Medicare pays podiatrists to cut the toenails of seniors. The last time I looked, the government paid Dr X $65 to cut Mr Charm's toenails. To reach Dr X, we needed an appointment, and upon arrival, we had to walk down a long hall, Mr Charm had to climb up in a chair, and wait. And wait.
So I am bypassing the government. I now take Mr Charm (and myself) to the Vietnamese nail salon. No appointment. We park in the handicapped parking spot, Mr Tran comes out with a chair and helps Mr Charm into it. He helps him climb into the pedicure chair. Then he washes his feet up to the knees, scrubs the bottoms of his feet and removes any rough skin, and gives his legs a nice, soothing massage. He also cuts Mr Charm's fingernails. For this we pay $35, plus tip.
Why doesn't the government pay Mr Tran or his staff to cut toenails? Dr X could sub-contract the task. Mr Tran could be a paraprofessional, a parapodiatrist, if you like.