A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests
I see no issue with Extra Medical Tests. More data points do not hurt a diagnoisis if a proper scientific method is followed.<p>The primary issue here is the resulting cost.<p>As the article points out: &quot;about 26 percent of every dollar spent.&quot;<p>You probably won&#x27;t complain paying 26 cents for a $1 popsicle, but if the same popsicle cost you $100, you might be upset paying $26.<p>But is not the bigger question: Why is the popsicle $100 when it could have cost $1?<p>Here is a useful chart to show where the money goes: <a href="https:&#x2F;&#x2F;qph.fs.quoracdn.net&#x2F;main-qimg-d68aea3ca1e466f166752e261b9e28d3" rel="nofollow">https:&#x2F;&#x2F;qph.fs.quoracdn.net&#x2F;main-qimg-d68aea3ca1e466f166752e...</a><p>Where do you think malpractice costs fit there?<p>I personally feel sad everytime malpractice fears enter the discussion of costs - its a tiny, ignorable portion right now of total expenses.<p>However, to a typical layperson, it sounds like a big deal to worry about but actually distracts the attention costs should be getting.<p>As a result, I have tried to cover it here: <a href="https:&#x2F;&#x2F;www.quora.com&#x2F;Why-does-one-believe-that-malpractice-insurance-is-the-primary-reason-for-US-health-care-being-so-expensive" rel="nofollow">https:&#x2F;&#x2F;www.quora.com&#x2F;Why-does-one-believe-that-malpractice-...</a><p>Real input from real practitioners in the industry in the real world.<p>Sure, Malpractice overhead exists but it&#x27;s analogous to a drop in the ocean. There is severe waste elsewhere that need to be handled first.<p>It&#x27;s a nosebleed in a patient hemorrhaging blood through a punctured artery.<p>The argument that ordering extra tests offer doctors &quot;additional defense&quot; in case of a lawsuit is absolute hogwash. If anything, the test results put the doctor at a further disadvanatge wrt defense because they had an additional datapoint they should have considered in their diagnoisis but did not.<p>The primary issue with Healthcare in the U.S. is cost - for those who have the money and the will to spend it, it&#x27;s one of the best in the world. A lot of  the rich visit the US for their Healthcare needs.<p>Healthcare in the U.S. is optimized for profit: <a href="https:&#x2F;&#x2F;www.quora.com&#x2F;What-makes-the-US-healthcare-system-so-expensive-Why-is-the-US-so-expensive-compared-to-Canada&#x2F;answers&#x2F;33451192" rel="nofollow">https:&#x2F;&#x2F;www.quora.com&#x2F;What-makes-the-US-healthcare-system-so...</a><p>This is very wrong as it encourages short term profit seeking behavior which is absolutely the opposite of what healthcare should be (eg: C Sections being preferred over natural but long childbirth)<p>A for-profit system does not help the doctor&#x2F;provider either (although it gives an illusion of it) - in such a system, the patient&#x27;s only recourse is to sue the doctor&#x2F;provider for damages instead of both parties focusing on the root cause which brought the patient to the doctor&#x2F;provider in the first place.<p>Extra Medical Tests might be suboptimal but the real pain points are the marginal costs of each test.<p>Tests in the U.S. are extremely expensive. There is no standardized pricing for any test in the U.S. unlike the rest of the world.<p>While the rest of the world has pretty much agreed, for example, that a blood group test might be no more than $10 (In India, it costs 20 cents upto 70 cents at current INR-USD exchange rates), in the U.S. depending on which lab you go to, your insurance coverage, your ability to pay and other factors, you might be billed anywhere from $0 - $2000.<p>That is completely insane.<p>Also, labs in the U.S are not setup to take requests from customers directly. There are kits you can order and all that<p>Everytime I try to send a blood sample to a lab on my own, the lab staff seem to be lost - they want my insurance information, my EHR information, my NPI ID and when I explain to them I am not a doctor they ask me to provide my physcian&#x27;s who ordered the test. (my physcian didn&#x27;t order the test - I did).<p>I have had a few labs bill me outrageous out of network fees because the lab tests were not ordered by an in network provider (because I ordered them and I am not a doctor) and the amount of calls and paperpushing I had to do to correct the billing has made me just give up and let a doctors office handle this.<p>I can read a lipid panel. I don&#x27;t need to go to a doctor&#x27;s office to drive in traffic, wait an hour or more just to draw my blood and have it sent to a lab and then have the doctor read the panel to me. I read spreadsheets every hour of the day. I know what mean median and mode is and the lab result often offer these values anyways as part of the report.<p>I just need the test report.<p>Now, if my HDLs are too high and I cannot figure out why, sure, I do need to discuss this with a professional.<p>The solution to this madness?<p>An &quot;all payer rate set&quot; system. EVERYONE pays the same for the same procedure. Who pays for the care, while important, comes later, not before.