We have allowed our healthcare industry to evolve without guidance or structure. The result is a system today where access is a function of employment, intermediaries act as an oligopoly, conflict of interest is rampant and the incentive structure in place is perverse.
For decades the US auto industry led the world--and it did it without any (government imposed) "guidance and structure." More "guidance and structure" (CAFE, rules giving organized abor an advantage in negotiations, import quotas (explicit and back-door) ) are largely responsible for the state of the US auto industry today.
The US agriculture industry is among the most productive and efficient in the world. Amazingly, it has almost no central control. Nobody in the government tells farmers which crops to plant where and when, nobody in the government allocates fertilizer according to need, nobody in DC arranges for harvesting equipment to be on hand at each farm and for trucks to move the crops to market. Incredibly, a system based on millions of individual decisions and miraculous communication via price levels exceeds the best centrally planned systems in the world. Other governments have imposed "structure and guidance" on their agricultural system, with resulting famine.
Medical care is a commodity with some unique characteristics, but it is not entirely unique. And, the mess we have on our hands right now is largely due to Washington's "structure and guidance." Without DC's invaluable "assistance" we wouldn't have the problems we've got (though we might have a different set ). Helpful "structure and guidance" hs included poorly-constructed wage controls in WW-II that excepted fringe benefits, including medical care--which led to the idiotic employment-health care linkage we have today. Un-equitable tax treatment of employer-bought insurance vs individually-bought insurance perpetuated this foolishness. Government-mandated coverages in health insurance policies have also driven up costs and reduced freedom of choice. We've seen where "structure and guidance" leads. Maybe the solution will be found in taking less poison, not in doubling the dose and hoping for an improvement.