Once, before the private equitification, the fun thing was to run your own dialysis clinic and handle your patient till they’re ready to get you another Medicare client who provides ARR till they die.

In other countries this would cause the medical practitioner to lose their practice license for life + get huge fine and depending on the damage they could be judged and even serve jail time. This usually deters anyone from doing such things as they already earn good money. As for the ones trying...well, they end up serving as an example.