I strongly agree about tort reform, but I doubt it will happen as long as most legislators are also lawyers. As part of that, I would like to see "loser pays" legislation that makes the filers of frivolous lawsuits pay the legal fees and costs of the person against whom they filed the frivolous lawsuit.You hit on a few things:
1-Sit in front of a collections person if you can with your checkbook and offer to make your invoices go away "for the right price."
2-Tort reform!!! The days of rejecting frivolous lawsuits are long gone and we all pay for this mentality of people thinking they've hit the lottery if something imperfect (real or perceived) happens. I have a $1,000,000 umbrella policy merely because I own a house and someone might hurt themselves within it's boundaries. Makes me sick!!!
3-Lots of people are getting care at no cost to them, and it's worked into the prices everyone else pays. It is the most perfect, most efficient, lowest cost way to do it. But as you said, it needs to be universally formalized.
The problem with the system as it is, even if you are insured, is that somebody can file a frivolous suit with absoltely no factual or legal merit at all and your insurance company nine times out of ten will go ahead and settle with the plaintiff because that's usually cheaper in the end than taking the matter all the way through the courts. Then, of course, the insurer raises its rates and/or refuses to renew your coverage.