This seems like a troll post, but I will bite in the spirit of hn and consider it very serious. The brain drain idea is a fallacy. These aren't doctors who will flee to private practices away from Medicare spot where they can earn more money. These are elected public representatives of the people. More power translates to more corruption and tyranny, and I'd be 100% opposed. Our government would be approaching near complete erosion of trust and values if we further empowered these people to become elected privateers. That may be silly to say given how low trust and value are at the present time, but this notion of empowering them to earn more money feels like it would be a defining catalyst moment in future history books to where it all went wrong for the American Republic.