Individual pharmaceutical companies and their trade organization spent approximately $220 billion in lobbying in the United States in 201810 [2018 typo?]. Although nations recognize the major problems posed by high prescription drug prices, little has been accomplished in terms of regulatory or legislative reform because of the lobbying power of the pharmaceutical and healthcare industry.
That is the big elephant in the room and the overwhelming cause.
There was a study, an examination of 22 different studies specifically, by researchers from at least three campuses of Universities of California. They confirmed the abundant evidence that a "Medicare for All" single-payer system would give quality comprehensive coverage to everyone in the US and save money. All 22 studies that were examined, no matter what political leaning they were, showed that long term savings possible and probable. Even the right-wing think tank, Mercatus Center, found around $2 Trillion with a big T to be saved over 10 years with a single-payer Medicare for All system. Expand savings much more if it was connected to global health care spending budgets. Why the industry spends so much buying politicians, small investment for profits made.
Administration savings were a big bulk of it, at $600 billion savings a year. Scripts, between $200-300 billion savings per year. Billions more saved with better fraud control, a central system instead of the thousand different systems between insurers and the hospitals/health providers. Even the Mercatus study, and others, stated savings could be had even with the elimination of out-of-pocket expense and deductibles.
Of course, if we would go that route, trillions of profit would disappear for the industry, and so would the full pockets paid to politics. It'll never happen, the politicians are not working for us.
Study; Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013 Christopher Cai , Jackson Runte, Isabel Ostrer, Kacey Berry, Ninez Ponce, Michael Rodriguez, Stefano Bertozzi, Justin S. White, James G. Kahn Published: January 15, 2020
Other sources where some of the numbers came from: