Insurance, at least today's insurance is the problem, no matter who pays. Here's my simple cheap prescription to dramatically decrease the cost and increase access to medical care:
(1) permit pharmacists to prescribe legal medications and labs to prescribe tests. Less Doctor/Gatekeeper.
(2) forbid direct payments from insurance companies (including medicare/medicaid) to medical service suppliers.
(3) make medical malpractice a crime like assault with a similar burden of proof, but forbid civil actions entirely - no law suits with monetary damages.
(4) make individuals the sole legal custodians for their own medical records. Care providers may not maintain records for anyone they have not treated in 6 months.