I like to think about it less as free market vs universal healthcare, and more in terms of incentives of incumbents and political power of incumbents to protect

I like to think about it less as free market vs universal healthcare, and more in terms of incentives of incumbents and political power of incumbents to protect those incentives through regulation. If your regulatory regime doesn't adequately deal with incentives, then the companies you regulate will just find a new way to abuse the system to suit their needs Right now, lack of public understanding of healthcare quality and lack of transparency is a big weapon for providers. Providers have a lot of political clout, as hospitals are huge employers at local levels and thus have lots of local political influence, plus they are powerful on a national scale bc its a huge industry. There could theoretically be a large scale political movement against hospitals, though it would probably have to be grassroots, as again, hospitals have lots of control over the political incumbency because hospitals employ so many people and are important to communities. However, it is hard for grassroots movements to propose effective policy recommendations. Healthcare is complicated, and presenting simplistic solutions that sound good but probably won't work gets more grassroots support than complex solutions that may be more effective (i personally think that single payer is one of those solutions that sounds good but prob wont work, but i know thats controversial). In many cases, its probably possible for hospitals to push legislation that sounds like it is decreasing costs, but actually helps powerful hospitals make more money (one could argue that ACOs and ACA in general are an example of this). Making the issue worse is that hospitals control data, so they are able to cherry pick data that makes them look good and get public support based on these factors, but grassroots organizations cant access data to counter those claims So hospitals have tons of political cover to protect their interests through 1) control of information and 2) influence on politicians through their roles as large employers