Part of that is it was very very hard to know back then what was needed and what would work. Now a lot of the fundamentals are well hammered out and the big challenge for SpaceX was the landing not figuring out how to build rockets in the first place.

Also the ACA did have some successes in doing kind of what you're talking about. There were incentives in there to avoid readmittance before 30 days and to all appearances it's been a success.

https://www.statnews.com/2016/12/27/obamacare-success-penalt...