I have been half-reading a book called "Overtreated" by Shannon Brownlee recently. It's about the U.S. healthcare system.. It was written in 2007, before the ACA, so some parts of it are outdated, but it's an interesting book overall.

The writing isn't the best. I have tried to read it before and failed.

But anyway, back to your question. I think some people who have a long history of health problems become "knowledgeable patients" and it's frustrating for those people to deal with the restrictions that you mentioned. In their cases, it probably does end up costing more having them follow those rules.

One thing I read in the book that I didn't know is that the US has fewer physicians per capita than most western developed countries and they see more patients per day than in other countries.

The move to adding nurse practitioners may have started with cost control, but now that the ACA has taken effect, it's probably essential just to have enough providers.

I keep hearing that the US is going to move towards paying providers for results rather than for number of procedures performed. I'm not sure how that's going to be implemented. The idea sounds good.