Medicare solutions

Having retired from working in the hospitalas a registered nurse, I've some ideas regarding solutions for saving medicare. First, a great deal of money could be saved by having patients pay a small co-pay (sliding scale basis) for Drs visits. Second, each medicare patient should have either a Nurse Practioner or Physicians Assistant as their primary care provider. They have prescriptive authority and would transfer patients to a doctors care if needed. Third, patients should have a follow up educator for nutrition, and exercise following major illness and surgery that has been caused by smoking, obesity, and other self imposed ailments. If people refuse to make healthy changes, they should not get the same surgery over and over. Example, a obese man has clogged heart vessels. He has a major surgery called a coronary artery by pass graft, sometimes done on all major vessels. After discharge from the hospital, he makes no effort to change his eating habits that clogged his vessels to begin with. He eats fatty food, hydrogenated oils, and never exercises. We cannot afford another $100,000.+ surgery every year. Help me tell our politicians we can save medicare by co-pays, different primary care providers, and limited surgeries at the end of life.
Thankyou for your support.