First, let me go on record as being a supporter of a single payer approach to medical care. I think that, in time, we will become enlightened enough to get there, but not this year.
With that said, here is what that I think is possible to attain, and it is much better than nothing. Please help me to punch holes in my approach, because this is an extremely complex subject and even I (LOL!) can not get it all correct.