Getting More Health Care for Less

Matt Yglesias asked yesterday if we're ready to accept cheaper health care if it's as almost as good as the health care we're paying for now. I'm ready to raise my hand and say that yes, I would, because, in my particular case, at least, I think that cheaper health care that sacrificed quality on one front could mean I'd be getting better health care overall.

The example of a quality-sacrificing measure that Matt brought up was the MelaFind, a device that's supposed to identify melanomas but did not find every melanoma it was presented with. I had melanoma removed from my leg as a teenager, and since the thought of having another one is slightly terrifying, I make a point of following my doctor's orders and visiting the dermatologist every year for a skin check. Mostly, it's to reassure myself: I know that none of the moles on my body look anything like a potentially cancerous lesion. What I don't do each year is go to a primary care doctor -- I don't even have a primary care doctor -- in part because going to the doctor takes time and money, and I'm already going to the dermatologist, the eye doctor, and the OB-GYN.

This goes back to the idea that the health-care system is over-reliant on specialists. If non-dermatologists could be trained to use a device like the MelaFind (and I don't see why they couldn't be -- it sounds like it's basically just a scanner that compares your moles to moles in a database), I would go to the primary care doctor for a check-up every year. I would be seeing fewer doctors (cheaper!) and would probably be paying less for a visit in which I could get body parts other than my skin checked, leaving me with better health care overall.

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