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I see the problem to some degree as there is no connection from costs and what patients want. They have no idea of how much an exam costs and ask for more. If there was a way to have them pay it may cut down some. The problem is they won’t know what should or could be cut and what is truly needed. We could leave that up to doctors as with capitated system, but they don’t do what is right frequently if it means that they lose money on a patient. I would prefer an IMAC type system that uses cost/benefit analysis and best medical practices guidelines. I also think that there decisions and care provided by doctor following those guidelines must be immune from suit.
