Who's to Blame for Healthcare Costs?

My sister in law was asked to have a hs-CRP level checked as part of her annual visit to her primary care physician. She is in her mid forties, mildly obese and has hypertension. The level came back elevated. Rather than repeat the test, her physcian refers her to a cardiologist who has her scheduled for an echocardiogram and a stress myocardial perfusion study. She is asymptomatic. The liklihood that she has significan multivessed coronary heart disease to the extent that she would benefit from revascularization therapy is extremely small. Whether or not the perfusion scan shows any perfusion abnormality, she may also undergo angiography via CT and or catheterization. After spending thousands of dollars for the testing, the end result will be the same even if her CRP had not been checked. Loose weight, exersize and control blood pressure. Some physicians like my sister in law's primary order innappropriate studies out of fear of litigation. Others, like the cardiologist in this case, order tests that will generate income. The patient most often is out of the loop and will follow the doctor's orders. Physician's have failed in the attempts to police themselves, now the government has to step in and has no choice but to cut reimbursement rates. We likely have no one to blame but our selves.