The question for me is, does it work?
Now, I can see twisted financial incentives and the silliness of a 3rd party payer system (as we have here in the US) just as easily as the next person. The patient hasn’t really been the primary “customer” of healthcare - monetarily speaking - for quite sometime.
Still, insurance companies and caring doctors - who I still presume to be the majority of them - have strong incentives/desires to avoid detrimental health conditions. No one benefits from someone whose overlooked symptoms lead to extremely expensive treatments and/or life long conditions that truly do require regular, pricey monitoring or maintenance.
What is new, I hate to say, is data. Massive insurance companies and health care delivery “systems” have so much data about who had what exams, symptoms, conditions and treatments that they’re remarkably successful at avoiding those types of long-term costs. I would bet - IANAD - the types of conditions many doctors used to search for in those detailed exams are rarely encountered without significant enough symptoms that a person would normally come see a doctor and be able to get it addressed before it was too bad.
Another faction is modern medicine’s ability to treat conditions successfully even later in discovery. Conditions like cancer are the obvious outlier, but maybe the exception that proves the rule? Breast exams and Pap tests (doctors tho debate on the latter continues) are often still considered essential, annual rites primarily because their objective is the early identification of cancer.
Just imagine - a blood test was discovered that could identify 99% of all breast cancer, even earlier and more accurately than the typical gynecologist. Regular breast exams would probably become as rare as many of the other rituals we remember from days of yore.
And - you do hear about more diagnosis of some diseases. IBS springs to mind.
Im not saying it’s all good. And there are people who fall through the cracks - the ones with rare diseases, or who acquire rare forms of a cancer that tests cannot catch. That’s when the financial trade offs are made that condemn some people and sound horribly callous to many. But, consider travel by car… We could make almost all vehicle accidents safe and survivable, it would only cost about $50-$100k/vehicle and for all passengers and drivers to wear things like helmets and 5-point harnesses. That’s the exact same calculation being made as in health care. That’s not to say it’s “right”. Only that it’s reality.
One day maybe we’ll all be relegated to almost no exams except a doctor running a Star Trek tricorder-like thing over our bodies. And damn if that won’t be boring as hell for folks like us, but the March of progress continues, regardless of whether or not our fetishes approve.
Sadly.
-g