Yeah, those people DOA are cheaper than surviving, if you ignore what kind of wealth a person is likely to create by being alive. AFAIK, the latest numbers on a

Yeah, those people DOA are cheaper than surviving, if you ignore what kind of wealth a person is likely to create by being alive. AFAIK, the latest numbers on acute MI survival are ~30%, and getting better in recent years due to the widespread adoption of the CHAMP protocol. Rates go up if things happen in a certain sequence of events, within certain prescribed timeframes. Medicare is beginning to compensate at a higher rate based on how well hospitals perform in cases like heart attacks. (And other common procedures/infection rates.) I'm not familiar with the specifics. I don't disagree on running the numbers on primary care, but any savings is likely to be trivial next to other areas of improvement. "Fixing" medmal is likely to be bigger than changing primary care, and the latest numbers on that (Amitabh Chandra, 2008, IIRC) are $50bn/yr. Medmal rates don't keep pace with the rest of health care inflation, so this is basically a one-time discount, and in terms of overall health spending, $50bn is only like 2%. In addition, even in states which have instituted some kind of tort reform, it hasn't changed how medicine is practiced, which is the ultimate cost driver. (Refs available, I'm just not at my primary computer.) It was very depressing to watch "health care reform" become "health insurance reform" sometime between late 2008 and summer 2009. The two aren't the same, and insurance reform won't due anything in the long run because demand for health care services is relatively inelastic, as you had mentioned, and I had alluded to before. Very depressing.