They are optimizing for posts that generate revenue. Since users don’t pay, the news feed is optimized for advertisers and the user posts that lead to more advertiser engagement.
The dismantling of the Fed Gov is decades in the making. While there may be recent foreign influence on the margins, the Kochs, Adelson, Mercer, and the rest of the GOP donor class are the originators of this GOP agenda.
Marketing is a fool me once scenario. Quality products earn repeat purchases. You don't become the world's most valuable company with one-and-done sales.
There were provisions that addressed cost containment (ACOs, Quality-Based reimbursement models for Medicare). In fact, medical cost inflation has come more in line with general inflation since about 2009/2010. But, you're right, the market based reforms like cost and quality transparency were left to fight another day. The ACA focused more on access to coverage than it did cost.
I would not put too much weight on conspiracy theories though. The healthcare system is massively complex. It will take multiple reforms to eat this elephant.
Payors are healthcare wholesalers. They can buy health services from physicians and facilities at about a third to a tenth of the cost you can because:
1) It's not life or death for them; and
2) They can buy in bulk
This kind of proves the thesis. EV is a hobby for the legacy guys that competes with much more powerful (by revenue) business units in the company. It's like expecting Kodak to compete and win with their own digital camera.