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[–] sumguy ago 

Having witnessed what you want first hand (Indian Health Service, US Native Americians have Gov provided/free healthcare), its not that easy. This is an easy example that happened frequently:

Person has a minor annoyance, an ingrown toenail, and wants it take care of. This isn't an emergency so triage makes an appointment (nearly always the same day), but the person doesn't want to wait in the office so they leave. Doctors office hours end and person returns and is shuffled into the ER because no one can be refused. Mind you, this is now costing Hundreds of times more money and taking up one of two (in this specific case) ER beds. Hope there are no incidents that need more than one bed because it's not available... again, that ingrown toenail can not be refused.

They all knew exactly how to game the system. More drugs? no problem, they lost/had stolen whatever they were on (normally dosed for 30 days at a time, in the case of suspected abuse the pharmacists would limit that to a week at a time but would normally just hand out enough for the remainder of the month). Whoops, got addicted? No problem, we will just give you more drugs to let you down easily (remember, no one can be refused).

The problem is that some people will always try to game the system. That means the whole system is made worse for everyone, and thus more try to game it and the admins try to stem the abuse while making it worse. It's just a downward spiral.

I don't have a solution... but mandated care isn't it. Just like insurance isn't the real problem (only in the US, the rest of the world still uses insurance, has medical care/coverage and doesn't charge even a tenth of what you find in the US... but it's not the Insurance.)