The U.S. healthcare system is totally distorted by profit taking and lack of collective economy of scale. A lot of the analysis was done by a great MGI (Mckinsey Global Institute) study. U.S. as a large geographically dispersed country than EU or Japan may explain why smaller clinics can sustain here. (Hospital is too far away and inconvenient for primary care visits.)
The Obama and Democratic plan is a baby step towards the socialist structure in the U.S. but it is so laden with special interest protection and is not going to take much bigger change to be efficient. However, efficiency in socialist structure is going to cause disincentive in capitalist creation/production. What is balance? Will America decline? I hope not.