This is not the time to enforce the law; this is the time to change the law so that the system can cope with the volume.  

Doctors must be permitted to extra  bill at market rates after satisfying a minimum number of medicare billable  hours--- say 25 hours per week over 45 weeks per year.   

And hospitals must meet a number of medicare hours per year too, determined by the budget allocation they get from the government.  Thereafter, they can charge doctors for services... such as OR use... this will enable them to create business plans to expand services based on anticipated extra billings.  The additional expansion will  come from private fees and add to the government funded hospital services.