The main cause of this festering medical mess is the constant increase in costs.  It is imperative that these costs be reduced to the point that people can either fund their own medical bills personally or through insurance.  One of the main causes of the incredibly high costs of medical care is the threat of litigation that the legal system constantly holds over the head of doctors.  When a doctor can be sued for literally millions for malpractice, it is a threat to the entire system.  Far smarter to develop a schedule of amounts  proportionate to the injury  caused rather than a pie in the sky amount that enriches both the patient and the lawyer at the doctors expense.  Pharmaceutical costs are unrealistic (in spite of R&D expenses) and hospitals bill for far more than their actual expenses.  Costs can and must be reduced to a level based on reality if a public healthcare funding policy is ever to be created.