>>If we have four more years of Obama, we will be a 3rd world country and we are already close to that now.

It's not that bad (yet) but may I suggest that the big problem is that US taxation and public programs have to be run as Ponzi schemes. Insurance underwriting tells us exactly how these schemes should be run (levies struck to cover predictable future costs) but because the electorate punishes raising of taxes, levies are minimized to cover current costs only, leaving a growing underwriting hole for future politicians to worry about. That's what you face now with Medicare: people squeal at the suggestion of higher tax contributions to cover previous shortfalls plus our own future costs, though they seem happy to pay comparatively vast sums for private health insurance while they're young and fit.

Perhaps the solution is to establish a separate health insurance contractor owned by the state but run as a corporation, with officers rewarded accordingly. The corporation should provide insurance cover for all care including the most expensive >65y sector that is currently dumped on the taxpayer. If allowed to charge the same fees enjoyed by the private insurers, such a scheme would generate the same surpluses that could be partly invested and partly pumped back into the shortfall, probably becoming fully self-funding inside a decade with increased services and decreasing premiums as the investments kick in. The only victims would be the current private insurer shareholders who siphon away huge surpluses that would grow into billions and trillions for policyholder benefit if invested against future predictable costs.

Another possibility is to pass the predictable costs of the elderly back to the insurers, but then regulation will be needed to prevent harvesting the young and fit and then firing people once they get sick. In the end so much regulation will be needed to control pillaging behavior that the first option might be more rational.