The article focuses on one patient’s (Ms. Yapalater) financial experience with her colonoscopy and zooms out to explain that such an experience is not an anomaly, but instead the norm with an average colonoscopy costing close to $3,000 on average. With more than 10 million people getting them every year, the final tab is a profitable one for healthcare. Mentioning the size of the health care industry, $2.7 trillion, and examples of other severe price-inflated medical procedures.
The most expensive screening test routinely undergone, colonoscopies are a perfect example of what is wrong with the healthcare system. The procedure done in the U.S. does not provide any additional benefit vs. same procedure done in another country, but with the amounts that are able to be charged for them, they are increasing in popularity with an industry which has “business plans seeking to maximize revenue”.
Colonoscopies are no longer done in a physician’s office but in a surgical center, which were designed to reduce costs. However, it has actually increased the costs as additional services, costs are tacked on. The healthcare industry has propagated colonoscopies vs. other less-expensive, less-invasive screening procedures even though research shows colonoscopies do not provide prevent colon cancer any better. With the demand for the procedure increasing over 50% between 2003 to 2009, prices have inexplicably gone up, not down. Part of the reason for this is the use of anesthesiologists had doubled for the procedures over this time period.
The most interesting part of the article mentions that the insurer negotiated down each final bill in the colonoscopy cost data that it surveyed. Just the idea that it is common for a hospital or doctor bill to allow for negotiation of their bills should cast some suspicion on its pricing policies. It is also mentioned that there is a different pricing structure for those who have Medicare, as Medicare has more leverage in negotiations and able to ask for a lower price. It is fascinating to know that price discrimination laws don’t apply to the health care industry.
Brent, this was a very interesting debrief on the article. Was there anything specific showing how much cost has increased after they decided to have all procedures done at surgical centers? Also, with the way medicare is going, do you think prices will become more negotiable or would it be harder in the future?
ReplyDeleteHi Brent. I think it was interesting how you noted that there is frequent negotiation that takes place with prices related to colonoscopies. In the research I did on the diabetes industry, there is adversely very little negotiation performed. I guess maybe it's a good thing that Medicare is able to negotiate from a consumer perspective? Or maybe it means prices are ridiculously inflated?
ReplyDeleteThis was a post by Linjie Liu that I'm going to add here as a comment (edited by me):
ReplyDeleteSome reasons why Americans are paying so much more than patients in the other developed countries is because of the high demand for colonoscopies, which may drive up the price. For example, one American colonoscopy exam costs around $1000 on average in the U.S., while in Switzerland it costs around $600. Another reason for the high cost is that the U.S. is not able to regulate the medicine market, like other developed nations can negotiate lower prices.