[DanBC]

> The calculus of incremental value vs. cost is subconsciously seen as inhumane across the industry -- it's seen as starting down that slippery slope that ends with a "dollars per life" number which feels wrong to everyone. Nobody wants to be the person who traded someone's health for a buck.

That's not what's going on though, is it?

All across healthcare you have groups trying to provide an evidence base, and other groups trying to decide whether that evidence base means something is value for money or not. In England that's going to be NICE, in the US it's insurance companies.

The US has a serious problem of over-testing. The reason isn't because they think it improves outomes. They know it doesn't, they know it makes things worse. They over-test because it means they're less likely to get sued. The cost of the test is lower than the cost of getting sued, even though too much testing is causing harm.