America’s Medicaid and Medicare programs are, IMHO, effectively impossible to reform. The massive entrenched government and private interests will never allow serious change
So what should be done in the USA - allow states and counties to establish medical free-trade zones. Allow doctors to set up in particular areas, allow low or no income tax, limited liability, and cash payments.
We will need a secondary system to back up the expensive, failing, legacy systems.
What reform does Medicare need?