An excellent suggestion by Paul.  With two sides working together, for once, it should be simple to design a basic healthcare system that requires the participation of all, has reasonable rates, attacks the causes of high costs, protects the poor and those with pre-existing conditions, can be portable across state lines, encourages competition, separates out all the add-ons to Medicaid and allows each state to decide priorities, gets people out the ER and into doctor's offices, etc.   Chance of those kind of adult negotiations taking place......zero.  Political power more important to both parties than a practical, coordinated solution, cause the average taxpayer is  going to pay either way.