Medicare is an excellent option for seniors and disabled persons. To survive, it like any other business, must operate like a business.
Businesses negotiate bulk purchasing contracts to reduce costs. Medicare should do this with prescription drugs. This would result in reduced costs to Medicare and its recipients. Savings from this could be used toward elimination of the doughnut hole.
Eliminate Advantage Plans. These allow insurers to flood the market with confusing products that claim to produce savings to participants when in fact they negotiate contracts with medical providers that pay them several times what would normally be paid by original medicare. This drives up the cost to Medicare and to recipients
Do not reduce payments to physicians. Control costs of duplicate tests.