> How do you determine when "just in case" costs too much?
the physicians usually try to take the safe route just in case - if they deem it worth it. i'm still in the low risk category (~~young~~ not old, passably athletic) so my doctor told me more than once that it's probably nothing and we don't need to do the (expensive) X, the (cheap) Y is enough (maybe Y reveals something that justifies X).
it doesn't always work; as a personal anecdote - my uncle suffered a debilitating headache once and was told to take aspirin for several days until my aunt had enough and drove him to the hospital on her own. turned out to be cerebral bleeding. he barely survived and is now mentally disabled.
this a) takes him out of the workforce, which looses the state money through reduced taxes and b) ensures him an invalidity pension, which costs the state money.
was it worth it to save the money? on paper it's the additional cost of checking N people who're having headaches plus the cost of treating M people who're actually affected vs. the money he would have paid into the system plus the money he now costs the system over, say, 20 years. additionally he consumes less and his wife's business is struggling because he's not much help anymore.
for us, personally, it's still a tragedy, but those cases happen. you have to draw the line somewhere. it's not just additional costs though, it's still a trade off.