It doesn't matter who pays, the government or private insurance or individuals, the major cause of rising health care costs is doctors/health professionals who place primary emphasis on increasing their revenue stream rather than on the quality of care their patients receive. They stress quantity over quality, and prices soar.
"Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check." - Atul Gawande,The Cost Conundrum in the New Yorker.