we live in a litigious society. we also live in a consumer is always right society.
the combination applied to medicine is therefore ALL doctors must be RIGHT 100% of the time. they also need to keep the patients happy by giving them what they demand.
how do doctors make sure they are RIGHT 100% of the time? they order tests, lots of them. they also give in to patients who want the newest (and therefore priciest) medication that was just advertised on TV.
the end result is the cost keeps going up, and the premium keeps rising.
Here’s the example:
let’s take 10 people showing up with cough in America. that 10 people will all get chest x-rays because the doctors don’t dare miss anything. 3 out of the 10 will have an incidental finding on the chest x-ray that will require CT scan, 1 will need the CT scan repeated 2 or 3 times to ensure it is nothing. nothing was found but that’s 10 chest x-rays, and 5 CT scans.
take the same 10 people showing up with cough in Taiwan. all told most likely cough would just go away. 2 comes back with the cough after a couple of weeks, those are the 2 that gets the chest x-ray. having only had 2 chest x-rays done, there are fewer incidental findings, no CT scan had to be done.
the result? the American gets more radiation, and the American then goes on a blog to complaint that his insurance premium is going up by another 24% this next year.
