Insurance companies, Medicare, and public health authorities haven't yet sorted out the complexities of the survival benefit found in the Lung Cancer Screening Trial. The number needed to screen to prevent a death was ~300; ~40% of patients had at least one false positive scan, 95% were false positives overall, and overdiagnosis was very likely present. Until that's all more settled, payers aren't paying for CT screening. But that hasn't stopped our competitive, financially-driven medical care system from offering a private sector "solution."