[Broken_Hippo]

Actually, they are incentivized! It keeps taxes down, which means voters are happier, and sometimes benefits people as well. It is a balancing act, since having bad care also makes folks unahappy or makes for bad outcomes and you wind up having to balance costs like paid time off and travel costs vs building more facilities (assuming you actually offer paid time off and travel costs for long travel, which any decent health care system should for better outcomes). I'll add that it isn't a fair comparison to use things like medicare to speak for publicly funded systems because things just don't work the same in other places.

You don't have to have recommended patent-drugs unless, of course, they are the best option. Sometimes the newer drugs really are better.