One of the hard truth of modern medicine lies in the fact that cost of treatment is increasing day by day.Due to globalisation,easy access to advanced researches in advanced countries of the world to very less developed poor countries via advanced internet through social,print and electronic media via mobile or computers or tv or ewspapers,even physician of these countries write all modern investigations to diagnose the disease and adopt all best therapies,instruments and surgeries to treat the diseases.

            Clinical assessment has been taken over by blood,radiological,microbiological,histopathological investigations involving multiple less costly to very costly modalities and Physicians want to treat patients by best available advanced medicines,surgeries or radiotherapy etc leading to very costly therapy.Due to putting Doctors throughout the world in gambit of consumer,civil or criminal court Doctors donot dare to treat patients on simple clinical assessment or old trust mode of therapy involving ordinary medicines and surgeries.As people may live in developing or poor countries so if any mishappening happen in diagnosis or treatment as They know the best diagnosis modalities and therapies,they lodge complain against Doctors in their different courts and in such litigations court is also very harsh usually very high compensations are awarded to these doctors who treat patient more traditionally and clinically. Therefore cost of therapiesis vey high and almost affordable to many and many families become very poor in getting treatment of family member as they want best and best comes with hugh cost.

                    Therefore,WHO has sloganed  this year as "Universal Health care for every where anywhere". universal health coverage implies that all people have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative and rehabilitative basic health services and essential, safe, affordable, effective and quality medicines, while ensuring that the use of these services does not expose the users to financial hardship, with a special emphasis on the poor, vulnerable and marginalized segments of the population.Universal healthcare provides Affordable, Adequate, Accessible, Available, Appropriate and Accountable quality and safe healthcare to the public.

         As part of the Choosing Wisely Campaign, clinical societies like the American Society of Anesthesiologists, the American Society for Clinical Pathology and the Canadian Association of Pathologists recommend that routine preoperative laboratory testing, including, CBC, coagulation studies, and metabolic panels for low risk surgeries without a clinical indication should be avoided.

       Universal health coverage is the answer to affordable healthcare of quality in the developing countries of the world including India.Evidence baded medicine should be shifted to clinical based medicine,for diagnosis specific test should be done rather than general test to cut the cost.A good peripheral smear should be able to tell  about the white cell count (total and differential), platelets, types of anemia, parasites, sepsis, etc.there is no need of costly cbc,blood tests and culture or different cultures from different secretions.Urine routine and microscopic gives information about diabetes mellitus, renal disease or urinary tract infection (UTI).Good clinical examination supported by peripheral smear, urine analysis should be able to give a diagnosis in most cases. A third test that can be done in chronic fever is ESR.

           Most often, we ask for liver function tests (LFTs), kidney function tests (KFTs) or a lipid profile as a whole, for instance, without mentioning the specific test/s in the panel. This is the general practice and it is done quite possibly to avoid legal consequences.In lipid profile, total cholesterol or high-density lipoprotein (HDL) cholesterol may be the only tests required. If HDL is low, then triglyceride (TG) level is high. High TGs indicate serum lipemia.In non-alcoholic steatohepatitis (NASH), serum glutamic-pyruvic transaminase (SGPT), now called alanine aminotransferase (ALT), may be the screening LFT required.In suspected hypothyroidism, thyroid-stimulating Hormone (TSH) is the only screening test required.

                      Therefore,WHO and even our Government wants that cost of therapy isless,more patients are treated,the cost provided to Doctors and Hospitals in Ayushman Bharat scheme is another example but neither WHO nor Indian Govt doesnot provide any relief to Doctors in litigations as Consumer courts are sword on doctors and Hospitals providing treatment on clinical knowledge with simple specific tests will cut cost but many patients and greedy advocates will drag Doctors and hospitals in courts for any simple lab prooved ommission of diagnosis or required treatment.Secondly why Doctors are only taught to be poor and compromise cost where lawyers,engineers,charted accounts all professionals charges so high and their service is so costly and a costly market of education,livinghood food ,water,cloth,residential items,transport, communications, digitilisation etc has spread around Doctors who cant survive lonely with family in such compromised state.In every big city or town due to privatisation and hugh gap in have and havenots sophisticated luxurious multispeciality hospitals has been opened in India and less developed countries like bangladesh,Nepal,Srilanka,Nigeria,uganda etc too where everybody wants to move in case of severe crisis of disease or impending death of nearone relative resulting into deep grievances if initially at their place of residence or in other hospitals or nursing homes  of these town or cities Doctors treat them on clinical ground doing less tests and compromised therapy or surgery.