> ... would be fine if healthcare was a competitive market. But it isn't, and I honestly don't see how to make it one.

The "mixed economy" model - introduce government run hospitals to create competition.

Indian healthcare industry is experimenting with such a model. There are free to cheap government hospitals (along with medical colleges that provide cheap labour in the form of student interns) and smaller public health clinics, that work somewhat like the UK NHS model. But as they tend to be over crowded, or have high wait times to see experts, people with money (and / or insurance) tend to prefer good private hospitals. Private hospitals do charge a lot, but where there are good government hospitals, they have to be mindful that they do not charge too much. Affordable insurance (along with socialised government insurance) and medicines also make access to quality healthcare possible.

Huh, I really like this approach. My economics knowledge isn't great, but I do know that healthcare is quite inelastic because people are willing to pay high prices to be healthy. A mixed model would siphon off the most desperate to a good option, and inject local competition.

I advocated against universal healthcare for a long time, since I was worried that it would cause stagnation in health innovation, but now I see a need for universal healthcare for the 80-90% most common procedures (and leave private clinics to innovate). The only downside I can think of is less dependence on insurance, which has the potential to drive up premiums. But, if that means taking care of the poor for the most common ailments, then it's a worthwhile tradeoff.