Unfortunately the issues you describe below are not limited to Medicare patients.

I am enrolled in one of the region's biggest HMOs, and I've already related a few of my observations regarding minimal care and attention by many of the providers. Our original family physician dropped patients insured under the plan because of the reduced compensation for services, and he did not want to lower his quality of care but he determined he could not serve those patients for the amount he could bill.

We went through a couple of interim physicians who came in for 5 minutes then ordered lab tests that didn't solve anything before deciding to drive all the way across town to visit a physician we know personally. We receive great care, and excellent personal attention. Our plan has no limits on the number of visits, we have no deductibles, and the copays are minimal. Even so, we visit only when we NEED to.

Obviously each person has a different view on what medical care constitutes "necessary", but the only way I can think to control it would be to have spending limits for routine care while providing necessary and prudent treatment for catastrophic illness or injury.