I don't disagree with your opinion that people (doctors and patients) are willing to allow taxpayers to pay for services that we shouldn't be on the hook for - but I would doubt seriously that the people who take advantage are limited to the "wealthy and conservative". I spent many years working in medicine caring for indigent people, then in a private care environment. The people I cared for weren't necessarily trying to "scam the system" in either place. They looked at what was paid for by THEIR tax dollars and asked for those services. From their perspective if the government pays for it - it's not wrong for them to have it. I think our primary problem is that our country has huge, unwieldy bureaucracies that are poorly set up, poorly thought through and poorly managed. What do you do about that?