This TIME article really puts a human face to a social issue. In a system where payers and providers battle over who pays the bill, what are doctors to do when they get the short end of the stick? Cost shifting from payers to providers harms patients, many of whom desperately need care. Doctors get stuck in a horrible position; they have to decide either to protect their livelihood or to treat the patient for free:

There was at least one thing we didn’t have to worry about, Haile assured me. Pat’s kidney doctor, Peter Smolens, would keep treating him even if he couldn’t pay. Smolens, a thin, soft-spoken man, later told me that about 10% of his patients have inadequate insurance or none at all. He has agonized with some as they struggled with hard choices, like whether to have a hospital biopsy or pay their mortgage. As a physician, he said, “you just see them. You know you’re not going to get paid.”

Why does the American health care system force doctors to question caring for their patients? Health care only works when a patient centered approach is taken. “What is best for the patient,” should be the main question on the mind of every system participant. The financial incentives of the system, however, have an opposing influence: “What is best for our (insurance companies, hospital administration, drug/device producers, etc) wallet,” seems to be the driving force behind so many patient care decisions. Sadly, overall costs to society continue to increase while quality of care continues to decline.

For further elaboration, read the original TIME article:
TIME — The Health-Care Crisis Hits Home