Thoughts from a libertarian family physician (where did it all go wrong?)

I am particularly cynical today, so I thought it might be a good idea to vent on one of my favorite websites.

This whole medical misadventure began quite a few decades ago. Years ago, all of health care was cash pay, barter, or charity. This worked out just fine. A physician basically needed himself, his clinic, and his nurse. He took care of the patient, and was payed a modest sum. The patients were taken care of. Then along came "insurance". Insurance was initially just for hospitalizations (isn't it supposed to be for this?). Unfortunately, it was abused, and routine tests that could have been taken care of on an outpatient basis were done in the hospital. Instead of logically changing the policies to make sure that only people whom belonged in the hospital were admitted, we all decided to do something different. Then along came health insurance for outpatient coverage. At the time this was about as logical as paying a monthly premium to insure your 20$ wrist watch. Naturally, with all of the little things that take place with routine medical care the insurance companies realized that they had to do some cost containment. So, they built a massive amount of paperwork into the system. That doctor and his nurse had to hire a bunch of people just to handle it, and this contributed to the price increases. Of course there were other things. Technology did contribute to this, but not as much as one might think. We also became a fatter, lazier, society; and this ushered in more and more people with chronic, costly medical conditions. Unfortunately, unlike all other forms of insurance in which the consumer has signifiant influence on the cost of their own premiums, health care really did not have this in any appreciable way. The fat, lazy american was and never has been held financially responsilble for their own health outcomes. I would hate to forget the way our society became increasingly litiginous. It was easier to sue your doctor that seemed to be just a part of some big out of control machine than it was to sue the guy that delivered your kids for "whatever you could pay" years ago. Doctors had the knee jerk reaction to cover their buts. Then along came more excessive testing, and excessive documentation, and the increased costs that came with hiring all of the people to support it.
Of course, the government in all of their infinite stupidity, had to show how to really make an inefficient system even more inefficient. This brings up medicare with all of it's lopsided reimbursment for more excessive procedures. Medicare was such a large machin that all of the rest of the health insurance companies had to follow suit. By the way, the democrats and republicans both have had their hands dirtied on this one.
Well here we are in 2009. I would love to type more,but I have to see an ER full of medicaid mom's that bring their children in for a runny nose.
I Just thought it might be a good idea to review how we got here.