LABORATORY MEDICINE AT A CROSSROADS: VALUE, PRIVATIZATION, AND THE FUTURE OF DIAGNOSTIC STEWARDSHIP

Laboratory medicine plays a unique position within healthcare systems. Although it accounts for only a small fraction of expenditure, in vitro diagnostic testing plays a central role in screening, diagnosis, therapeutic decision-making, and disease monitoring. Increasing financial pressure on healthcare systems worldwide has stimulated discussions about outsourcing, privatization, and consolidation of laboratory services as strategies to improve efficiency. At the same time, the shift toward value-based healthcare requires healthcare disciplines to demonstrate measurable clinical and economic impact. This opinion paper presents personal reflections on the economic paradox of laboratory medicine, discusses the implications of privatization and outsourcing of diagnostic services, and highlights the growing strategic importance of laboratory diagnostics in the era of precision medicine. Ultimately, improving value-based healthcare in laboratory medicine does not mean indiscriminate cost reduction. Rather, it requires systematic measurement of outcomes, transparent demonstration of clinical value, and governance models that preserve accessibility and quality. Laboratory medicine must remain a cornerstone of sustainable and equitable healthcare systems.