I suggest that there are two types of patient; the problem patient and the compliant patient.
One thing the USA must reckon with is that with universal care, it becomes harder to ensure everyone gets served. Everyone who wants healthcare, be it an extension of Medicare, Obamacare, or something like MassHealth wants everyone to be served. However, if we have universal coverage, then we face the problem of burned out healthcare workers. For example, in the instance of heroin overdoses, everyone either should want, or actually wants for that person to be served, but the problem is that there are limited resources. For example, there may not be enough ambulances.
So here is my suggestion: we keep universal care, but create a two tier system.
One tier would be the medication compliant patients that demonstrate effort in trying to get better.
The other tier would consist of patients that refused medication; those that make no compliance effort of trying to follow a treatment plan in order to get better.
The reason for this two tier plan is so that for example, repeat narcotic abusers who overdose may have to wait longer in order to get served, because they would be a second tier problem patient. Nobody wants to see anyone die for any reason, but the healthcare community owes it to its clients to treat the people who actually want treatment first.
Also, I suggest that these two healthcare tiers should not be made permanent.
If someone decides to quit their medications against doctor advice, this should transfer them from the compliant tier to the non-compliant tier.
Differently, if someone wants to improve their medical rating, they should also have the chance of proving that they are fully medically compliant or want to be fully compliant, such that they have the right to be among those to be served first.