Here is the good news. Responsibility for managing health care spending is being increasingly shifted away from third-party payer bureaucracies to individual patients, who often are much better at evaluating the costs and benefits of their own care.
Here is the not-so-good news. Although the responsibility is being shifted, much of the time insurance dollars are not. That means that patients may face large medical bills without the wherewithal to pay them. Or they may forgo care altogether because of large out-of-pocket costs.
Basically there are two types of insurance: third-party insurance and individual self-insurance. The third-party insurers are employers, insurance companies and government. Individual insurance means that people put money aside in accounts that they own and controlto be used when medical events occur.