I'm certainly no expert but I think that one answer to your question of why it's so expensive is actually relatively simple. Bureacracy. Whether insurance comes from a private company or the government, it does NOT improve the quality of healthcare nor does it increase the number of doctors/hospitals available to see you. It DOES, however, create a massive amount of paperwork for doctors/hospitals. Just think about the last time you were at the doctor. Mine is an office with 2 doctors and I believe 1 PA....there's also a nurse and then there is a receptionist plus 2 more people to deal with paperwork. If you want to exclude the receptionist, there are 4 qualified "healthcare workers" and 2 paper pushers. Both of whom require salaries and benefits. Add in malpractice insurance and lawyers and you're on your way to realizing why it's so expensive.