Gina Kolata writes about some different thinking with respect to opening arteries (using stents & bypass surgery) vis a vis heart attack risks:

But the new model of heart disease shows that the vast majority of heart attacks do not originate with obstructions that narrow arteries.
Instead, recent and continuing studies show that a more powerful way to prevent heart attacks in patients at high risk is to adhere rigorously to what can seem like boring old advice ? giving up smoking, for example, and taking drugs to get blood pressure under control, drive cholesterol levels down and prevent blood clotting.
Researchers estimate that just one of those tactics, lowering cholesterol to what guidelines suggest, can reduce the risk of heart attack by a third but is followed by only 20 percent of heart patients.

Clayton Christensen, a Harvard professor who studies disruptive innovations recently discussed an idea to reduce health care costs for many typical patient requests:

“Christensen nailed it on the head when he said this is an industry in desperate need of disruption. In its current state, a gross amount of overhead costs prepare hospitals and doctors to treat the most complex illnesses known to mankind.
In reality, most people need a quick look and a prescription. Christensen talked about a new business model coming out of Minnesota as the perfect disruptor for medicine.
Because Minnesota allows nurses to write prescriptions, the idea would be to create medical drop-in sites that treat 14 primary illnesses. Everything from strep throat to “burn your warts off.”
The flat rate for a checkup and ‘scrip is $29. If it takes more than 15 minutes, it’s free.
This is what you and I want, right? No long wait on the phone. No huge bills for a simple checkup. Quick and easy, in and out.
This would provide an alternate product to consumers and make going to a big ol’ HMO with a sore throat an unacceptable hassle for most consumers.
Christensen is suggesting this model to the Johns Hopkins hospitals in Maryland as a way for them to build their brand, embrace a disruptive force to come and give their patients what they want.
The Baltimore medical giant is reticent, he says, which is a typical response from an existing business reluctant to embrace disruption. “