When you have a system in which customers don't actually pay for the products and services they use, it is unsurprising that quality goes downhill.
That is not quite true. I used to do a lot of shopping at Sears and also Toys"R"Us but the investors pulled the same shit there as well.
It seems that we have an investor class that no longer cares to wait for a day for the golden goose to lay the proverbial golden egg; they will financial engineer that shit to extract maximum value right now.
By the plain language of this, it would apply to privately insured patients as well. No matter how pricey the plan, it's the insurer that controls how much is paid, not the patient -- and their incentives are to promise a lot, and then pay too little to cover it.
So, is a private insurance+hospital system likewise doomed to "go downhill"?