For many physicians trained in the United States, costs are generally one of the last things considered in medical decision-making. Throughout medical school and residency, we often do not learn about the direct costs of health care for patients. Tests are ordered and procedures performed, many times without much regard for the bill that is generated. However those bills, if unpaid, are passed along as higher fees that providers charge and as increased premiums for health insurance. Ultimately, higher costs contribute to making health insurance unaffordable and decreasing access to care.

If we are to ensure we have enough healthcare resources to cover everyone while not bankrupting individuals or the government, the next critical step will be addressing the growing cost of healthcare. It will be about everyone—not just poor patients—considering costs. It will involve moving beyond one patient asking, “will you charge me?” to all patients and providers asking, “Is this really necessary?” and “Is it worth it?”

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