One of the greatest frustrations for any physician in the U.S. is the "uninsured patient". Coming face to face with one of the 'forgotten' patients can ruin an entire day of work. Knowing how to help a patient and being totally powerless to do so ranks right up there with an announced audit from the IRS and/or a letter from a plaintiff's attorney that you are about to get your a-- sued.
In fact what has evolved in most practice offices is a highly refined filtering mechanism to keep these patients away from you, the physician. This vicious and exclusionary process developed without any forethought as a means to insure the financial survival of our present health system. It flies in the face of what physicians are really all about....caring for people.
In order to see a physician you must be a 'card carrying" patient or have a wad of cash (which is rapidly evolving into a wad of plastic bits and bytes, or a wheelbarrow) At any rate the 'plastic card' now carries more power that one could have ever imagined.
At one time it did not matter, doctors and hospitals could and did give away millions of dollars of care because they were compensated fairly and sufficiently. Even if ph ysicians gave away their services (which is a small percentage of total health care costs) the patient could not access lab work, imaging services, nor have access to medications.