>As for costs: your other problem is the perverse incentive for insurers to tolerate increased costs because ACA has capped their margin at 20%. If costs double, premiums can follow suit, % profit follows suit and bonuses and shareholder celebration follows on.
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>Who should have controlled costs? Elsewhere in the world, citizen physicians cheerfully act as gatekeepers because waste is unethical. But don't worry, the US tendency to attack physicians for not ordering every test under the sun or not performing heroic surgery on 96-year-old Aunt Alzheimer or for performing the surgery without Aunt Alzheimer making a complete recovery afterwards, is catching on elsewhere so you can be sure that the pain will spread.
One of my recent reads was "When Doctors Don't Listen" by Leana Wen and Josh Kosowsky. It's meant primarily as a guide for patients (and secondarily for doctors) to avoid getting put on "pathways" that lead to incessant testing instead of diagnosis and treatment. It resonated strongly.
Tamar
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