To go under the knife or not?

This article from the New York Times about the effect of the economy on people's decision to have surgery or hold out puts the financial state of the nation in perspective.
Some choose to have their surgery sooner rather than later for fear of losing their insurance coverage with their job. Others sacrifice having surgery that could relieve pain or prevent further complications because of a tight budget. This leaves hospitals in a quandry, doesn't it?
Are doctors and surgeons really in control of their patients well-being? It seems in this system that the patient has the power to make decisions that can be detrimental to their well-being. When there is such economic strain, it seems that the patient is in the driver's seat.