I think you are on to something with all of these. For medicare, I don't think the problem is how much we spend but how much healthcare costs. Healthcare prices are actually set by a group of doctors called the Relative Value Update Committee (RVUC) that meets every 4 months. The meetings are in total secret and if you do get an invite to attend then you have to sign legal paperwork swearing you won't leak what you saw and heard. Here is one scam they run: the balloons used to do a sinus procedure cost $2600 each so the RVUC valued the cost of the materials for the procedure at NUMBER_OF_SINUES*2600 when only one balloon is typically used for all of the sinuses in a procedure. This is how these values get set and there appears to be ZERO oversight.