Serving Two Masters: Patient and Bureaucrat

Most doctors want to serve patients. But there is a conflict: the patient is not the one who pays the bills. Instead, the customer that health care providers must learn to serve is the private insurance company or the government program. If doctors want to get paid in today’s environment, they have to play by rigid third-party rules imposed by employers and government, not patients’ choices.

Reducing our reliance on third-party payments will not be easy. Our moral instinct tells us not to take advantage of someone in distress. That translates into a reluctance to have individual patients pay for their own health care services. Unfortunately, insulating consumers from the cost of what they buy is incompatible with efficiency. In health care, third-party payments force providers to serve two masters—the patient and the bureaucrat.

~From Cato Institute's Briefing Paper "Does the Doctor Need a Boss?" by Arnold Kling and Michael F. Cannon