I disagree with most of the argument in the parent
> I think the problem stems from there being too many people in the profession that care about almost nothing
IMO you need to substantiate this claim.
> even a very small percentage of wildly greedy people can damage a system severely
This is medicine you're talking about. If the doctor doesn't have contact with patients, they aren't affecting them. I just cannot follow the claim that a greedy doctor can have an outsized effect. What is the mechanism?
(Half a joke, to make my point:) Greedy doctors aren't like greedy venture capitalists... It seems like they can only suck $500k out of the system every year.
There are amplifiers that increase the suck. One is physician ownership of diagnostic clinic(s). A strong tendency to order tests can be remarkably enriching, way more than a paltry $500K.
It's complicated. Physicians can own imaging equipment, for example, but they can't require you to use it for the radiology tests that they order. There are weird carve-outs for in-office ancillary services (e.g. you're an orthopedic surgeon who uses x-rays in your office, which is common and arguably necessary).
There's also rules regarding things like percentage ownership of physician owned facilities and the percentage of referrals to that equipment that come from the physician owners.
Urine drug screens in an in-office "lab" are another big source of revenue for certain specialties that involve referring patients to your own tests, or doing your own pathology on biopsies as a dermatologist or whatever. My understanding is that most of those things, and many like them, are not Stark law violations.
> I think the problem stems from there being too many people in the profession that care about almost nothing
IMO you need to substantiate this claim.
> even a very small percentage of wildly greedy people can damage a system severely
This is medicine you're talking about. If the doctor doesn't have contact with patients, they aren't affecting them. I just cannot follow the claim that a greedy doctor can have an outsized effect. What is the mechanism?
(Half a joke, to make my point:) Greedy doctors aren't like greedy venture capitalists... It seems like they can only suck $500k out of the system every year.