Well, I don't think anyone sees Medicare as the optimal model. I don't know what the proposed Obama model is, since it appears he's having Congress do the heavy lifting. All I know is, I think the system in place currently should be scrapped in toto. And that's from someone with damned good insurance, co-pays, etc. I think we can do better, more patient- and physician-friendly, more economically sound, etc., but I think we're slouching towards halfassdom.
I know this is all over the place, but one more thing. One reason we aren't seeing the benefit of increased cost of care in life expectancy or however you want to measure it is that we are battling against an ever-worsening lifestyle. We eat more, eat worse food, and exercise less than most other countries. I think the fact that we're in the ballpark with those nations is a testament to a pretty good health care system. We live longer than previous generations despite a less healthy lifestyle. Why? Better health care.
I know I've been on this soapbox for quite a while, but if you get a chance, see Food, Inc. It's a nice summation of my basic polemic on the American industrialized food system. DVD out in November.
Msdmnr, what is your current job, if I may ask?