One fundamental cause: Medicare which established government permanently within a free market medical system which was then the best in history.
Medicare led to Capitation of doctor’s rates which led to best docs quitting then to increased price and behavior control.
Once government is given ANY role in any sector, eventually it takes over 100% which is where we are thanks to passage of Obamacare. There is no going back except establishing in future government will never give money to hospitals, clinics, individuals, researchers, colleges...nobody.
I am loathe to defend any Great Society program, but fact is private insurers did not want any part of people over age 65. We all suffer some expensive, critical health failure at some point beyond that. You become a pure loss on the P&L, and they know it.
Insurance companies WANTED to slough these customers off on the government. It that had not happened they would have just refused to write the coverage. It’s the desire of industry to privatize profits but socialize losses that is leading to the death of capitalism as much as anything IMHO.
Pssst.... here’s a secret. People aren’t dying because they don’t have “access to health care”. They’re dying because they eat too much, smoke too much, drink too much, and take too many drugs. My brother is a Doctor, and he says its the above group that keeps him in business.