Colonoscopies are billed as quasi operations. What a short time ago was a simple office procedure has morphed into a more complex booming business. Now there are surgery centers where lucrative colonoscopies are prescribed and performed in excess of medical guidelines. The goal is to maximize revenue; lobbying, marketing and turf battles among specialists, plus huge profit margins, account for the high costs. Other tests for colon cancer are far less invasive, cheaper and equally effective, according to a federal expert panel on preventive care.
Australia does not even pay for colonoscopies as a standard screening procedure and it is not common in other western nations, either. Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, is quoted in the Times story cited above, as follows: We've defaulted to by far the most expensive option, without much if any data to support it.
The American Free Enterprise Anomaly
Medical Bill by John Jonik
In this country, the government, unlike in any other industrialized nation, does not regulate or otherwise intervene in medical pricing, other than setting payment rates for Medicare and Medicaid. Other nations view health care as a right for all and regulate hospitals and the rest of the delivery system as public utilities. What conservatives like to call a free market is not so free for consumers. Again, citing the Times report: Patients do not see prices until after a service is provided ... there is little quality data on hospitals and doctors to help determine good value...and even doctors often do not know the costs of the tests and procedures they prescribe.
Imagine if you went to a restaurant and ordered your meal with no clue what the dinner would cost. Imagine the anxiety waiting for the waiter to arrive with the check. Or, apply the medical care model to other normal purchases, large and small. What if the supermarket groceries you loaded up, took home and consumed were added up and recorded in your account, but you did not see the bill for days or weeks, well after you processed most of what you carried off! Such transactions are ridiculous, of course and yet that's how it is in the medical system. I sometimes receive bills for medical procedures rendered a year earlier, after the hospital or medical practitioner has given up on negotiations for full or good enough payment from the Medicare insurer). It's bizarre, irrational, unfair and intolerable.
Summary and the Promised Takeaway Lesson
For starters, read the New York Times story about paying till it hurts entitled, Colonoscopies Explain Why U.S. Leads the World in Health Expenditures. It's five times more detailed than this overview and loaded with references and examples.
Then ask yourself, Do you have to be passive and tolerate this state of things? Consider that you do not.
First, with regard to colonoscopies, know that for most people, regular testing for blood in the stool is sufficient. Unfortunately for unwary, easily intimidated patients, settling for this low cost option is difficult. Such resistance to colonoscopies will be mightily resisted by medical counselors involved with the procedure. Stool testing is not a high revenue producer for this industry. Consider this, also from the Times report: Studies have not clearly shown that a colonoscopy prevents colon cancer or death better than the other screening methods. Indeed, some recent papers suggest that it does not, in part because early lesions may be hard to see in some parts of the colon.
What can you do to avoid spending more for lower quality medical care while becoming less and less well? You have three options: Die, move or adopt a REAL wellness lifestyle. Stick with the latter until you do move or die. Personally, I'm going with the REAL wellness lifestyle. With regard to the colonoscopy issue, I favor a whole food plant based diet, plenty of exercise and lesser methods of cancer detection over the unpleasant, costly and dubious invasive procedure. Life is full of risks--and the flesh is heir to more slings and arrows than there will ever be costly medical tests to detect and treat early on.
Getting back to the three options (die, move or adopt a RW lifestyle), I go with the latter as well because the few countries I'd want to call home (Australia, New Zealand, Canada and El Dorado) might not have me. But of course I really and truly favor this choice because REAL wellness is a richer way to be alive. It's the only way to fly, or live, in my opinion, even if it did not save money and grief on all kinds of chronic medical problems I'd surely have to endure if I were obese, sedentary, bored or ornery--and I'm definitely not fat, sedentary or bored.
Real wellness is my suggested takeaway from this precautionary tale of the colonoscamy in America.
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