A few years ago an article was published in the British Medical Journal; the lead author was Richard Feachem, who is British but works at UC San Francisco. The study compared cost of services (adjusted for purchasing power parity) between the UK NHS and the Kaiser Permanente system in California.
Their findings were that the adjusted cost of care with Kaiser is within 10% of the cost of the NHS; but in waiting times, access to specialists, and other measures Kaiser was far ahead of the NHS. This study was timely, in that many in the UK were saying that the problem with the NHS was lack of resources. The implication of the study is that it is failure of incentives to provide access to care that is the problem, not the amount of resources.

Having worked for many years in Kaiser Permanente, I can tell you that 25-30 years ago they were very inexpensive compared with other health insurance plans; as a result did not have to compete on the basis of quality or access, and it showed. The organization remade itself into one that can compete at the highest levels of quality–but is no longer the least expensive alternative. In any case, it is competition that has made KP as good as it is. Without competition of the free market, it would be like the VA system or the NHS in terms of access to care.