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I don't think insurance is a poor method. For health care it is the same as for other risks, like insuring your house. There are risks that would ruin you if you had to pay the cost yourself. E.g. your house burning down, or you needing an expensive operation. But for low expenses it it is actually more expensive to insure them as you also have to pay the cost and profit of the insurance company.
There are two important aspects to make the insurance work well: there must be enough competition and it must be sufficiently regulated so that the companies cannot rip you off. (These aspects apply to most businesses I think.) The ripping off is especially important for people who have chronic diseases. I think health is so important an aspect of life that the decision about people's health should not be made by a commercial company. Therefore it is important that insurance companies shouldn't have the right to deny people solely because of their current health situation. Or otherwise their should be a fallback insurance, e.g. from the government for these. Of course the latter wouldn't be profitable and must be subsidized by the government from tax incomes or from a percentage of the income of the other insurance companies.
I don't think government programs by themselves are necessarily wasteful. But there are also mixed forms, like a private company where the shares are owned by the government. Then there isn't that shareholder's pressure to be only profitable at the expense of all other values. It can still be run biy managers that try to make the best out of it, including doing things at lowest cost. But the government can then put other objectives, like having to accept all sorts of customers, something that normal shareholders wouldn't be willing to accept, as these have profit as the major objective.
The insurance company where I have most of my insurances was originally founded as a pure `mutual', i.e. a group of people (in this case civil servants, teachers and similar) coming together putting money in a box, so to say, from where there risk expenses could be paid. No profit as objective, only covering the risks at the lowest possible cost. I don't know if it still works that way as they have merged with other companies. They are still one of the cheapest and have a good service. They don't sell through intermediaries which also saves money. I got mine when I started working at the university which had a contract with them.
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