Mind you, the German system is one of the most expensive in the world. It's also only of middling quality in terms of outcomes compared with other wealthy nations.
But it's still less than half as expensive as whatever it is the States are doing, still has effectively universal coverage, and is actually competitive with other wealthy nations.
All because we regulated the everliving shit out of the whole process. You can't as much as fart incorrectly in the German healthcare system without having an army of bureaucrats breathing down your neck in one of three prescribed breathing rhythms, one of which only applies if you farted in a hospital. Reports will be written, filed, and sent to recipients who can only change their mailing address on one of four specific days a year and only if they announced the move four weeks in advance by sending special crafted EDIFACT files to the right people.
As much as it sucks, that bureaucracy also shuts down a lot of nonsense. Insurance networks, deductibles, most copays, and ruinous hospital bills straight up don't exist because everyone in healthcare has zero leeway to do anything in a non-prescribed manner and the prescribed manner was designed to keep as many people as possible reasonably healthy.
It's a very German approach: Massively bureaucratic, regulated to an almost comical degree, and reasonably effective.