First, distribute control and management of the system to the States with a fifty-fifty cost and revenue sharing formula. This immediately removes the whole subject from the National legislature, rarely to be heard from again. It also gives the states a high level of responsibility and localized management under the pressure of state to state competition.
Second, design the program around a broad palette of authorized core services. There will always be someone unhappy and complaining, but good investments in future human productivity can certainly be identified and nurtured. Let the States manage this. Failures will attract censure and keep them all honest.
Third, permit premium services but do not allow anyone holding a medical license to provide such services to more than a third of his practice. Ensure that all practitioners are trained in modern scheduling methods to eliminate wait times.
An umbrella organization can be set up and extended to each State as it adopts the program and sets up. Ensure that licensing and all individual rights are completely transferrable between States. Some States will have to solve funding issues, and some will be more restrictive than others, but in time this will all sort itself out without wasting further effort on the part of the National government. Private insurers will be allowed to provide extended services not covered by the basic coverage.
I have kept this as short and simple as possible. The idea is to lay this off to the States as quickly as possible. They want State rights – let them have the hot potato. It will keep them on their toes for the next century or so. It certainly worked forty years ago in Canada and a noticeable result is that medical profession has forgotten what bad debt is and they rarely let themselves be dangerously overworked.
Of course, young surgeons will complain about the long waiting times that they are subjected to because the old boys have first dibs.