In Boca Raton, Florida, doctors frequently lock their doors at lunch in order to prevent Medicare patients from crowding into the office while they’re away. One doctor commented that these patients have few serious medical problems. Rather, visiting the doctor has become a social activity, in which patients “bring their spouses and plan their days around their [doctors’] appointments” [Kolata, 2003]. What is there about the structure of Medicare that leads to such situations?