Preventative programs are now given lip service and dispensed of because of the realization that despite wellness programs 'shit happens'. All consults, procedures, medications, judgments are fair game for second guessing by someone who has never seen the patient and has no legal responsibility to the patient. If a person needs hospitalization a negotiation session develops between the physician and the managed care person for days or outpatient vs inpatient. It is not based on the needs of the patient but the negotiation skills of the two 'combatants'. The government can determine how to fix medicine, there appears to be no one in government who understands the process.
Specialists are responsible for the cost of medicine.
With or without them the cost goes up, likely higher without them. Reality speaks for itself. Most disease can be fixed by health life changes. Disease happens one way or the other. It builds a whole entity of its own which is very costly, very meddling, and saves no money.