It is straightforward.
You have not communicated what context you mean.
Trump's response was SPECIFICALLY to Letterman challenging him to show there was waste and fraud in the system. Saying that he sees invoices with such is NOT saying doctors should be paid less, just that there should not be the level of waste and fraud that we have now.
You might try actually watching the 2nd video with Letterman instead of just swallowing this drivel because you like the taste.