does it make sense to simply use the existing medicaid system, and extend its reach to include uninsured americans, instead of starting up a whole new system?
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Well, I have dealt with medicaid before. It is not easy. It is run VERY inefficiently, has a VERY limited network and super huge waiting lists for almost every service that is not general practice. It sounds like a good idea, though I think they need to get rid of the HMO's that are involved with it. They should also speed up the process to pay the doctors for their services. It needs some serious work done to it, but I think it could work.
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