There is a misconception that health care is a commodity that responds to free market competition with lower costs. If you need to purchase a refrigerator, you go online or to a store that has several brands and models all lined up and choose the one you want and can afford.
However, if you suddenly have sharp pain in your left arm, a crushing chest pain, can't breathe, feel dizzy and faint, do you: A) Call 911 and ask for the paramedics or B) Call the paramedics and ask how much it will cost to save your life and get you to the cheapest good hospital? Most people will do A.
Health care is not a precise cost service, like replacing a leaky water heater. Humans are not machines.
One of the leading factors of higher cost is the profit margin that publicly traded for-profit insurance companies, hospitals and other health-delivery entities must carve out of the premium dollars you, and maybe your employer, pay. The fiduciary duty of any for-profit company is to provide to shareholders a high return on their investment. You, the patient, are not their primary concern.
Health care is like the fire department, police department and the paramedics. You don't want them asking you what credit card you will be using before they send help.