>>The patient has been bamboozled into thinking that needless tests and drugs equate to quality care and becomes an accessory by going along with the spiral.
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>You speak as if the patient is a helpless victim in all this. How many individuals go out of their way for highly questionable (or outright needless) procedures and then expect their coverage will handle every one of them?

In this system there are three parties, the MD, the patient, and the insurer.
If a patient wanted something frivolous and at least one of the other parties refused, the system would work.
When both the other parties stand to gain by having the patient do frivolous things, the system doesn't work.

Yes, the patient is accountable - but at what cost?
Since there is no apparent cost to the patient, there is no restraint.