Ejecting illegals from our country would be the best place to start. After that, reforming consitancy of care standards is most important. Start a timer as the metrics.

I receive 45 minutes of awesome attention from my Medicare paid provider four times per year. His staff attends to prescription refills and prescription adjustements. He has memory recall of over 2000 patients without pulling my file and knows my health problems first hand. He has called me at 7 PM after a long hard day to ajust medications. Under Medicare, I could demand treatment or medical visits several times per week from as many physicians as I chose, because there is no financial disadvantage. I could visit providers as quickly as I coud arrive, if that was a choice. There needs to be financial disadvantage for taking what one does not need. Folks should take what they need, but not more than they require.

Other physicians couldn't attend patients faster unless they built the exam rooms on a carousel to shorten the visits. They scan lab test in pretext of providing care, but it is negligent care. They would not know my patient history. The Medicare billing numbers are not really relevant for compenstation between a one minute manager and an involved physician. They are paid the same rate.

I know patients who seek doctor attention numerous times per week, just because the Medicaid system allows that abuse. There is no benefit for this intensive and distracted care. In fact, it is harmful. I had an aquaintance who had three to four doctor visits per week, because there was no financial consequence for his demand for services. In one year he spent what I cost in ten years. And at the end, he had dangerous surgeries that harmed him, because that is what he wanted to hear for advice. If one seeks enough opinions, you can find someone who will harm you by accident or by intent.

I think people should receive the care they need, but not demand or get care that does not help.