“Doctors and patients being the decisionmakers is fine - it fact, its the only way to fly.”
One more element must be added....payment terms are between the doctor and patient as well.
With that, you have a way to fix the system.
Frankly I think completely eliminating SS, medicare, and medicaid - COMPLETELY is the way to go. That’s the only hope - though some will see it as contradictory, especially those on SS, medicare and medicaid.