The way Medicare is artificially restricted from driving down cost is atrocious. Medicare + Medicaid combined costs about as much per capita - NOT per patient - as the UK NHS. Except the UK NHS provides universal cover.

Now the NHS is an aberration and under severe pressure, but it is a good indication of just how inefficient Medicare and Medicaid are - and it's not that they can't do better, it's that they're legally prevented from using their market power.