To elaborate on 1: the rise in the reliance on third party payers has been mostly due to the steady expansion of Medicare/Medicaid, and the piling on of laws th

To elaborate on 1: the rise in the reliance on third party payers has been mostly due to the steady expansion of Medicare/Medicaid, and the piling on of laws that encourage reliance on health insurance over out-of-pocket healthcare spending, like "Patient Bill of Rights" laws that probibit all but the most comprehensive health insurance plans, and rule out catastophic-only plans that were at one time more common: https://archive.is/GHjIl https://archive.is/GHjIl