How much could be done with a minimally licensed person doing most of the basic stuff.
1. look,listen to eyes ears, throat, heart, lungs - digital camera tied to a special lenses, or audio recording device
2. strep test - seriously I watch the my doctor swap my throat and put it in a little tub and shake.
3. taking blood - why do I need a doctor visit.
A lot of that could be charged a lot cheaper. And free up doctors, nurses for other tasks.
Pricing this out, it's almost cheaper and easier to just get an order online that you can have handled at Quest and pay out of pocket than it is to deal with the hoop-jumping and co-pays that insurance requires. That's what I've started doing, because I know what I need done, and that way it takes me about 15 minutes on a lunch break, as opposed to eating up part of two days, scheduling an appointment to convince a doctor to order it and then having to go to a lab to actually get it done.
The other one that enrages me is the difficulty of getting drugs for common ailments that aren't sold over-the-counter. If I have bronchitis or strep, a zithromax pack will knock it out immediately, or if I get into poison ivy badly, I'm going to need some prednisone, but I can't just buy those, I need to have the gatekeeper sign off. I can probably go down to the pet store and buy them for my dog, though.
"Will my copay be cheaper if I see a PA?", I asked.
"Absolutely not" was the response.
So why would I pay the same to see someone less qualified?
Incentives in the American healthcare system are extremely screwed up.