Interesting article linked below. One of the main themes is one I first heard from Clayton Christensen, which is that medicine is heading toward a disruption based on technology. Providing better and cheaper care in the future will be made possible with technology.
Again, this is a moral duty and not just a pragmatic and necessary set of reforms. If the poor are going to get more health care, health care is going to have to become much more abundant and much cheaper. Before the industrial revolution, many poor people lacked decent clothing. The poor used to dress quite literally in rags, but the industrial revolution eventually made serviceable and even stylish clothing available to almost everyone. The guilds of the spinners and the weavers hated the way the new looms took away their special status and cut their wages; so be it. IT makes it increasingly possible to have the equivalent of an industrial revolution in health care; it is our duty to carry these changes through.