What do you do when broad changes ARE required?

Unless broad changes are made, incrementalism becomes the self-fulfilling standard. Once incrementalism is the standard most all changes aimed at effecting a large population "success" are muddled compromises. Oftentimes meant to fail, or just often do because they get "half" the money and-time to succeed.

This means most bigger, one-off changes become bad and-or failed ideas in the public psyche. It becomes a vicious cycle of almost no real effective change. Therefore the providers continue to mostly benefit, and the masses continue in some comparative degree of squalor.

As to doctors and other not making "enough" money, that is a "free" market consumerist built expectation. Corporations fostered that and pushed governments to accept their goals so it was a self fulfilling prophecy. Many doctors don't do it for the money, and many others may not have if we hadn't elevated the consumerist focus in the way we have. Some of it is human nature, but a lot is also incentivising by the corporate culture.