One of the huge issues here that is hindering change was masterfully placed by the government years ago. Go back 10-20 years and walk into a doctors office. Your primary care physician had everything that was needed to take care of you there. Labs were there, Xray machines were there, EKGs, Lung Function Tests, etc.... Now fast forward to our time and almost none of it is there. It's all outsourced, why??? Because the government has determined physician reimbursement for these things and they have decided that they don't want pcp docs having these things in their offices anymore. So they have made it where it is not very profitable, and in some cases it can decrease you income. The system they set up allows us to bill a little higher for that office visit but have someone else at a lab company run the tests. And the gov will gladly pay both because it takes autonomy away from docs and makes them more dependent on other people...
I think this has been a long time coming and the only way it is going to stop is if physicians will get it out of their heads that they don't need a guarantee. See that's the deal with the gov or any sort of healthcare system set up by them...they guarantee physicians that they will keep their earning potential as long as things keep going the way they are headed.
But if a doc sets off of his own to try and take care of patients the right way....well, that's just not heard of in today's society because of the fear and risk of not being successful. I mean, most docs have 200000 or 300000$ in debt alone, not to mention young families starting around this time of life, and who wants to work their asses off for years to get into a field they love and then be unsure if you will be able to survive.
The gov is also forcing docs to do things their way by their loan forgiveness programs for physicians - making them work a certain amount of time, in the system that the government wants them in, and then forgiving all outstanding loan debt after a period of 10 years. But by this time docs are so conditioned to doing things the way they have been done, chances of change are little to non.
Healthcare can change, but it has to start with the men and women that are responsible for it. Not the government, insurance companies, etc...but the doctors and nurses. We need to have a different mindset and until this happens - healthcare will continue it's slow grind to death.