Medicare for all should be a hard nosed service that only pays for good enough

     With Next for Obamacare Could Be Medicare for all Professor Frank makes a good point, which is that a government provided minimum health care service is where we are heading. If so then it should be a system that freely uses clinics and para medicals as gate keepers and is administered by hard nosed types who only pay for good enough services and drugs, generic off patent ones only!  An insurance floor that directs the public to supplement their coverage to take advantage of the latest medical advances and services.
     Medicaid comes of Age showed my ignorance, nevertheless a minimum level of health care, much like a utility, is our national reality so Congress should maximize competition on low level health services and drugs by minimizing barriers to entry.