[cmrdporcupine]

Not-American here: the issue is having to have a program like Medicaid in the first place.

A half-century of struggle in other industrialized western nations happened precisely because of this kind of thing. And in the 50s and 60s and 70s ... because of that -- and because of fear of contagion from the USSR -- most countries put in universal health care systems of various forms which eliminated the need for means testing and "charity" type medical care in the first place and defined quality health care as universal available.

Time for that struggle again.

[nickff]

The US's problem seems to be that citizens demand a very high level of (costly) medical care, which would not be sustainable if implemented as a taxpayer-funded universal program. As an example, the numbers which I've seen indicate that the USA has about 10x as many MRI machines per capita than Canada (which is generally a comparable country). The other big problem is the way that Medicaid is implemented, with funding and accountability divided between the Federal Government (which doesn't have the constitutional authority to run healthcare), and the States (which do); this is rather similar to Canada, which also has major issues caused by this division.