I've only worked in a few hospitals, but I have had the privilege of practicing in both union and non-union shops, so here's an example that I think simplifies one of the major issues I see in the health care industry. See if you can guess which of these is the union shop and which one is non-union (or, more accurately, anti-union - at least they were as of the time I practiced there).
One hospital I worked at had an RN-only policy for direct patient care. The only people who were allowed to lay hands on the patients, aside from drawing blood for lab tests, were RN's and MD's. There was significant literature and statistical support strewn throughout the hospital's mission statement, employee handbooks, the nurse's lounge, and even out in the halls in the form of posters suggesting (almost certainly accurately, in my opinion, for whatever that's worth) that patient outcomes improve when only an RN-or-higher professional interacts with the patients. We were assigned a maximum of six patients on the medical or surgical units, which can be a little taxing if the patients are more demanding (receiving active insulin drips, suffer from dementia, are in extreme pain, under the effects of hallucinogenic drugs, combative, threatening respiratory arrest, etc..) but usually the maximum six was pretty easy work. Compared to the nursing homes I've worked in, it was a cakewalk even WITH a load of six time-demanding patients, but the truth is that we probably averaged just a shade below five per RN.
Another place where I practiced had a little different outlook. They had RN's on staff, but they also had LPN's (Licensed Practical Nurse - legally can do just about everything an RN can outside of certain IV administrations) and CNA's (Certified Nurse Aides/Assistants. This is more of a manual labor, lower-skill* job designed to take pressure off the RN's/LPN's by fetching meals, refilling water pitchers, swapping out bedding, helping patients to the bathroom, etc..). In this alignment the RN had, usually, an LPN and a CNA assigned and they formed a team. The RN took care of the periodic assessments, coordinated with the doctors for order updates/changes, and administered any of the medications the LPN was unable to dispense while basically serving as the team leader. The LPN took care of the rest of the medications and helped out with the labor aspects when the CNA needed a hand. And the CNA did basically what I outlined in parenthesis above. This team was assigned a maximum 15 patient load, and they almost always had a minimum of 12. There was no literature in the nurse's lounge, or posters in the hallway of this facility, supporting their in-house system of direct health care delivery. It was simply the way they operated.
One of these hospitals was a union shop and the other was anti-union. One of these hospitals served as a major trauma center for a metropolitan area and the other was a small-town, rural-type hospital (although, to be fair, both hospitals were parts of larger networks which provided all manner of care spanning the entire spectrum).
Unfortunately, I applied for a job at the hospital I really wanted to work at but didn't get the post out of school. So I ended up working at the rural hospital instead.
*CNA's, in my experience working in a nursing home, are almost always the most important cog in the machine. They don't get paid much, they get too much asked of them, but they are the ones that the people who live there relate to and trust the most. I would 'go to war' with a much higher percentage of CNA's that I have had the pleasure of working with than I would RN's or LPN's who I have encountered professionally.

and most likely higher, depending on how far along in their schooling they are. It's a funny thing regarding med students, though. My only experience in a teaching hospital (where MD's are trained) was brief and it was in nursing school. But basically they (med students) operate outside of, but parallel to, the standard hierarchy in most cases early on in their schooling. So a med student's patient assessments, observations, and such are largely independent of the primary care delivery process (which goes, roughly, Assigned MD --> Physician's Assistant (if applicable --> RN/Respiratory Therapists (they're pretty even when RT takes a direct role in patient care rather than a supporting one) --> LPN --> CNA/Med-tech/Lab-tech/etc..). So a med student, while attached to the team briefly, isn't directly responsible for much other than the procedures they perform (again, my own experience is extremely limited but if you watch TV shows like ER it *seems* that my own experiences line up with those of others). They still make notes on the charts, and they can even order-and-perform procedures with their supervisor's approval, but they kind of exist outside of the delivery chain. I hope that didn't confuse.
But definitely a med student is 'RN or higher' by this particular metric since they're trained in a whole host of things RN's never learn to do (direct wound care, diagnostics, lumbar punctures, and central IV line placement to name just a few). Even when they haven't been trained in those things, a med student has far better theoretical background for analyzing patients than an RN does, although after five or ten years on the job an RN can usually out-diagnose the vast majority of starting med students.
Regarding the literature and statistical data supporting the notion that 'RN or higher only!' is preferable, the majority of the linkage between improved patient outcomes and higher-skilled contact seemed to stem from early detection of condition changes. For example, a patient with COPD (Chronic Obstructive Pulmonary Disease) who only had RN's interact with her would have a higher probability of a pending arrest or critical event being detected and dealt with before it became life-threatening. The actual delivery of care didn't seem to correlate positively in favor of the RN's (actually, if I remember correctly, it was slightly pushed in the other direction since each member of a team like I outlined above (RN+LPN+CNA) would be able to specialize in specific techniques and deliver superior direct care, whether it was ambulatory assistance for post-surgical patients, or dealing with combative patients, or those with dementia, etc..).
The 'RN only' approach was very much a 'one size fits all' approach in a literal sense, and while cooperation between nurses did occur frequently (one nurse may be better at placing IV lines, for example, and would often be called on by her co-workers to fill that role when dealing with a person who had particularly difficult veins) there was a chance that everyone would be too busy to help out, or that someone possessing that particular skill wasn't working at that particular time, leaving someone like me (who wasn't great at IV placement) to try an extra two or three times before succeeding. The plus is that the 'floor' of care quality is set at the minimum standard of an RN, which is to say it's definitely higher than that which a non-skilled person would be expected to deliver. But the downside is that everyone you see when you're in a hospital with this type of policy is going to be paid RN wages - and I already went into how that can, actually, make aspirin cost you $12 apiece when delivered by a nurse. This is, as Doc points out above, most definitely related to the absurd levels of litigation in the USA. It seemed like every three months the hospital I worked at was updating its policies in direct response to a major case going against a health care system which created new definitions of culpability for health care professionals. I'm not saying doctors, nurses, and others involved in health care don't make mistakes and shouldn't be called to answer for those mistakes, but we are well past the point where making your health care workers think about, and address, professional liabilities is a net positive. At this point all we're doing is increasing the costs of health care to cover the liability end, which prompts people to file greater numbers of suits when things don't turn out how they had hoped, and that is the very definition of a vicious cycle.
My own strengths were, oddly enough, social; when dealing with people who were hallucinating, or suffered from dementia, I always got better responses from them than my fellow nurses. Part of it is that I'm 6'2", dark haired, and have a pretty powerful voice (I only ever yelled when dealing with alcoholic dementia) with what many have described as an expressive face. So I could always get people to focus on *me*, rather than whatever it was that prevented them from doing so with others, and more often than not I could help them calm down when they were distressed (which is a very real plus, since hallucinating or demented patients are at extreme risk for falling, and hospital floors aren't exactly soft). I was also the best with little kids; again, I think it's my dark eyebrows, expressive face, and reasonably deep voice.

I tend to focus on the labor cost aspect of US healthcare, but your second to the last point is also incredibly well-taken.
The phrase I hear that absolutely sets me off is one that starts with, "The least we can do..." when dealing with patient care decisions. The harsh reality is that the 'least' we could do, is nothing. That's where the conversation needs to start, and I think that if it did our entire society would take a different view of healthcare in general.
One thing I say to my girlfriend all the time is, "Two hundred years ago we didn't have names for 80% of the stuff that killed us. We just 'got old' and, invariably, died. Nowadays we have names, and treatments, for everything that killed the elderly a century or two ago and nobody even stops to think about whether or not we should actually DO those things."
I've seen people living in abject misery and barely-mitigated suffering whose lifespans have been prolonged, but whose lives have been completely destroyed, by the healthcare system in the USA. I've also seen people recover from afflictions which would have been utterly untreatable even fifty years ago and go on to live fulfilling, happy lives. Somewhere along the line a decision is being made (or, more worryingly, NOT being made) as to just how far we should go with healthcare delivery.
I love my grandmother dearly, and spent my entire childhood within walking distance of her house. I have countless stories of how she shaped my life, and I will forever speak fondly of her. For the past fifteen years, however, she has been in and out of the healthcare system and has cost the country over a million dollars. I'll say again: I love my grandmother dearly, and if you don't believe that it's best you keep it to yourself. But who, exactly, is paying for that care? My grandfather and her never even sniffed contributing a million dollars to the system (and I do understand the concept of earned interest, net present value of money, and other fairly basic economic principles, thank you very much), so I start looking around my family and adding up our direct contributions to social programs like Social Security and Medicare. You know what? Even if you added all of their children's contributions, they STILL don't make up the bill. You have to get down to us, the grandkids, before you can even think about satisfying the debt. So who's paying for all of this - and, more selfishly, who's going to pay for ME if I decide to avail myself of the same care late in life? (If you think that wealth redistribution, of which socialized healthcare is often recognized as being a part, is anything but an illusion then I will calmly assert that *all* costs are eventually passed on to the consumer, regardless of political rhetoric.)
This is a new problem for humans, because until the last couple of generations we haven't had access to this level of healthcare quality or availability. So I understand the delicate, sensitive nature of the situation fairly well, but we are ignoring the elephant in the room and doing so might be taking us down a very, very dangerous road.

with Doc. There is simply no comparison between the education I received in my seven years of home schooling and the ~six I spent in public schools. (Community) College was a different deal, at least for me, because I was working toward the RN degree from day one. But there were plenty of people there (probably half) who saw it as nothing more than an extension of high school.
I was pulled out of public school at age eight, and by age thirteen I had completed everything my home school network required for me to graduate high school legitimately through one of their partner/affiliated schools. I decided at age fourteen that I wanted to wrestle, so I postponed graduation and went to high school for a couple of years, marveling with a slack jaw at just how little was actually being taught in the classrooms. The AP classes were a bit better, but the homework loads were so onerous that I bailed on them. I aced very nearly every test ever put in front of me, so the idea of doing 3-4 hours of schoolwork AFTER I left seven hours of school was something that never did, or will, sit right with me (note: my TOTAL schoolworkload, if that's even a word, during my home school years was ~1.5 hours per day, and that included blasting through high school from age 11-13 because, frankly, I didn't want to draw the whole thing out any longer than absolutely necessary. Though to be fair to the comparison, my older brother needed about 2.5 hours per day to accomplish largely the same goals.)
I'm 33 years old, so my experience is probably still within a couple of degrees of what's going on nowadays in public schools. I have yet to meet a parent whose kids were home schooled who didn't have great things to say about it. I've known a few people for whom it wasn't a great fit (my sister, for one, and we kept her in public school after trying at home for a couple of years) but the vast majority are simply amazed at how much their kids learn, and how much extra time they have on their hands as a family. Read any study of home school outcomes vs. public school outcomes, even those normalized for family income, geography, and parental education level, and they all have the home schoolers ahead very nearly across the board. Even the socializing aspect, which frequently gets brought up as a supposedly self-evident negative facet of home schooling, shows that home schoolers are better adjusted socially than their publicly schooled counterparts. If you can't do it better institutionally compared to doing it at the home, then you probably need to overhaul (or scrap!) the institution, no? That's what a free market would do, anyway...
Now, obviously, a stay-at-home parent is a seriously beneficial component of the system, but a grandparent works also if the kids are ~well behaved. But my mom once said, in her usually concise fashion, "It takes me less time to help you guys with your schoolwork each day, here at home, than it does for me to prepare your meals, drive you to school, and pick you up again each day. This is a no-brainer; now let's do some anatomy! ::begins cutting open a cow's heart*, eliciting 'ooh's' and 'aaah's' from her spellbound children::"
To my mind, and based purely on my own personal experience at a high school with over a thousand attendees, the modern public school system is little more than a disgraceful daycare system filled with political agendas that are forced on the attendees. That's harsh, I know, but it's how I see it - and how I saw it when I was wrestling for those two years. It is a colossal failure on every level imaginable. Even Diderot's example of school shootings, which are generally blamed entirely on guns, owe the basis of their existence to this horribly failed system.
*during this particular anatomy lesson we learned the names of the various structures of the heart, drew our own versions of them, and were quizzed on said structures for several days. After we had passed that particular course, we ate the heart. It was chewy, but good. My mom was an amazin' cook ;-)

This is always the perfect argument to an outsiders criticism of poverty in America. How many of other nations poor have color TVs and cars and cell phones? If someone is malnourished in this country I am willing to say its from an act of criminal negligence. Between EBT cards, food banks and religious charities food is available for those truly in need. There is no excuse for not utilizing available help.