For the love of God, don't do this. This will mean MBA's do 2 things:
1) on the medical provider end, find every possible excuse to charge 1% more and pay it out to themselves, not using it for patient care
2) on the insurance/government end, find every possible way to charge 1% less, no matter the cost
So yes "let science decide" means to let doctors decide what care to provide (meaning you'd need a difficult admissions test for this class of people). Yes, they will cheat, which will benefit themselves, but also patients. And there's a limit, because doctors are fundamentally limited. And then you just eat the cost, and have a board (IMPORTANT: of doctors) weed out the worst abusers on a regular basis. And yes, if a doctor says "spend X on this patient", then we spend X on that patient. End of discussion.
And yes, this is probably "mercantilist" instead of capitalist, and provides a fundamentally unfair advantage in the economy to people who manage to get the degree of medical doctor. In trade, you get good health care.