Could re-installing the "gatekeeper" referral save on health care costs in the U.S.?

[frazzled]

3. I have a "gatekeeper" plan

About 4 or 5 years ago we switched from an employer PPO plan with Cigna to the same company's HMO plan, which requires referrals from one's primary care physician. The reason we did it was because it was during the time when deductibles and cost-sharing started going up and up. The HMO plan offered us access to our same doctors, but at a cheaper premium price, and with NO deductibles and 100% coverage for hospitalizations and procedures in network. Since we live in an urban area with a wide network, it made sense to try.

So we have personally saved TONS of money by making this switch. It's a bit of a pain to have to go to your PCP to say, "I have this thing on my face that I think needs to be seen by a dermatologist," and he says, "you need to see the dermatologist." But considering the savings, it's not that much of a pain. And if this hadn't been a basal cell carcinoma that needed Moh's surgery (100% covered by our insurance), it would have been wasteful to see a specialist.

Whether we are saving money to the system is another question. We're the type who only go to the doctor when absolutely necessary (and have to be dragged then)--so I don't think we were overusing the system ever, and are capable of choosing our own specialist appointments. But many people want to see a specialist for every bump or hiccup, so overall, I think it's a good plan. Plus, there is a doctor coordinating all your care.