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The equation is maximize coverage with acceptable costs

Personally, if I was health care czar, I would end every health care program including military and VA, put everybody (including illegals and refugees) into one big pool, and go Canadian-style National Health. I think we have a much bigger pool and way more resources so it would work well. I would also nationalize all the drug companies and medical device manufacturers and make all their employees civil servants.

I would also nationalize all the medical and nursing schools or at least support them with federal dollars so medical training was free but with a service requirement upon graduation. There is no reason we can't train enough students to have adequate numbers of rural GPs. Maybe those will be doing their service requirement, maybe they will be the folks who entered medical school with just an A average instead of A+, maybe they will be mostly PAs.