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Saturday, September 11, 2010

The Cost of a Colonoscopy

Okay, many people I know keep saying that a person of a certain age should get a colonoscopy at regular intervals just as a preventive medicine health care measure. I understand the necessity for a person at risk, i.e. for someone in which a health problem is medically suspected; but to have a colonoscopy on a regular, just because basis, I don't know. Especially when I see what the costs are for a colonoscopy.

Recently, my wife, Judy, was in need of a colonoscopy due to medical necessity in that the primary care physician suspected some problems after a physical examination and the return of some medical tests. I will not even go into the costs of these preliminary exams and tests.

However, I feel compelled to tell you about the costs of the colonoscopy including the associated costs of the removal of the five polyps that were discovered and removed during the process of the colonoscopy itself. All total, there have been five different medical providers involved. i.e. the surgeon, the facility, the anesthesiologist, the laboratory, and the pathologist.

Are you ready?

$3517.83 or $1363.10, depending upon how you look at it.

If a person has no medical insurance, the medical providers would make that person pay $3517.83 out of his or her own pocket.

But, if a person has the same medical insurance as I do, the medical providers would accept $1363.10 as payment in full. In our situation, my insurance company paid $729.90 and we paid $633.20 out of our own pocket. The medical providers actually wrote off $2154.73 of their charges because - - - well, basically because the insurance company said the medical providers were overcharging by that much.

This is a summary of that of which I just wrote:
Amount billed: $3517.83
Amount allowed: $1363.10
Insurance paid: $729.90
We paid: $633.20
Written off: $2154.73

If you want to know the details of all that, like how each of those line items are broken down by medical providers, go over to read my comments on Judy Hansen Commentary Medical Cost Ripoff and see the precise amount for each of the medical providers --- and I name names.

A person without health insurance would have to pay $3517.83 for a colonoscopy and removal of polyps. But, as you can see in the case of Judy, those same medical providers are willing to accept $1363.10 as payment in full for persons who have insurance such as mine. That means the person without insurance is charged $2154.73 more than a person with my type of medical insurance. HECK, for the uninsured, that is almost three times as much as it is for the insured. That kind of gouging of the uninsured by the medical providers is a real pain in the ---, just like a hemorrhoid.

I will never ever understand the compassionless political Conservatives and Republicans who think it is all right for low and moderate income people without adequately sufficient health insurance to go without needed health care because of the expensive, overpriced American Health Care Industry.

I do not need to go on with my thoughts on that particular matter because, as my regular readers may recall, I have written a previous Roland Hansen Commentary about health care in the United States.

4 comments:

Hooda Thunkit (Dave Zawodny) said...

Amigo Roland,

If I may ;-)

”A(n) individual person without (the clout of an insurance company behind them) health insurance would have to pay $3517.83 for a colonoscopy and removal of polyps. But, as you can see in the case of Judy, those same medical providers are willing to accept $1363.10 a negotiated payment as payment in full for persons who have insurance such as mine. That means the uninsured/uninsurableperson without insurance is charged $2154.73 more than a person with my type of medical insurance. HECK, for the uninsured, that is almost three times as much as it is for the insured. That kind of gouging...”

I wouldn't look at is gouging, rather than looking at it for what it really (to me) appears to be..., OUR form of socialized medicine.

The so-called gouging is merely the costs of Judy's procedures, an additional portion tacked on to cover the costs of those who won't or can't pay for the medical treatments that the hospital does not deny them. (No one is denied services, but the cost/burden is borne by those without the clout to negotiate a better price.


”I will never ever understand the compassionless political Conservatives and Republicans are you sure that you want to lay the blame for this practice on one particular party??? who think it is all right for low and moderate income people without adequately sufficient health insurance but everybody has an obligation to have adequate/sufficient insurance to go without needed health care because of the expensive, overpriced American Health Care Industry.”

How does one determine the “fair/reasonable” price/cost of of health care?

And, just how long would hospitals continue to stay in business if they weren't allowed to collect enough revenue (from everyone) to keep the bills paid?

It's just like these so-called bailouts; those of us who were/are prudent and have lived within our/their means are rewarded (by our government, both/all parties, by being made to bail out those including car companies, banks, etc. who were not so prudent in their spending ways.

If you think about it, we are more socialized/socialistic than we'd like to admit...

Tim Higgins said...

Roland,

I can understand your anger and confusion over what certainly appears to be an unfair payment system. You writing however, does not appear to take into account that many of the costs charged to and paid by insurance companies are dictated by those of a government-controlled Medicare and Medicaid system. Private insurers will often refuse to pay any more to the doctors than the government mandates.

Such artificial controls on care whose costs are increasing as a result of a lack of tort reform, increasing govt regulation, and an ever-increasing life span of our population add to the situation. Amigo Dave also has it right when he said that costs are also influenced by those who pay nothing, and can lead 'evil private enterprise' to raise prices where they can in order to cover such costs than are unchanging.

The question then, is whether the evil conservatives are to blame for attempting to keep government price controls and subsidies from the business of medical care in this country, or whether it's the good intentions of misguided liberals who have increasing created a crony capitalism in this country in medicine as well as many other parts of the economy.

The answer ultimately might be both, with the caveat that government has proved itself particularly inept in functioning in a business environment. Giving it increasing control in one as important as health care seems reckless at best, and as criminal as the costs you decry at worst.

Judy said...

Dave & Tim,
I agree to disagree with both of you on this issue, but respect your right to your own opinion. On another vein, WHY is it less expensive to get a flu shot at a local supermarket ot drugstore than at ones own doctors office?

Hooda Thunkit (Dave Zawodny) said...

Amigo Judy,

"On another vein, WHY is it less expensive to get a flu shot at a local supermarket ot drugstore than at ones own doctors office?"

I would have to hazard a guess that it's those pesky capitalistic forces at work allowing competition again...

Doctors tend to live and work in a vacuum and feel no pressure to compete, while the Walgreens and WalMarts of the world (with their buying power) can purchase and deliver the same medications for less and still make a profit.

Amerika..., what a wonderful country :-)