The solution you seem to advocate is to have the government take over or drive out of business all car companies and provide a one-size-fits-all Volga for everyone. I fail to see the benefit.

*Nobody* sees the benefit in that AFAICS. It's a straw bogeyman.

the current proposals seek to expand the role of Medicare, the single greatest cause of fraud in the current system

That may be true, but fraud does not account for the >50% cost markup.

not one of the current proposals seeks to address legal reform

The AMA would agree with you there though opponents would claim that litigation adds a single-figure percentage to cost, not 50%.

the free market is the greatest facilitator of cost reduction for new technology and all of the current proposals seek to further restrict the market

New technology can reduce cost but it isn't an explanation or solution in this case. Review http://en.wikipedia.org/wiki/Medical_tourism#New_Zealand and tell me where you suppose these cost differences are derived, bearing in mind that the patient will receive an identical prosthesis. FWIW NZ does have serious health system funding issues too- I think everybody in the first world does, not least because of the aging population- but for the US to start with such a cost disadvantage doesn't make it easy.