Economists talk about "the theory of the second best" - that the second best global minima might not be close to the best minima. The classic example is a union

Economists talk about "the theory of the second best" - that the second best global minima might not be close to the best minima. The classic example is a union and a monopoly is better than either a union and a free market of employers, or a monopoly and no unions. Theoretically, a free market is best. But if a free market isn't possible (and in the case of healthcare, it's nothing like a free market - there's all kinds of red tape, subsidies, and these aren't going away) then simply being more like a free market might not be the most effective solution. The US healthcare seems to be a system where the private market makes most of its money by outsmarting regulators rather than doing what regulators actually want. The US also spends far more than almost any other country (per capita) on health, but gets fairly bad outcomes. Worse, it even seems to spend more tax dollars (Medicare and Medicaid cost an unbelievable amount) than countries with universal healthcare, on top of what is essentially a hidden tax on the companies that provide healthcare and private spending.