Other countries define "what they legally deserve" that pretty much as "what makes sense, medically"...

The part that requires bureaucracy for Medicaid is making sure the recipient is legally entitled to Medicaid at all (and, if they are, that they still don't have other insurance which should be paying ahead of Medicaid.)

That’s where having a separate system for the medically indigent in a mostly prvate-pay system becomes much more burdensome, per covered person, than a universal coverage system without private insurance.