Where cheaper is not better

Take radiation. There are many studies showing that we get too much radiation. Routine tests using old equipment yields bad results.

But not all scans are diagnostic. Scans done during treatment can actually be an enormous benefit. Instead of waiting until a round of chemotherapy is ended, a scan during the round can cause an adjustment in treatment, possibly saving a life.

Just to make things harder, the tests that help most are PET scans, in which radioactive dye is injected into the patient. More cost, more scans, more radiation, but better results.

Patients are being told that a reformed health care system will make such intensive therapies impossible, that shortages will result. The idea of comparative effectiveness is not to create shortages, however. It's not meant to deny care. Effective care, even if it's costly, can still be justified.

Bet you don't believe that.