In years past, a doctor had the authority and power to decide what treatment and/or modality was appropriate. Each health care provider chose the remedy, relief &/or intervention based upon the following: (1) a specific diagnosis; (2) a tentative diagnosis [provisional]; &/or (3) a differential diagnosis [generally, that which relates to multiple conditions or causes that are based upon probabilities].
As medical insurance, Medicare, Medicaid and now Obamacare (officially entitled the Affordable Care Act) have intervened, their coverage for treatment rendered by a physician has been strictly refined and restricted, as well as subject to interpretation more often than not by lay individuals. These current business and regulatory systems in place seek to justify their role by pointing to, among other things, the nature and amount of waste, and their goal to make our health care better. In doing so, they often perceive medical treatments as increasingly suspect. As such, the scope of coverage of the third party payer system has continued to place limits on physicians, hospitals and other health care providers, along with using monetary incentives to achieve their political and business goals.
Clearly, there are many who support the current scheme and, therefore, contend it is designed to produce an effective health care system, albeit conceding it is far from an ideal one. The opponents assert this system will inevitably lead to the rationing of medical care with a much smaller group of health care providers who choose such a career and, therefore, less available to serve the public, fewer innovations, and eventually far less medical research. In addition, they cite other countries that have socialized medicine and the inherent problems therein, including but not limited to the increasing waiting time before one can obtain an examination or evaluation; the length of time until one can obtain certain procedures and treatment; the inability of the physician to choose the nature and extent of care deemed appropriate; and, the growing trend to depersonalize the health care system as a whole. The debate continues while the ability to produce a better result is limited as each side remains polarized, and at times vilifying the other.