Health care for the elderly in the US is almost entirely paid for by a government health insurer and has been for 44 years. This will not change under any plan under consideration. Thus your concern about end of life care is not necessary.
My father was on Medicare. If you think there are no concerns about end-of-life care, than I think you need to do some more research. I had to be extremely vigilant whenever he was in the hospital to make sure they didn’t issue a DNR. There was a time I walked into his room and saw that someone had issued a DNR in my absence.
The VA does the best job of the three, since they do not pay-per procedure (possibly the main reason for health care inflation), and has a strict, evidenced based formulary.
I had a friend who received his health care through the VA. He has since passed away. He used to receive his supply of insulin through the mail. The VA decided it would be cheaper to send it in padded envelopes rather than insulated containers. Do you know what happens to insulin when it sits in a metal mailbox in Alabama in the summer? It becomes worthless. But the VA managed to save money. They also wouldn’t give him the proper amount of heart medication because it was too expensive. So if we are using the VA as a model for health care, Heaven help us.