We already sort of had that in Massachusetts. For hospitals that treated large numbers of free care patients were given flat grants to cover operating costs. (

We already sort of had that in Massachusetts. For hospitals that treated large numbers of free care patients were given flat grants to cover operating costs. ("Free care" covers people too poor for health insurance or to pay for treatment and too young, childless, employed, healthy, etc. for Medicaid.) However, it is politically unfeasible, because people can't see what the money is being spent on and it was eventually eliminated to "save money". Even though local hospitals had created programs that helped lower costs and provided better care to populations normally ignored. People care more about punishing poor people than they do about saving taxpayer's money. Otherwise drug testing for medicare recipients wouldn't be a thing.