Scoping for Dollars

This article in the NY Times is just another example of humans seeing what they want to see.  The title is The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures and the author rips our system for being so expensive.  Agreed.

In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.

Does this not prove my point that we need to shop around so that prices come down?  Our government mandated that colonoscopies be put into EVERY insurance product yet never figured a way to bring down the price.  How about using the free market system?

She goes on:

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system

Agreed.  So, let’s makes prices transparent and let people have an Amazon type method of comparing. Instead, Obamacare did nothing to fix this and allowed some specialties to constantly be rewarded for doing procedures.

Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation. They are often prescribed and performed more frequently than medical guidelines recommend.

Here is my biggest beef. When I need a colonoscopy for a patient, the local GI requires that a consult be done first. Why?  And it is done by a midlevel.  When I need a consult, once again it is done by a midlevel and the recommendation ALWAYS is some type of procedure (upper or lower endoscopy).  How convenient and rewarding. Here is the kicker.  Most of the time they NEVER give me a diagnosis.  They just give me procedure report.  In other words, no brainwork done.  The result is I am stuck with a patient with abdominal pain and they can’t be bothered to help me figure it out.  That’s the missing piece that the author doesn’t see.