It can't happen here for a few reasons, not least of which is that unless you want to work for the military or the VA, there isn't much of an option. British M.D.s, as I assume you know, are mostly salaried employees of the National Health Service. However, some people with money think they get better service if they pay a physician out of their own pockets so doctor set up private practices to get themselves richer. But, says Dr. Dean:
[L]et’s face it: the whole business is largely a con. Patients think that paying must mean higher quality medicine, but—like paying more for shampoo with added vitamins—the promise is far greater than the reality. Rich and famous people may use private facilities to shelter from the public gaze; for most “ordinary” private patients, though, the main advantage is simply to jump the NHS queue. Private hospitals are like five star hotels, but for the most part they are no place to be if you are really sick.And why aren't the rich people getting higher quality medicine? Easy:
The business of medicine and the practice of medicine are at odds. Private medicine encourages doctors to make decisions on the basis of profit rather than need. When confronted with a choice between two treatment pathways in equipoise—one that earns the doctor no money and the other with a fat fee attached—that conflict is stark. I cannot say, with hand on heart, that I have never chosen the second option.In short, as I have explained here many times, the idea that the mythical "free market" is an appropriate way to organize health care is utterly nonsensical. I can go on at much greater length why that is so, but this should be enough.
The entire U.S. health care system is unethical, and everybody who works in it is part of an unethical structure. It's about vacuuming up money first, and taking care of people somewhere down the list. How to fix it? Socialism, baby. Just like the Brits.