When the government supplies any product or service to every citizen as an entitlement, the total number of dollars spent on that item will increase out of sight (as we have seen under Medicare for example). If it's "free," the cost doesn't matter the same as if we have to write a check to get the product or service. Cost containment is important enough that the survival of the healthcare system depends on it. Costs can be contained by limiting the dollar amount of care each person is entitled to, assembly line medicine, government enforced lifestyles and population control among others.
I don't understand what you're asking about "Alternate goals." In my view the goals are political. Otherwise we could market healthcare like any other product and issue indigent people cards that can be used at healthcare facilities like food supplement programs are done at the grocery store.