PSA: Scope Update

You probably don't remember this, but back in 2009, I had two colonoscopies in one summer. And because the pricing was radically weird, because one of them happened in the hospital and the other in the doctor's office, I had to write about it. Go on, read about it. Come back when you're done.

A couple of years later, Elisabeth Rosenthal (a writer for the Times) started a series of investigative articles about medical care pricing, called Paying Till It Hurts. Her first piece was about ... colonoscopies, and my expensive hospital based scope made it into the second paragraph. It is probably the last time I will be on the front page of the New York Times.

Sometime last summer, I got a note from the gastroenterologist reminding me that my five years were up and it was time for another. Oh the joys!

I duly scheduled an office visit, and had the scope, only to be told - when the propofol wore off - that I needed to have another in six months. So, if you're keeping track, this is four colonoscopies in about five years.

Since 2009, the Affordable Care Act has come into play, and my office's insurance carrier has changed, and my co-pays and deductibles have skyrocketed. But at core there's this: the doctor's office charges some wackadoodle number, and gets paid a negotiated rate. So, as a public service, and to aid in transparency in health care costs, here are the prices for my four colonoscopies:

#1 - 2009 - in the hospital

Charges billed by doctors and hospital	$9,143
Amount paid by insurance	$5,743
Co-pay due from me	$125
TOTAL PAID TO MEDICAL PROVIDERS	$5,868

#2 - 2009 in the doctor’s office

Charges billed by doctors and lab	$5,323
Amount paid by insurance	$2,923
Co-pay due from me	$30
TOTAL PAID TO MEDICAL PROVIDERS	$2,953

#3 - 2014 - in the doctor’s office - diagnostic

Charges billed by doctors and lab	$9,022
Amount paid by insurance	$2,812
Co-pay (deductible) due from me	$1,243
TOTAL PAID TO MEDICAL PROVIDERS	$4,055

#4 - 2015 - in the doctor’s office - screening

Charges billed by doctors and lab	$7,711
Amount paid by insurance	$3,995
Co-pay due from me	$75
TOTAL PAID TO MEDICAL PROVIDERS	$4,070

So what have we learned? In five years, the contracted rate for a colonoscopy at the medical practice I visit has gone up by a third (from $3K to $4K). What else? Even though the Affordable Care Act and the insurance companies make a distinction between a diagnostic colonoscopy and a screening one, the doctor ends up getting paid the same amount. Screening scopes are supposed to be covered in full under any ACA compliant insurance; diagnostic ones are subject to deductibles and co-pays and what not, so the patient ends up paying more. [I'm not sure why both #3 and #4 weren't coded as diagnostic...that may have been a coding error. However, since I'd met my deductible by the time #4 rolled around, it may not have made much difference in my co-pay.]

The issue of medical billing, and the prices paid, is an interesting one, which is why I am putting this out there.

If you too are interested, the New York Times series spun off into a Paying Till it Hurts Facebook group - "a forum for conversation, analysis and insight into health care pricing and costs in the United States".

And, by the way, I'm fine. I just seem to have a propensity towards polyps.

Get Swabbed!

A friend - an acquaintance really - has a son with acute lymphocytic leukemia, a relapse, actually. So I did the only rational thing that I could think to do, and signed up as a marrow donor.

It was incredibly easy - you fill out the forms on-line, they send you a kit, you swab the inside of your cheeks, and mail the swabs back to them. If I'm a match, they'll either collect peripheral blood stem cells via a blood donation, or pull marrow out of the pelvic bone.

If they call me because I'm a match, I'll tell you all about it.

You too can register - go to getswabbed.org. It won't cost you anything, and you don't even need to leave your house.

Also, lest we forget, FUCK CANCER.

PSA: What To Do About A Not-Okay Touch

After last week's Zygote Nephew post, you know, the one about, um, masturbation, I got an email from someone who preferred not to comment. I could have asked her to add the comment anonymously, or I could have done that for her, but I think it's a point that needs to be made and therefore deserves the spotlight of a post.

Good call on the zygote conversation. But as the mom of a child who was sexually molested, I'd say that when you have those conversations about what's an okay touch and what's not, it's important to realize that knowing something isn't okay doesn't mean a kid knows what to do to stop it. You need to say, "What would you do if someone touched you in your private places?" and "What could you do if the person didn't stop?"

The key line is something like this: "No big kid or grown-up needs you to keep a secret from your mommy. If someone touches you and then tells you not to tell, that is a SURE SIGN that you need to let me know." It was shortly after my annual conversation about private parts being private, in which I (for reasons unknown) emphasized the need to come to me *especially* if she was scared, that brought our unhappy situation to light. It's not that I hadn't talked to my daughter before, but that I hadn't discussed how to handle the situation if it arose.

Thank you, anonymous non-commenter. I'll be having this conversation with my seven year old, soon.

Also, if you're having these conversations with your kids, and would like the support of a book that the child will read over and over again, It's NOT the Stork, the book that prompted this in the first place, does talk about "okay" and "not okay" touches.

Two Answers, A Questions, A Request, and An Apology

Lord knows I am no kind of blogging guru. I know enough to get around, meaning, I only mess with HTML if I have to.

But I figured out two things about Blogger recently that I thought were worth sharing.

Answer 1) Like lots of people, I am periodically plagued with comment spam. Word verification helps, but it's so annoying that I usually leave it off. Recently, the comment spam has all been landing on old posts - which, happily, is easy to remedy. Find your Blogger Dashboard and then go to Settings > Comments > Comment moderation - and enable comment moderation on older posts. Blogger's default is 14 days, but you can set the time frame to longer or shorter. Then, if a spammer tries to comment on an old post, it won't appear, and you can easily delete it from your Blogger dashboard.

Answer 2) I finally got sick of the blogroll that ate my sidebar, a blogroll that was pulling from Bloglines even though I stopped using Bloglines as a reader. It was out of date and out of control. But I'd been reluctant to use the Google Reader widget because it was, to me anyway, ugly and I didn't know how to make it match my template. I figured it out! I started by selecting a handful of feeds and tagging them "Blogs You Should Read" - tagging them let me select a subset of the whole damned list of feeds, and creates a folder with the tag name. Then, in Reader, click on Settings > Reader Settings (towards the upper right of the window). From Settings, click onto Folders and Tags.


Make sure that the folder is marked "Public", and then click the link that says "Add a blogroll to your site". That'll take you to a pop-up window where you can configure the sidebar widget. Leave the title box EMPTY and set the color scheme to NONE. Copy the generated HTML and go back to your Blogger Layout page. Add an HTML widget and paste in the HTML that you just copied out of Reader. If you want a title, add one here. That way, the title and list in your new blogroll widget will pick up the styling that applies to the rest of your blog. Matchy matchy joy!

Question) Sitemeter lets me see a lot of information on a per visit basis - like Domain Name, IP Address, Country, City, Time of Visit, Visit Length, Page Views, Referring URL, Visit Entry Page, etc. Is there a way to get that kind of detail out of Google Analytics? Because if there is, I can't figure it out.

Request) Please enable your email in your Blogger profile. Click on your profile and make sure it's linked to your blog and your email. You can have a separate email exclusively for blog stuff, if you'd like. If you don't have a real blog, you can set up a "blog" without any content so that you have a profile with an email. This also goes for people with other than Blogger blogs - you can have a Blogger profile that links to your Wordpress/SquareSpace/TypePad blog - or even to your Etsy shop. But the email is key - it's what lets me reply to your comment, which I dearly love to do.

Apology) Blogger seems to be comment challenged of late. I can't comment most of the time, at least from the (cough) PC in the (cough) office. So, I may well have been reading and not commenting, but the not commenting isn't my fault. And I still love you.

I Know What I'm Doing In 2014

As much fun as it was to have a colonoscopy in June and another one in July, it’s much nicer to be told that all’s well and I don’t need another one for FIVE years.

Don’t let me stop you from having one of your own though. The procedure is a piece of cake, and the prep really isn’t that bad. My two cents? The orange flavor packet for the Trilyte is better than the lemon-lime, and drinking it at room temperature is easier than drinking it cold. Mind you, “better” and “easier” are incremental improvements, but improvements none-the-less.

You know you ought to, so just do it.

Making Books

My sister-in-law sent along this link to a new blog at the San Francisco Center for the Book. It's just begun, but it's got some great ideas for making books with kids. So, it's my public service announcement for the day, and for the beginning of the new school year. Enjoy!