The opioid epidemic was caused the the corrupting influence of money in the medical profession. And your solution is to remove the only countervailing force - regulation - and turn the whole thing over to money-driven incentives?
I'm sure you're right, and without regulation doctors would be paid less. They'd make it up in direct sponsorships from pharmaceutical companies though.
Arguably, regulatory forces created the environment in which money could be used to so effectively manipulate doctors at the cost of patient outcomes. If doctors stood to lose business when they lost patients -- instead of fearing only for their license being revoked -- perhaps they'd be incentivized more to treat patients well than to engage in opioid schemes.
Sometimes well intentioned regulation gets it wrong. Sometimes it's perverted in Congress. Sometimes it's designed to fail. It is congresses responsibility to police themselves as much as it is the people's. When regulation fails fix the regulation. That's hard when Republicans are dying on the hill of Government Bad.
It's not a crazy thought at all. Many Americans see government in this light. Others do not:
"No one will really understand politics until they understand that politicians are not trying to solve our problems. They are trying to solve their own problems -- of which getting elected and re-elected are No. 1 and No. 2. Whatever is No. 3 is far behind".
I'm sure you're right, and without regulation doctors would be paid less. They'd make it up in direct sponsorships from pharmaceutical companies though.