As I see it, there are basically two separate ways to make healthcare work -- expose consumers to prices AND give them the tools to make decisions (with subsidies, etc. if we want to let poor people consume more health care than other things, as a matter of policy; I don't think that's an economic argument), or have an external entity with the correct incentives acting on the consumer's behalf. Medicare seems to mostly work on the latter model.
It's clearly possible to screw up both ways, but an even surer way to screw up is to do neither/both-partially.
Ending employer deduction for healthcare (and/or making it deductible for individuals) would be a huge step, too (in either model). I see no actual upside to employers paying for health care vs. individuals or the state at all.
And stuff like charities to help certain classes of people (poor kids who would benefit from a $300-5000 operation once, like Watsi, seems like a better use of charity money than an 80 year old guy living one extra day) seem like absolute good, too.
I have noticed a lot of doctors refusing to take medi-cal (Medicaid) and some other doctors who won't take any Medicare and some who won't take insurance at all, but these tend to be specialists and not hospitals.
