This article by Milwaukee Journal Sentinel Human Interest writer, Jim Stingl, outlines the differences around how colonoscopies are treated by insurance companies and the negative impacts on everyday Americans.
This is flat out idiocy. It is life threatening. There has no reasonable support for this medically. Once again health care is all about the money.
How can one colonoscopy be entirely covered by insurance because it’s deemed to be a preventive screening and the next cost us thousands of dollars out of pocket because it’s labeled slightly more ominously as diagnostic?
And why do people who need the test the most get charged the most? This may encourage them to skip it and run the risk of colon cancer, which is going to cost way more in the long run.
Meg’s ( former Journal Sentinel reporter Meg Kissinger ) younger sister, Patty Kissinger, 59, was diagnosed with colon cancer in October in New Orleans where she lives.
The cancer was discovered by a colonoscopy. Because Patty was having symptoms before the test, they wanted to charge her $3,500 to diagnose rather than screen her, even though the test is the same. (emphasis mine)
Patty urged Meg and their other siblings to get a colonoscopy because this kind of cancer runs in families. So Meg, who lives in Fox Point, scheduled hers for Dec. 4 at Ascension Columbia St. Mary’s Hospital Ozaukee in Mequon.
“Minutes before swallowing the gallon of colon blast, I got a call from my insurance company telling me that my copay would be $3,100. Gulp. Turns out I am now flagged and any colonoscopies from this day forward will be considered diagnostic, not screening,” Meg said.
“When I challenged the nurse on this, she told me that they hate this policy and blamed it on the insurance people. The insurance people told me it was the government, which I took to be code for Obamacare,” she said.
Meg is insured by UnitedHealthcare, which gave me a statement that reads in part:
“UnitedHealthcare’s commercial benefit plans provide preventive coverage, without member cost sharing, for colorectal cancer screening in accordance with the Affordable Care Act and the U.S. Preventive Services Taskforce recommendation. Preventive services covered with no member cost sharing under the Affordable Care Act are generally performed on patients who do not have symptoms or above-average risk factors.”
But patients with those symptoms or risk factors potentially are subject to member cost sharing, the statement goes on to say.
So yes, the person who needs a colonoscopy the most…someone with symptoms or risk factors…is the one who pays the most. How is that even fathomable? Why is this even allowed? Now we all know that the Affordable Care Act is far from perfect…and here is one more concrete piece of evidence that it needs to be replaced…with a comprehensive universal single payer plan that covers everyone for everything.