[mjn]

I used to have that view, but from what I've read more recently, the cost of doctors' visits is basically negligible in the overall U.S. healthcare picture. Almost all the money is going into major medical expenses: hospital visits, surgery, end-of-life care, nursing-home care, and chronic conditions with expensive medication. So either doubling or halving the number of times people go to the doctor for colds, by changing incentives on that front, just doesn't seem like it'll move the needle on healthcare costs.

If anything, some of the actuaries seem to think people aren't going to the doctor enough: my dad's corporate health insurance plan recently changed their policies to incentivize going to the doctor more often, by giving you a discount for various kinds of visits: you get a discount if you have an annual physical, and another discount if you have less-frequent major workups / lab tests done.

[crusso]

hospital visits, surgery, end-of-life care, nursing-home care, and chronic conditions with expensive medication

Any list of major costs in the medical system that doesn't include legal expenses is highly suspect.

[mjn]

Depending on which estimate you believe, legal expenses (including direct and indirect) account for about 1-3% of overall US healthcare costs. Not nothing, but not in the range of what we're spending on, say, end-of-life hospital care (10-20%).

[crusso]

Okay, fair enough. I remember reading about substantially higher percentages in the past, but googling just now turned up a best guess of 2.4%. I couldn't find any details on how they calculated the indirect nature of defensive medicine, but what they did have didn't seem to be very comprehensive.