Why oh why cant the usa afford it? Serious question because it amazes me to read about healthcare not beeing equally avaliable and affortable in a first world country.
A few reasons:
We are probably a bit unhealthier than other advanced nations (obesity, lack of exercise) equals higher costs
We always insist on the most and the best, we are Americans
Our hospitals build the fanciest facilities in the richest suburbs to stay competitive with other hospital networks equals super-high construction costs (more so than in other countries)
Our doctors enjoy higher fees and a higher life style than in other nations
We pay full ticket or near full ticket for our drugs here; other countries allow their governments to negotiate down the drug prices and the drug companies go along with it rather than lose the business
We use a lot of drugs, we are Americans
Our insurance companies take an administrative cut that goes to shareholders in dividends, more so than in other countries
We have more newly arrived immigrants and poor people whom we subsidize than many other nations
I used to be against a single payer solution, but the above reasons are so complex that I am beginning to conclude it is our only way out. "Market solutions" are a mirage that will go nowhere. I liked the comment above that the doctors don't know the prices of anything any more than the patients do.