Until recently most medical practices consisted of at most three partners, a receptionist and a nurse or a nurse/receptionist. An office visit was within range of the average person and doctors were able to allow a patient to "payout" a bill over time, even for conditions requiring hospitalization. The average person could afford to pay out of pocket and used medical insurance for big expenses thereby not driving up his premium.
Today most medical practices have more categories of employees than a military regiment. Malpractice insurance rates and frustration with insurance and governmental regulations have led to early retirement for many physicians. Diagnostic testing has become increasingly expensive. Hospital costs have risen astronomically. Today only a wealthy person can pay for most medical expenses. When medical treatment can rise into the tens and hundreds of thousands of dollars and even more even the wealthy can not afford the costs.
However, We all benefit from the increasingly effective diagnostic and treatment advances of the past few years. The only aspect of medical care which has not changed is the human. There are still more gifted, caring, well educated and observant medical professionals than the other kind. It is unfortunate that the cost medical care has become so regulated by insurance companies and governmental regulations. It seems to me that the best answer would be to have physician peer approved practices for every specialty with latitude for physicians judgement in certin scenarios. Every physician should be required to participate in at least one specialized "board" and receive on going information about his specialty. There has to recognition that the patient/doctor team is the best source of evaluation of treatment.
No one should be forced to undergo any examinations or treatments (such as mammograms, prostate checkups, etc.) no matter how obvious it is that by so doing money would be saved down the line. Likewise no one should be denied treatment he or a physician feels is neccessary. We have to recognize that not only "medically neccessary" options are important to a patients well being.
How to pay for this?? I am afriad that there is no good answer. It is foolish to believe that any party paying the bill should give out blank checks to doctors, hospitals or patients for every treatment without some determination of standards. The problem is that there will always be bureaucracy and associated red tape.