Medical costs per service are increasing less than inflation. However medical expenditures are rising faster than inflation because we order more services per procedure. We are cautious, maybe overly cautious. Medicare must force patients to pay for more services per procedure, or absorb more of the national budget.

Last week I learned it’s easy to order extra procedures and ignore costs.

My abdominal aortic artery has an aneurysm threatening to burst, which could be fatal. My doctor recommended I see a surgeon. The surgeon reviewed my CAT scan and believes inserting a stent is minimal risk given my health, current technology and his team’s experience. I ordered one.

Then came decisions about cautious procedures. He was prepared to perform my operation, but traditional practice is to see a cardiologist in case insertion fails. In that event he would switch to major aortic repair, which could be fatal if I had coronary heart disease. He has switched only once, ten years and one hundred operations ago.

Nevertheless my aneurysm is a marker, a warning, that I may also have coronary heart disease. That marker depressed me, especially since I have no symptoms from chest pains or EKGs.

Should I see the cardiologist? If it was a business decision, or put me close to my lifetime insurance cost limit of $1 million, I probably would not. Medicare coverage and fear sent me to the cardiologist.

He was enamored with a robust test called a nuclear scan, which tests whether sufficient blood flows to the heart through coronary arteries. “Yes, maybe it is overkill,” he said and then chose a better phrase, “overly cautious.”

I ordered that test, meeting 4 technicians hovering around computer screens.

The scan indicated an artery was partially blocked because insufficient blood flowed to my heart when beating 136 times per minute. My cardiologist said the scan might be a false positive, meaning my artery was not blocked.

He was more enamored with a procedure called a cardiac catheter that sends an x-ray camera up my coronary artery to repair blockages, or prove scan are false positives.

So I ordered that test, meeting a larger team of nurses and technicians. My cardiologist cheerfully reported a false positive. My blood flows smoothly through clean arteries. I did hear him say, “Let’s insert dye to take a picture of his valves since it’s free.”

I am relieved to know I have no coronary artery disease. Except I have more time to worry about Medicare costs.

Medicare needs to limit the amount of money I can spend for my care. If my cardiology visit had been more expensive for me personally, would I have ordered the tests? I doubt it.