I don't think you're conclusion is supported by facts.  The rate of healthcare cost increase has declined substantially since before the ACA. see http://www.milliman.com/mmi/.  Whether that slowing is because of the ACA and/or other factors like the 09 recession is a matter of debate but group payers (insurance companies, the government) are far more effective at bargaining prices that individual consumers.   Which brings us to your latest point - single payer.  I could not agree more with you.  Single payer means massive control over the prices that providers charge.  No more out of network bullsh*t.  No more balance billing.  The EU counties are quite good at it.  Compare the cost of a new hip between the US and Belgium.  About 10:1.