Ultimately the real issue is that healthcare is really expensive. And I'm not talking about inflated costs from inefficient delivery systems, "greedy hospitals/doctors/insurance bureaucrats", and all the other problems so frequently brought up. These issues, while important, are largely sideshows. Sure we can always improve the system and minimize those factors, but it will only put a tiny dent in problem. Focusing all our energy on those relatively trivial issues is dangerous because we end up neglecting the address the facts.
Healthcare is expensive. It has to be if it's going to be any good. It starts with the armies of researchers--clinical, scientific, pharmaceutical, etc.--that dedicate their careers to improving our knowledge of human biology. Every single one of these people needs to be compensated for their expertise and efforts. If they aren't, then nobody will go into research and the advance of medicine will halt.
Then there is a long road still from initial research findings to actually producing something useful. For every drug or procedure or instrument that eventually reaches market, many do not. The incredible amounts of labor that go into this effort require a lot of compensation. People still have to get paid for their years of hard work, even if their product, which was initially based on a sound theory, ultimately fails. Otherwise the industry would stall. This is why it is very misleading to say "it only costs 5 cents to make this pill, yet its marked up to $1.50. That's outrageous!! Criminal!"
And so far we've only touched the technology. There is still the physical facilities, many of which must be operational and fully staffed 24/7. And the staff aren't McDonald's minimum wage type workers either. Nurses, techs, security, social workers, etc. all have specialized training and aren't going to work for unattractive salaries. Even if nobody checks into the ER or is admitted to the hospital all night long, every single one of these people still has to get paid for sticking around just in case. The same thing goes for the doctors, except their specialized training is through the roof and they are also entitled to a pay that represents that level of sacrifice/expertise. As mentioned, they still have all their overhead that adds to the cost as well. Plus places like the ER are financial black holes and other departments, like labs and radiology, have to make up the difference for the hospital to break even.
My point is that the cost of healthcare isn't the biggest fish to fry. It's an issue, and can be brought down a little, but the same underlying problems will still exist after you do. The costs are generally fair (yes, that's right) and accurately represent the resources, time, and skill that goes into producing it.
The problem is that very few people can afford the costs associated with the care they would like to consume (that some even consider it their "right" to consume). Behold, the advent of health insurance. Once upon a time people actually thought of health insurance as insurance. When this is the case everything works fine. You still pay your yearly routine costs (deductible) but also contribute to a pool for the unlucky ones who get really hurt/sick (premiums).
But then people started expecting something for nothing. And politicians started demonizing anybody and everybody if it would win them votes. And as a society we let our welfare state grow to an unprecedented size, thus shifting more and more of the costs to the people who work hard and actually contribute something.
Of course nobody with a serious medical condition should go untreated because they can't pay. But at the same time people are going to have to start taking more responsibility for their actions and for what they consume. The ultimate problem is that many in our society are unwilling to do this voluntarily. We need to spend more time and effort addressing this, and the trivialities we are currently obsessed with will work themselves out.
