Yes re the system. Not having perfect health, I am just navigating the morass of trying to get out it. Basically, you have to keep Part A, which kicks in for hospital coverage, and file an affidavit with Medicare to drop Part B ( doctor visits). Part D is Rxs, which I think would also terminate. If one drops Medicare B, I don’t think you can keep supplemental private insurance, so you are going all direct pay. Medicare has the effect of stripping you of the choice to pay for private insurance. Of course, we could move to Italy which has big problems collecting taxes and is not popular with the EU bankers.