A major problem with the existing health care system, whether privately or federally (Medicare/Medicaid) funded, is the medical bureaucracy, as manifest in the following example.
Some time ago I pulled a hangnail and developed an painful infection on a Friday evening. It was too late to call my GP so I went to a hospital emergency ward. To shorten the long story I spent four hours there which included a long clerical interview and about two hours lying in a ward bed, fully dressed but covered with a sheet. A tired intern, who seemed bored and annoyed by my relatively minor complaint, insisted on surgically opening the infection in spite of my request for an antibiotic prescription. The bottom line was a stinging incision, a half-hour soak in Betadyne, a huge bandage and two days inconvenience during healing.
None of the above was necessary. I'd had the same infection twice before, once in the military and once during my GP's normal office hours. Both times I was given penicillin tablets. Both times the infection receded within minutes and was gone within hours. But the bottom line in this emergency ward situation was my insurance provider was billed over six hundred dollars (for "surgery") and I was hit with a $175 co-pay.
When I had the same infection while in the Marine Corps I walked over to Sick Bay, a Navy Medical Corpsman looked at the finger and gave me a little box of penicillin tablets. The whole thing took about ten minutes and the infection was gone within a few hours.
Another time, while on field maneuvers in the Philippines, I developed a huge boil on an inner thigh that was painfully disabling. A Navy Corpsman, who appeared to be no older than I, gave me a shot of novocaine, a penicillin shot, he lanced the boil, put a drain in it, dressed it and gave me a little box of penicillin tablets. All this took about half an hour and was done in a squad tent -- and I was back on my bulldozer next day.
The point I wish to make is too much time, money and talent is wasted in our Country's hospital emergency wards, most of which is the result of treating the poor and indigent for everything from minor injuries to major medical problems. The problems are the bureaucratic procedures and the legal requirement that every case, no matter how minor, must be treated by an MD.
I've described my emergency ward situation and how it compared with basically the same situation in the military examples. Massive, unnecessary waste!
There is a great deal of educated talent going to waste in the form of nurse practicioners, ex-military medics and trained EMTs who quite competently could handle a significant percentage of emergency room cases, most of which are relatively minor complaints. I believe that appropriately situated walk-in medical centers, open to the poor and indigent, including the illegal populations, would take the pressure off hospital emergency wards and dramatically reduce the overall cost of public health care. And the bottom line argument in favor of such a program is if that level of treatment is good enough for military personnel it certainly is good enough for the poor and indigent.