It is a gross oversimplification to state that all patients should be treated according to some dictat handed down by protocol, but this is what is happening. Mindless protocols are replacing thoughtful deliberation, and patient care is becoming less accountable, not more. There are reasons some patients don't receive what Medicare thinks they should.
The government is practicing medicine by fiat. The hospitals don't care if its quality...they just want the rules followed. Physicians who deviate from the protocols are increasingly hounded by chart reviewers, who don't understand medicine...just the protocols.
Health care costs will inexorably rise as long as the government keeps sticking its fingers into the equation.