With all of the discussion regarding the changes that should occur in the health care system it seems odd that rarely any discussion on what role the patient plays in these changes.
How many our practices are being abused by the patient? How many of our patients actually believe that health care is free? Have the years of employer/government provided health insurance so insulated the patient from the cost that it will take an equal number of years to re-educate them?
My point is the patient is as integral part of the problem we face today as the insurance industry, the government and yes, even our practices. Why does it seem almost heretical to discuss the patient's role in the tough time we face? I think there has to be more reasonable expectations from our patients that they cannot have everything at a time when they demand it. Patients will have to come to grips with the fact that rationing may be coming. I also believe patients should face the consequences of non-healthy behaviors, be it through higher insurance premiums or a restriction from certain types of care. For example, why should the system be forced to pay the costs of the traumatic head injury incurred by a non-helmet wearing motorcycle rider? Don't get me going about tobacco.
What say you?