How? The government runs it, and/or heavily regulates it, and shifts costs.

> and they're better off for it

In the US, the cost of medical care rose in step with inflation until 1968. After that, it rose at a much steeper rate, and has not slowed down. 1968 was when the government got involved with health care.

Countries with a heavily-interfered health care system are poorer as a result.