I would like to point out its not always the patiants fault I often get treatment orders up front I have no hope to follow up with. Case in point I had a leg infection and was in the hospital almost a week ,yes I paid the bills the charity care law eliminated all hospital charges, but the doctor ordered a $1500 antibiotic (10 pills) and I was clear I did not have that kind of money. I insisted he find something I can afford or I would not sign any release papers and when he did not take that seriously I did just that. A visiting Indian doctor suggested a drug available at Walmart that cost $4 for a ten day course of treatment (40 pills for $6) and it worked fine. My follow up was not an issue. But the prefered drug was for me astronomical in cost.
So what is a patiant to do if you say this to most doctors its like talking to a brick wall that money is an issue in care. I would argue most of the time its this case we are not bad patiants just have to be realistic on what we can and cannot do.
A fine example of a big part of the problem, RubySlippers: the $6 treatment did the job, so why was your doctor trying to spend the extra $1494? How many patients with the "Cadillac" insurance Congress denounced (while quietly retaining for itself) would just have handed over the $1500 from their insurance company's funds without quibbling or even thinking? That's the problem with Trieste's $400 contraceptives becoming "free" ... what will stop her doctor up-selling her to the same pills for $900 from the company with the hotter sales rep, or encourage her to switch to a $100 treatment that does the same job?
I've been away lately (illness in the family), and see a lot more posts on this subject since I started on this reply - all essentially pointing out the problem with the "blank check" mentality. HMOs were supposed to fix this sort of thing - they'd have contracts with the hospitals they use, ensuring they can veto the $300 teddy bears and object to paying $300 for a $10 wrench - but there seem to be obstacles to that now, often from well-meaning people thinking an HMO must be evil if it tries to stop the hospital buying the most expensive tool in the catalog... Why isn't there more anger about that? Maybe someone could do an exposé documentary - instead of posing in Cuba, get the $300 wrench from the medical supply company and the same one for $10 from Home Depot, the teddy bears, etc, and try asking the people involved about the insane prices.
It's a bit like the recent debit card processing fee change - the companies were giving some services away "free", then making up for it with hugely inflated charges for the other services. Half of the $300 teddy bear fee will be going to pay for other things: the loss they have to eat on Medicaid patients, for example, other bad debts... That, getting back on topic, was the one area ObamaCare was
actually supposed to address - although it accidentally prohibits the introduction of fraud counter-measures in Medicaid, as well as imposing massive cuts in Medicare.