Other Factors

As has been discussed, the laboratory has developed through a series of advances and setbacks. Until recently, the volume of testing has gone up dramatically every year in excess of what is predicted for diagnostic purposes. One contributing factor may be that in the mid-20th century, health insurance became available to a large portion of the working population. Under this type of program, medical care was delivered with little concern about the cost. These costs were passed along to the insurance company, which paid the charges. This put the laboratory in a revenue-generating position, and more tests translated to more income. There was no incentive to control costs; in fact, there was an incentive to do more tests, hire more staff, and buy more equipment. This led to a considerable growth in laboratory services, and although test costs were coming down, the increased volume made the total cost higher. As this new technology matures, there might be a paradoxical financial shift; that is, the individual laboratory tests might currently be more expensive to perform than more traditional assays, but the benefit from earlier intervention and genetic counseling could reduce the long-term aggregate cost of health care.

The subsequent chapters will outline a wide variety of diagnostic testing that is available, along with the benefits and medical options that are available to the patient and the health care team. This technology will carry laboratory diagnostic medicine into the 21st century.

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