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> where the cost is too great AND the outcome is not good enough can and should get denied.

I'm not completely clear on the point you're trying to make, but this is how things work in socialised healthcare. Not everything is paid for - instead the money that is available is spent on those that return the best value-for-money balanced against not being unfair on an individual level. The question of whether to MRI everyone with tummy pain is translatable into a clinical question and can be tested in clinical studies.

In the UK we work on using a QALY - or quality-adjusted life-year to help with these sorts of decisions. They are used on boards in NICE (for general health-provisioning guidance) and the cancer drugs fund [1] which aims to give quick guidance on the fast-developing and expensive field of anti-cancer therapies.

Sure there are no silver bullets, but issues you bring up are being tackled to a relatively sophisticated degree in other countries.

[1] https://www.england.nhs.uk/cancer/cdf/




> Sure there are no silver bullets, but issues you bring up are being tackled to a relatively sophisticated degree in other countries.

That's perfect! One more question: how do you handle things like tobacco, alcohol, sugar, daredevils (think jackass the TV show)?




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