This whole issue is SPIN, SPIN, by both sides.
It is true - 10% of the people require 90% of the services.
I see this in my family, friends and neighbors.
The simple solutions will always be unpalatable and lobby blocked.
Full preventive and wellness care until of age.
Then voluntary risk grouped (lifestyle choices only - all other factors averaged out) privately paid for insurance.
And a national safety net program financed by diverting all of our current "sin" taxes out of general fund diversion directly in treatment programs like they were supposed to go. In fact anything determined to be a negative health factor slap on enough tax to pay for the full social cost of tobacco, alcohol, drug usage, gambling, fast foods, convenience mealing, X style adventuring, etc. Virtually nothing illegal, just very expensive.
In the US we do currently pay a federal "sporting goods tax", model after this.
'Course we know this ain't gonna happen. Too many toes to step on.
In the mean time my wife and I will contiue to pay $7000-9000. a year in private health insurance for our annual wellness check and once every three years. actual needs visit. Damn spiders.
All my own opinions
SteveU.