what any one person can do. Sure, when I filled out my job's open enrollment last month, there was no checkbox labeled "Evil Corporation Insurer (y/n)", but there's no inviolable law of nature that requires the US to be this way.
I wonder how people would respond to a survey that asked: "Would you support policies that aim to increase foreign drug imports to bring down pharmaceutical prices?" and a follow-up: "If yes, what about lumber, steel, etc?" My guess is that many would say yes to question 1, but not apply the same logic to other goods.
For this trade deficit question the important context is that some trade partners artificially devalue their currency (relative to the USD) to maintain strong export advantage (which therefore directly disadvantages their own people, since their wages are worth less on the global market, ie. when they are importing they have to pay more, when they are going on a vacation abroad they have to pay more, and this is a large chunk of the "missing trade" (the trade deficit), which translates to missing demand for US exporting sectors.
The other important piece of the puzzle is that US residents are also negatively affected by one distinct factor, which is the resource curse of the dollar's reserve currency status. Because due to the exorbitant privilege[1] (of the USD being the de facto global reserve currency) the financial sector is at an advantage compared to other sectors, and it slowly crowds out other economic activity.[2]
[1] https://en.wikipedia.org/wiki/Exorbitant_privilege
[2] https://www.phenomenalworld.org/analysis/the-class-politics-...
What there _is_, is too much pain and too many spoons that each and every person needs to manage every day, and most (nearly all) people are unable/unwilling to let even more important things drop.
We also have crab mentality in the US, where if one person hopes for, or even gets, something better, they're pulled back down.
And we have an efficient, powerful propaganda machine that tricks people into voting against specific areas of their interests - see "I love ACA, but I hate Obamacare" commentary.
The work to fix this is terrifyingly hard and *huge* and the people that will choose to fight and improve the situation will be making absolutely enormous sacrifices to do it.
To be fair, ACA passed, and here we are. Healthcare companies are making more than they ever did. Have you considered that powerful propaganda machine works both ways?
https://www.axios.com/2024/08/08/insurer-profits-health-care...
The historical reason for why it's tied to specific jobs is because salaries couldn't raise for a period of time in US history and so jobs started offering other perks, like paying for all or most of your health insurance.
Now, companies get group discounts and still (often) pay meaningful percentages of many employees healthcare, and so getting private insurance is a nonstarter.
It was less concentrated industry before the ACA.
the fundamental reason is as usual: too much government regulation that was erected with good intentions, but ended up becoming a competitive Moat that reduced the competition and entrenched big players. With that amount of regulation healthcare should be universal like in Canada or UK.
To maintain private healthcare sector, there should be less government
While I agree with this, that regulations are often championed and even written by entrenched companies to increase the barrier to entry, the government can sue to block any merger they deem a harm to competition. Unfortunately they choose not to.
AI is a good example of this. If the government regulated AI, the only companies who will control and profit from AI are the ones who already have it.
As someone that's lived on the Canadian border for the past 20 years, I frankly think we need more regulations. Drug prices in the US are so absurdly high that most terminally sick Americans will happily drive back and forth to Windsor if it means treatment they can afford. It's a testament to America's core dysfunction, something that Canada can somehow get right on their first try but America... well, we struggled to put Shkreli behind bars.