Don’t reject Charles Hugh Smith’s assessment of Medicare before you’ve read his whole argument. Unless you’re a better person than I am, he has thought harder about the matter than we have.
Given the choice between government ownership (Veterans Administration) and a “please loot and overmedicate us” Medicare system, I’d go with the VA model. The bastardized socialism of Medicare (no ownership, no accountability to anyone) is the worst possible system; at least the pure socialism of the VA eliminates the stupendous incentives for looting (bill for services) and the malpractice nightmare in which providers’ attempts to ward off lawsuits via endless tests and specialists end up costing more than the lawsuits (go ahead and sue the VA; good luck with that).
Given a choice between government care and a completely free market, I’d choose the free market — as “unfair” as it is. If people had to pay all their medical care in cash, an astonishingly rapid transformation would take place: virtually no provider could collect the bills Medicare routinely pays. The single greatest driver of Federal insolvency (Medicare) would disappear.
In terms of social welfare, the government could then fund modest programs in support of wellness and not getting ill in the first place, instead of funding programs which encourage illness because it’s so darned profitable, while keeping people well is insane because there is literally no profit in that at all…