Air travel and health care

Jonathan Rauch imagines air travel organized like health care.

One of the big attractions of the Canadian system is its administrative simplicity. You go to a provider (if you can find one taking new patients) and show your card and you're done.

My sense is that health insurance systems in other countries with universal coverage but without a single payer are also substantially simpler on the administrative dimensions highlighted in Rauch's piece.

This suggests that the key is not single payer but some other aspect of regulation. Put differently, I have wondered for some time what aspect of the US health industry regulatory environment prevents it from acting like the airlines? Is it some obscure aspect of antitrust legislation or case law? Is it the lack of national market? Is it state insurance regulators captured by some part of the industry that benefits from this inefficiency? I've never seen a clear discussion on this aspect of the current situation but would like to.