>Hospitals have an operating margin of 2-5%.

I don't see you complaining that the US military has a low operating margin, so maybe we can just agree that some things are just normal expenses for a population. Which therefore leads to step 2: nationalize every single hospital.

>cutting salaries for doctors/nurses/etc

Considering that over 50% of the money that goes into healthcare is just siphoned off by middlemen, no, just getting rid of these means that your health workers do not have a worse salary.

>But, we're actually in a primary care shortage.

Because people do not even go see their GP since there's a chance it leads to life ruining expenses.

> fewer residents are going into family medicine.

Because they're going where money is. Remove that from the equation, and all you have is a public service with public servants.

>a lot of people in the industry believe that Medicare has a large amount of undetected fraud.

Aside from the fact that "people in the industry" have a financial interest in making you believe Medicare is a net negative, there's a great thing that comes from making healthcare a public service: there's no longer any fraud. And those "fraudulent" expenses you used to have that were costing you millions anyways have just had their costs cut in half.

>Healthcare reform is hard.

It's the easiest thing in the world when you have the amount of money the US does. Healthcare reform isn't a financial or infrastructure problem, it's a political one. Cuba has a working healthcare system despite being under US embargo. Botswana has a working healthcare system. Rwanda has a working healthcare system. Azerbaijan, Sri Lanka, Turkey, Serbia, and the list goes on.

Once you grow the balls to nationalize everything, even a first year economy student could make a plan that works.