I think OP is quite right that insurance drives tests and costs up because contrary to what we think it is good for the insurance companies if the doctor bill is high because then people buy more expensive insurances and thus higher revenue for the insurance company.

If the cost would be low there would be no need for an insurance.

Sure, my wife and I had to deal with that not too long ago when I was unemployed and had to use the subsidized MetroPlus stuff in NYC. It wasn’t as bad as I thought it would be but it was definitely not as good as my fancy PPO I get from sexy desk jobs.

I guess what I am getting at is that insurance sort of makes things worse for everyone here. When a person comes in with good insurance the doctor has incentive to abuse it, artificially driving up costs, making it harder for people with crappy/no insurance to get the treatments they need because insurance won’t cover it. It’s a messy system.

A large part of me would prefer that we abolish private insurance entirely, but I fear that’s not likely in the states.