Horrific situations like Brenda's would be far less likely to happen if those receiving health care were directly paying for the services they contract. When governments get involved with any action by way of regulations and payments for services (all of this funded by money extorted from taxpayers), the results are guaranteed to include examples such as this, and increasingly so as the involvement of governments increases. When a person, or his/her (hir) guardian, contracts for and pays directly to healthcare providers, s/he retains control and can easily take hir business elsewhere if not satisfied. But when anyone lets government, or even an insurance company, interfere in that contractual arrangement as part of being the services payer, then s/he has lost hir leverage to require modifications to the services received. Once any agency (either government or an insurance company directly) is paying the bills with funds pooled from all its income sources, it will always tend to become impersonal, bureaucratic, insensitive and even uncaring with respect to the needs of those being serviced. Such agencies and providers have little interest in prophylatic measures to reduce (if not actually prevent) the need for many healthcare services, and consequently will not inform their clients about such measures because the agencies and healthcare providers are mainly interested in expanding their own industry. Finally, those receiving such prepaid services (often with no choice not to have such prepaid arrangement), will also not be receptive to the idea of prevention (particularly if there is any cost or effort involved) because they know they will be able to receive all necessary healthcare services at no additional cost. Many will simply shrug - why take measures to become and stay healthy if someone else is going to pay the bills for any health problems?
Spreading the costs of healthcare services over a population of individuals on the basis of need - as dictated by government or decided by an insurance company - discourages the natural development of self-responsibility. It also fosters a lack of accountability by those who provide the services, particularly to those to whom they provide the services, because such providers of services (always individuals, whether they are self-employed, contractees or employees of a company/organization owning a facility or have "privileges" to admit patients to such a facility) under these conditions do not view the patient as a true client/customer to whom they must be sensitive and must ultimately satisfy if they want to be paid. Patients who are not paying their own bills are not customers of the hospital, clinic, or independent practitioner. Rather, such patients are effectively dependents of a paternal provider of essential services, which does not view its patients as individuals but simply numbers on some form and as statistics to use to its own benefit. It is no wonder that iatrogenic infections, injuries and disorders (originating in a health care facility or caused by a health care provider; definition of American Iatrogenic Association) are all too common in the US - Brenda's experience is not a rarity, though her public exposure of it is not nearly common enough.
A comparison of health care with other services may be illuminating. How long would a restaurant remain in operation and financially viable if its customers were routinely served unappetizing food, were ignored or treated rudely, or were presented with bills for items they never ordered? How many people would return to or recommend a hotel where the rooms were poorly cleaned, the beds lumpy, the staff begrudgingly responded to requests and bills contained charges for services never received? But hospitals, clinics and healthcare practitioners do not operate in even the semi-free-market manner of restaurants and hotels, which although still regulated via certain health codes and labor laws, are not totally inundated by a mountain of red tape from innumerable government agencies as are all healthcare facilities. Such a vast number of rules and regulations have driven away the most conscientious providers of health services and discouraged entry by most who might be. Instead it is the mediocre, those who are satisfied and even eager to simply follow guidelines set up by some paternalistic government agency, insurance company or healthcare provider organization (both of the last regulated themselves by government), who find the current environment conducive for offering services that portend to be for treating health problems.
In an environment where the majority of individuals are self-responsible, it would become standard practice to have a comprehensive contract specifying the terms of interaction for all parties involved with the provision of services, especially the customer (buyer) and the service provider (seller). Such an arrangement, initiated by an individual who has actively practiced known health disorder prevention methods, would be a significant deterrent to a situation such as Brenda experienced. Under such arrangements if a breach of contract did occur, seeking restitution for harm would be a relatively simple process. A self-responsible individual would fulfill the requirements of a contract of which sh/e was a part and if hir failure to do so caused harm to the other party, the terms of the contract would clearly specify the necessary compensation to be made.
Lack of self-responsibility is a major reason why incidents such as Brenda has brought to light (in living color) are not all that rare in the US - and likely all other societies operating with government regimented/regulated health care. The only way to reduce such incidents and begin to actually improve the quality of health care is to recognize this current lack of self-responsibility by large numbers and for individuals to enact measures in their own lives to restore and/or strengthen their practice of self-responsibility. Looking to government to "solve" the problem is simply an invitation for more and worse situations like Brenda's.
