Even leaving aside government provisioned care, there are several simple ways Medicare could use its massive purchasing power to control costs. Part A could take into account alternate available treatments and their effectiveness-adjusted-cost when determining what procedures to cover. Part B could coordinate care through a single gatekeeper physician. Part C could be eliminated, as it was a cost saving experiment that failed. Finally, Part D could negotiate with drug providers on behalf of the entire pool instead of delegating negotiation to dozens of insurance companies, each with smaller pools.