I’m talking about the reality we face right now using the example of healthcare, which tons of Americans don’t have access to. Which I feel is a bigger problem than the problem of choice.

Healthcare also being a public good that almost every other developed country handles at a national level with greater success (life expectancy/ childhood mortality, other major kpis) and far lower costs.

healthcare should really be the nail in the coffin of the efficiency argument. the reason it's more obvious that it works better provided publicly is basically that it's way more extensively studied and the US is such a great negative example of how privatization destroys it even in the middle of extreme wealth.