The US absolutely needs a state-run alternative to healthcare. The costs are a huge part of what's wrong in the US, and layers of administration and insurance companies contribute to that greatly.

But it's not even the cost which is most horrific. Healthcare has become capitalism run amok in the US. Insurance companies, (thankfully not after 2014) could deny coverage to anyone based on pre-existing conditions, which estimates say could be from 20-50% of adults. So 20-50% of adults aren't even eligible for US healthcare or have to jump through hoops and hope for the best to get it. Pretty much the only option is to be on a grandfathered plan. That's absolutely ludicrous. It's one of the most ludicrous things that we as a society accept.

The idea that US healthcare is not-so-bad relies on an idealistic view of the US system, i.e. where everyone actually has it and can afford it. But still ~15% of Americans go without it, with the brunt of them being the poor. It creates problems where hospitals will try to turn down patients without healthcare because the costs without it are insurmountable. It's absolutely not acceptable in a developed society. All the advantages of US healthcare would be well worth trading-in completely to fix its flaws. Let those things be luxuries if they have to be.