I'm pretty sure that's working as intended. Might be better off loosening restrictions on how health care providers operate so they can work it out themselves.

On a more serious note, there isn't one solution. There are hundreds of thousands of ways to spend less and bring more money in. It took this country, and that state, a few decades to get into that mess. It will probably take just as long to get back to the prosperity the 40's and 50's were known for.

Do you have evidence for worse services?

(E.g., something like higher post-diagnosis death rates for statistically comparable people?)

They often just get refused service, even after paying way more.

Sadly, the US Gov is going to make it worse. Go look at the budget for Indian Health Service versus the number of people served, then expand that to cover all Americans. For a bonus, check the level of service compared to the private sector.

It probably would have been cheaper to allow people to have real personal health savings accounts and provide a "last-resort" insurance that pays everything over some amount ($100K perhaps). That last bit probably would bring down premiums because of a max risk.