Moving toward two "classes" of healthcare?

Much of the general public is getting outpriced by current insurance premiums, hospital bills, ect. I doubt the ACA will end up being adopted and so there will be tons more people, especially with pre-existing conditions, unable to afford health care. Now, the option is to let them stay uninsured like they are now, but that will not be supported in the future as the number of people unable to afford healthcare keeps increasing. Thus, either the government will promote medical tourism (doubtful) or allow for a whole new class of healthcare provision by low-wage mid-levels for these poor people. The care will not be as good but it will be better than nothing. The consequences of this is that physicians will be left to only take care of the wealthy elite who can afford their services. This is not good for the profession both ethically and financially but there is not much else possible with astronomical healthcare costs and similarly astronomical medical education costs.