Looking it over, I am struck by how much effort has been spent on preserving the inequities and corruption in the system. The working poor are hit exceptionally hard, both by the refusal to expand Medicaid in 25 states and by the transition from Medicaid to subsidized insurance. People over 50 who are relatively well off are also pressed by the too-low cutoff of subsidies. In both cases, there are levels of income where small increases in income put a family in a worse situation.
Medicare part A (the free part) covers hospitalization but not ambulances in emergencies. Medicaid puts most of its clients into managed care systems, which take a cut of the expenses and are often corrupt on top of that.
And I don't have a conclusion yet, but wow are we cheap-ass, here in the USA. And yet we spend more government money on health care than any other developed country. WtF?