Reduce health care spending in the US by 50% without decreasing quality of life or life expectancy. Started a company that is trying to achieve those goals.
Near end of life procedures? A friend in health care told me 60% of one of our biggest hospital's costs go toward end of life (patient will die within weeks) treatments. Understandably, people request all the most expensive procedures because they don't want to let their loved ones go.
There are a wide variety of health care systems in other first world countries that are not single payer systems that don't have spending that is vastly higher than the countries that have single payer systems. For instance, Switzerland and the Netherlands both have mandatory private health insurance, similar to the way ACA was designed to work. Germany's system is based on a public option rather than being purely single payer.
I think instituting a single payer system in the US would be a good first step, but it is unlikely to completely solve our problems.