I think having cost be the anti-abuse disincentive is the worst of all worlds -- cost is clearly not an effective deterrent of abuse given our current state of

I think having cost be the anti-abuse disincentive is the worst of all worlds -- cost is clearly not an effective deterrent of abuse given our current state of overutilization. It IS a deterrent in the case of avoidance, or arguably worse, a punishment in the case of attendance, for those who DO need it. I'm a volunteer EMT and my org runs free clinics staffed by doctors+nurses at major events to handle emergencies. It's truly free -- we don't bill anyone, insurance included -- but I've had people in dire medical distress avoid coming with me because they're afraid of the bill. Hell, I've had people in the midst of full blown psychosis and their single lucid thought is to yell "DON'T TAKE ME I CAN'T AFFORD AN AMBULANCE BILL" and my heart breaks. The American healthcare system is continuously setting and raising the high water mark for how deeply in failure the system is, but bankrupting people is not the holistic solution we need, in my opinion.