Fixing both problems is ideal, and we should do both. But, I fear, that after fixing the "how to pay for it" problem, no politician will try to fix the much more complex, and much more important problem of the very high costs. At the rate we are going, by 2021 US is expected to spend nearly 20% of GDP on health care. To address this we will need to cut the spending on last-6-months care as well as reduce procedure costs. Even if we address the latter, I doubt any one in congress has the spine to address the former.