Do you have an example that doesn't involve an objective metric? Of course objective metrics won't turn bad. They're more measurements than metrics, really.
Doctors, especially young doctors, are not the wildly greedy people you paint them to be. There are dozens of easier paths to riches these days than medicine and we all know it. My medical school is "cheap" and tuition + cost of living is ~$90k/year. Then, we have 3-7 years of residency before we start making the real money which is less than any generation of doctors in 100 years. I could become a senior software engineer at a Fortune 50 company in less time than it takes to graduate medical school and be better off financially than most doctors. Ask me how I know.
"But even a very small percentage of wildly greedy people can damage a system severely."
You are close to placing the blame in the correct place. My emergency department was just bought by a private equity group. There were 28 doctors. Most of whom worked there because they could spend adequate time with patients and work a reasonable schedule. After the PE company bought us, they mandated less of EVERY position from CNA to MD. The MD headcount is now 11, and the 17 physicians who are looking for jobs are having a tough time (relatively) because most other emergency departments in the area are also owned by PE firms who care about money over health outcomes. Those are the greedy people damaging the system you are looking for.
It should inspire confidence that we have moved beyond that for many types of cancer. And if it can be done with cancer treatment, we are closer to doing it with autoimmune and anti-virus treatments.
I am here to restore your confidence about autoimmune issues.
Recently (and still in many cases) "turn down the immune system" was the treatment for most cancers. Of course, the purpose of anti-cancer drugs isn't to turn down the immune system. It just happens that the side effect of drugs that target cancer cells also target other rapidly-dividing cells like hair, endothelial, and immune cells.
In fact, chemotherapy drugs like Methotrexate are prescribed - at lower doses than for cancer patients - to people with Lupus and other autoimmune diseases.
There are similar challenges with cancer and autoimmune diseases, so progress in one might help progress in the other.
From the article: "They are now working to find ways to deliver these molecules safely and effectively to people." This is a challenge for many potentially effective cancer treatments as well.