This is simply not true, especially with respect to emergency room care. The system is increasingly dominated by nonpaying patients (and that includes those with Medicare/Medicaid who have not and will not pay into the system anywhere near what they will take out of it, even if their medical needs turn out to be only average), including outright fakers seeking free narcotics and people with self-inflicted ailments for which they patently refuse to follow to medical advice to treat or mitigate. The quantity and quality of service available is what can be produced with the funds provided by the 50% or so of paying patients, and the available service is then divided evenly among the 100% of patients who show up -- often actually going disproportionately to the nonpayers, since they tend to have more serious medical problems and injuries due to irresponsible lifestyle choices.
The people who pay for the system, who are pretty much the same ones who only come to the ER with legitimate emergencies and who either don't self-inflict ailments or who follow medical advice to treat self-inflicted ailments after they've arisen, end up getting treated just the same as the fakers and my-health-is-somebody-else's-responsibility crowd. What really aggravates me is that there doesn't seem to be any sense of outrage about this among medical professionals. The career gang-banger/crack dealer/crack addict with a history of faking seizures or extreme pain in ERs in attempts to get narcotics, shouldn't go to the front of the line even if he DOES have a dissecting aortic aneurysm that night -- he should have been arrested, convicted, and tattooed/microchipped after his previous ER misdeeds, to identify him as holding "Serve Last in ER" status. The hardworking, honest, heavily-taxed father with the very mild stroke symptoms should be popped ahead of him.
No way our medical system is influenced at all by a free-market economy-—wish it were so, but it isn’t.
To try to cut down on ER abuse in the military, there was once a push to charge people $25 per visit. All hell broke loose and the proposal was quickly abandoned.
I have repeatedly said I would willingly pay a surcharge to be able to go to a “private” ER where we didn’t have to put up with the usual crappola at the ER.