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Notes -
(I had a different reply here but I deleted it because I was triggered by stuff that resembled something that you weren't actually saying. Sorry.)
What metrics are there, out of curiosity? I've only really seen "outcomes" mentioned but in my surface view these are confounded by issues of affluence (e.g. more obesity, more driving everywhere). Also it seems like ass-covering and hostility-to-rationing drive up costs as well; a socialized medicine death panel could cheerfully say no that test is expensive and highly unlikely to find a problem so there's no rx for it end of story, but in the US an indicator that you could have a 0.01% chance of a horrific disease justifies the test so end of story.
So, interestingly, my current wealth insurance plan is one where I pay out of pocket for stuff and then apply for reimbursement. This puts me in a position to shop around before I get tests to find the lowest price out of an attempt to stay under the per-incident deductible and also generalized fear that I might be stuck with the whole bill.
It's really eye-opening! The variance between rates quoted for a test is sometimes an order of magnitude and I can't get anyone to tell me why.
I've listened to podcasts with doctors and they will complain about such and such imaging machines being shit and others being great and that's why they refer to so and so place only.
So. I dunno my prejudice is that these cheap tests produce crappy grainy images that your doctor hates but they just roll with it. But I could also totally understand if it's also because proper supply and demand forces are completely distorted and you really do overpay by 10x for the same stuff
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