In the US, the medical model is slowly beginning to change. There are some doctors now who are going to a cash-only system and thereby skirting all of the draconian insurance and government regulations/requirements. I fear that what’s coming is “the best” doctors are only going to be available to the wealthy cash payers, and the remainder of the population will only have access to the bottom of the barrel. In essence, it will be similar to the rich folks who get elective surgeries paying cash, except this will be for standard medical care. Even now, it seems almost a rarity for me to find a doctor who got a M.D. degree from a university in the United States. Almost all of them I’ve seen are from medical schools in a Caribbean or Latin country.