The US has states that are larger than countries in Europe. This may or may not contribute to the problem, but it is tiny in the big picture of US healthcare is

The US has states that are larger than countries in Europe. This may or may not contribute to the problem, but it is tiny in the big picture of US healthcare issues. The issue in the US is that the system is hugely inefficient compared to the models in Europe. There is an absolutely massive administrative layer between care providers and payers, price negotiations aren't transparent or efficient, the whole system is hugely complex, and the vested interests are incentivized to keep it that way.