how did the US screw up health insurance so bad?
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More or less a private health insurance industry was built up out of the efforts of individual hospitals and private hospital associations like the American Hospital Association and other groups to develop payment structures for care in the first half of the 20th century.
The US government never engaged in rate setting or any other policy aimed at managing the amounts hospitals could charge*. Public payers with the heft and and incentive to bring down costs while maintaining low prices for members were only developed for the old, disabled, and very poor. Private insurance and provider markets became extremely concentrated and there was basically no anti-trust reaction.
In short, the government didn’t do any of the several key things other governments do to contain healthcare costs. Every attempt to do so is, generally, met with violent screeching by the Republican party and determined opposition by providers and payers.
*I just want to note that, as a health policy researcher, it’s kind of BS just how little providers get blamed for astronomical prices.
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