An amendment to the constitution can be proposed by?

Article V describes the process necessary to reform the constitution. It establishes two methods of proposing amendments: by Congress or by a national convention requested by the states. With the first method, the Congress can propose an amendment with the votes of two thirds (of a quorum, not necessarily of the whole chamber) of the Senate and the House of Representatives. With the second method, the legislative bodies of two thirds of the states can summon and force Congress to convene a national convention, and Congress must convene that convention in order to consider the proposed amendments.

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health care plans in the united states having high costs because they are focusing on providing quality programs for different groups of individuals. the quality of the service is based on money flow received from the members. without this investment, couldn't be possible a constant scientific searching to prevent death and illness caused because of low levels of health investigation. currently, the complaints are not about the highest cost, but about the coverage and benefits to access the necessary health services required by the members.  

besides, if a global health system is established the quality levels will fall down because of the standardized of the health. the access to care will increase but the quality will be low because it depends on the money invested.