There is abuse of Medicare, and its not just fraud wherein doctors bill for ungiven service but where doctors unnecessarily increase care, which gets them more Medicare dollars.
This was pointed out in a TV program. And although Medicare officials are aware of this abuse, they dont do anything about it because if they ask for the doctors records, the doctors threaten to leave the program, saying getting all the records together costs too much. Of course, the answer to that is for Medicare to reimburse doctors for actual cost of providing the files.
But there are other schemes. One is that doctors of various practices form an association. In these, the primary doctor recommends unnecessary procedures by a fellow group member, as well as unnecessary tests conducted in their associations laboratory.
In one case I know of, the patient saw his new family doctor for the first time. During the exam, the doctor recommended a procedure to remove plaque from his carotid artery, which the patient knew from exams years before was blocked 50 percent. The doctor made no mention of the fact that during the procedure, some loosened plaque might get into the bloodstream and cause a stroke.