Why US Healthcare System is Permanently Flawed.

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It will never get any better because of one reason, regardless of what any politician says. Until the real problem, the desire of all involved to generate windfall profits on a regular basis and is simply unrealistic and not sustainable, is addressed and managed the same issues will crop up again and again because no one will do something about what is causing them to begin with and you can bet Republicans will not address it. Democrats haven't, either. Politicians, in general, are powerless against the mighty health insurers.

The ACA, unfortunately, did nothing to address the scummy way health insurers conduct business. I read an article last year about how these companies employ special software, dubbed "denial engines," to detect even the the most minor coding or billing errors, which results in them keeping as much of their profits as possible. While I understand insurance fraud is a major problem, it's unconscionable to have to take insurers to the wall for valid claims denied on a minor technicality. They realize that many people will just give up.

The single-payer system is the only way to address this problem, as far as I can see.

They are only one part of the problem, albeit a big part, but others exist. It's a system that revolves mostly around profit and not just a normal amount. They feel like they are entitled to windfall profits only because it's health which is the most important thing we have. If we don't have it, life is more difficult so we value it dearly and we get played because we place such a high value on it. In other words, it is super easy to exploit people. Just like with miracle cures and snake oil. Desperately ill people will pay a high price to get well, any price, even give their life savings and everyone in the medical profession, although yes, they can be really nice and do great work, not denying that, but they all know people will give everything they have for their health. This is the power they have over the situation but how can it be managed long term? You cannot expect millions of dollars from every sick person. You cannot build your business on the expectation there will be millions from every sick person. The medical industry, including pharmaceutical, is run on that idea, that everyone with an illness has a stash of cash they can spend on it. Even with insurance, that's not the case. That mentality must be abandoned or it's doomed. It will not continue. It will collapse, much like a pyramid scheme does.

There is enough greed to go around, but it really isn't the doctors or hospitals who are to blame.

Doctors spend a lot of money (nowadays, debt) to get the education then spend YEARS working like a dog to be a full "doctor." That's when they can start making money, and a medical practice is more and more regulated so that there's no assurance it'll turn a profit. Hospitals are in a similar situation.

Health insurance is a big part of the problem now that most everyone needs insurance to afford health care. Some doctors are revolting by refusing insurance and insisting on cash only. By not messing with insurance paperwork (give the patient a bill statement they can file with their own insurance), they don't need the legion of billing specialists just to handle the mountain of insurance paperwork. Hence, they can charge lower "cash" prices to those who come in.

You have other issues such as the greed of personal injury and malpractice lawyers, an unwillingness for doctors and hospitals that screw up to accept responsibility and quickly and cost-effectively address their error, the greed of Big Pharma that will reinvent a drug for no reason but to get a new patent they can charge more for than they get once a drug can be sold under generic labeling...heck, the drug companies charge different amounts for the same drug depending on what county the drug is being sent to. Hence, Americans subsidize the cost for people getting the drug in Mexico, Canada and pretty much everywhere else.