02 June 2013

My 15 Minutes of Fame?

In the department of "a lady only has her name in the paper three times in her life: birth, marriage and death", I have spectacularly failed, in as much as I am on the front page of today's New York Times discussing the price of my two back-to-back colonoscopies. In my copy of the paper, my name is below the fold, but other people have seen it on or above the fold.

My participation notwithstanding, it's a good article - pointing out the high costs of medical procedures in the US, using colonoscopy as an example.

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.

Health insurance reform is one thing, but unless and until we the people understand how much things cost underneath the protective veneer of our insurance, health care costs are going to continue to skyrocket.


Jennifer Denise Ouellette said...

I read it from your link on FB--interesting, indeed. Also? two colonoscopies--yikes!--I could barely make it through the prep for one.

Absence of alternatives said...

A while back ago McKinsey & Company published a paper on why US healthcare costs are so much higher than countries with comparable health care. Their conclusion: “In the United States, the ‘average’ consumer of health care pays for only 12 percent of its total cost directly out of pocket (down from 47 percent in 1960), as well as for 25 percent of health care insurance premiums, a share that has stayed relatively constant for the last decade. Well-insured patients who bear little, if any, of the cost of their treatment have no incentive to be value-conscious health care consumers.”

When my doctor told me to get MRI and CAT scan ( I suspect because 1. hey her insurance will pay for it anyway, 2. this way I cover all the bases so i won't get sued) I was extremely disturbed. But it takes the indeed "well-insured" patients to be aware of the consequences of unnecessary tests when they are not directly affected by this kind of behavior financially.

kathy a. said...

It is difficult to know the real costs, too -- the providers "charge" the max, but they have agreements with insurers about what will actually be paid. This means the only people who will be actually charged the list price are people not using insurance. There is also a huge variation in costs for procedures, depending on the area where one lives.

With for-profit players heavily involved (insurance companies; some providers; pharma), the system puts an emphasis on profitability, not patient care. Things get ordered, as AoA notes, because they will be covered, not always because they are necessary.

Any time someone starts talking about costs vs. benefits, we start hearing about "death panels." But shouldn't scientific evidence about indications for and outcomes of procedures and treatments weigh more heavily in medical decisionmaking than whether it is profitable (or fits popular notions) to proceed in a certain way?

kathy a. said...

The converse is true, also, because of the focus on profitability. Lots of us have known the pain of fighting an insurance company for something that IS necessary -- a med off their formulary; something or other that they deny for "lack of medical necessity" just because you might not fight it. (Seriously, they once denied payment for my son's treatment, which they previously approved, and told me I shouldn't be bothered because only the provider would be out of pocket.)

Bibliomama said...

Go Maggie, you un-lady you. Way to put your colon out there for a good cause.

ozma said...

I'm trying to avoid articles that make me crazy and that was one of those things that make me crazy but it's very exciting to be on the front page of the NY Times. And a good issue to draw attention to.

Health care is so nuts in this country that you wonder what the response to issues like this will be--colonocopies for rich people only?

Val said...

One of my aunts has been experiencing bleeding for at least the past year and was told by her doctor last summer to have a colonoscopy. Her insurance won't cover one, though, and she can't pay out of pocket (and/or doesn't want to go into debt now at age seventy over medical care, so she has yet to have the procedure.