Thanks John and Cal, this is most helpful!
Cal, I really appreciate the way your wit, always apposite, helps keep this an enjoyable exchange, thanks a lot. John's suggestions are ones many of us can support, I think. The idea of a two-tier system is not bad, it's what actually exists in some places (maybe many)--I think Austria, for example, but maybe they just have a parallel private system for those who can pay. Anyway, two-tier should be considered.
As for medicare fraud--is there some easy, foolproof way to prevent unscrupulous doctors from claiming whatever the medicare-mandated "patient visit" fee is ($80? $100? $60?) when they just stick their head in the patient's room, say "How are ya?" and sign a form in his room? So they claim to have "visited" 100 patients in a day? Or isn't that even the main problem in medicare fraud? Does anyone know?