Politicians must face the political problem posed by wealthy, high-risk users of Medicare who would be worse off should the system be made more competitive and fairer. Politicians cannot compensate all and will have to decide who cannot afford to lose Medicare benefits.
To control costs, the government will be forced to increase wait times for medical treatment. The best treatment will either be for those that can pay for it or those that can pull strings.
By using the law without any overview to punish doctors for procedural errors that are hard to get correct, it causes the principle of certainty before the law.