Your right, we disagree. Patients with Medicare HMO's are less satisfied and patients with Medicare traditional are the most satisfied. Medicare traditional has higher rates of satisfaction than private insurance, plus it costs 30% less than Medicare HMO (the supplimental they talk about ending for the last 10 years or more). Medicare traditional medical neccessity standards are developed by a panel of doctors in an open process that anyone can look up on line and read the transcripts (if you really want to) but references and citations are available. All that is behind closed doors, including utilization, with HMO's, Medicare or not. All Medicare traditional does is centralize payment processing. One forum, one address, one set of medical necessity standards, open and applied fairly to all. Doctors make the decisions.
Medical necessity standards have to exist in any system of care and do already. A doctor can't prescribe chemo for a hang nail to get more money. They can't get paid for removing your left foot when you went in for surgery on your liver. That sort of thing. It's better to have them in the open, discussed and challenged by their peers than behind closed doors of an institution whose legal obligation is first to their investors. As long as it's a corporation, patents are second and that's the law.
Centralizing payment processing would reduce overhead by at least 30% and probably more now. Currently doctors have to field hundreds of different standards and forumlaries. Estimates are it takes a minimum of 7 full time billing agents per doctor. It's nearly impossible for a doctor to go into single doctor private practice now. With centralized processing, they could. Canada experienced an explosion of private practice doctors and it's nearly triple the rate the US has per person. They also have centralized payment system.
It's not the same as socialized medicine like NHS (UK) where doctors work directly for the government. I don't know what people in the US were doing to miss the Olympics opening that celebrated the NHS system, but everytime I hear mention of it, the phrase includes how proud they are of it.
One of the biggest beefs in Canada is that they are afraid of regulations that might lead to an "american system" of healthcare. That's echoed the world over. NO ONE WANTS OUR SYSTEM. Medicare has been successful. One added benefit would be a central pool of anonymized data enabling researchers to pool effective outcomes from treatments. Currently getting a well rounded pool of data is expensive and time consuming that is often full of statistical errors or bias leading to faulty results.
I usually begin any type of medical research by pooling information from large reviews from universal healthcare systems since they are more interested in long term results being the most cost effective. That's not true in the US. Their reviews begin with exhaustive methodology of why which studies were chosen or not. Over the past ten years I've seen results in other countries conflict the US standards for the first time AND up to 3/4ths of US studies tossed out as unuseable due to conflicts of interest. The US isn't even close to running for "best medical care". We aren't even in the top third anymore. It hasn't always been like that. It's shameful.
More people die from inadequate or lack of medical care than anything else in the US. Insurance could be seen as another form of terrorism - so yea, I think it's a duty of government to protect us, only it's not in some other country.
DUH! You're the one who should be answering Shari's question then; well, you & Lox
my flavor molecules are finally here
package went from Nashville Tn to Mississippi then I forget where Tn then back to Nashville. 
