Ultimately this is probably the biggest thing that we need to fix, as a nation - we need to start regulating the pharmaceutical and insurance industries. There are other nations - Switzerland and the Netherlands come to mind - that require enrollment in insurance for all of its citizens (like the ACA) but unlike what we have here, they actually actively keep the prices of medicine and insurance down and mandate that expenses cannot exceed a certain percentage of people's incomes. Even if, as a nation, we absolutely insist on never going the route of single-payer, there are other ways we can achieve universal healthcare that might be a little more palatable to certain segments of the population (though, granted, I still just want full on single-payer myself). Either way, though, the federal government needs to have more oversight and regulatory power.