Over time, fewer Americans are taking responsibility for their medical expenses. Over time, this drives up costs and an entitlement state of mind.
Something similar has happened with education, I think.
So medical "insurance" is no longer true insurance except at the catastrophic end. If the old model was Major Medical insurance against catastrophe, the new model is more of a medical payment system. That has changed everything.
Related:
A Reader’s Questions About Health Insurance
The World’s Most Inefficient Healthcare System, Part II: Created by Government, Financed by Government
The American middle class does not believe in saving up for health care expenses.