Colonoscopies are promoted and priced for profit in America. Are they necessary? Do they help people, or do they help doctors and medical facilities pad their bottom line? In a word, or 14, is the colonoscopy profit motive so strong as to negatively impact a patient’s health?
Dr. Don Ardell, among many, believes the Western medicine profit motive compromises patient care. Dr. Ardell advises that you be wary and ready to verify anything you hear from your doctor. He believes you should obtain qualified opinions from others as well.
Doctors and other medical providers are not your enemies, says Ardell; but neither are they your friends. Though they may be highly trained professionals, they function in a dysfunctional system designed for profit. Most want to do the right thing, Ardell asserts, but financial and other pressures can lead even ethical practitioners to justify actions not in a patient’s best interest.
Colonoscopy Industrial Complex
Understanding the colonoscopy industrial complex can show us just how the whole system fails to function well for patients. Ardell’s nomenclature echoes the warning from former President Dwight Eisenhower over the Military Industrial Complex.
Medical Providers, Free Enterprise Run Amuck
Colonoscopies represent the most expensive diagnostic test in America. A Commonwealth Fund report showed colonoscopies is billed at rates from $6,385 to $19,438, at retail rates for uninsured people. Insurers can usually negotiate and cut prices to roughly $3,500. Americans with employer-based insurance often assume medical care is free. It is anything but free, as anyone knows who has noted rising co-payments, deductibles, and other phantom charges. Colonoscopy averages a few hundred dollars in most Western countries. In the U.S., where healthcare lobbyists spend millions to get us to spend millions more than other civilized countries, the cost is quite a bit higher than that. Though fully insured, my wife and I were just forced to pay more than $900 in Sept. 2015 for her unnecessary colonoscopy, which, at the time, we were dumb enough to think she needed.
Americans pay more for Healthcare
Elizabeth Rosenthal (“Paying Til It Hurts,” New York Times, June 1, 2013) points out that Americans pay more for nearly every interaction with the medical system. Dr. Ardell points out that a list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out for highest costs in all 21 categories – often by a huge margin.
Spend the Most, get the Least
Though we lead the world in medical spending, several studies show not only that we don’t receive better care, but that we’re less healthy than people in nearly every other Western nation.
Doctors promote Tests
The CDC says more than ten million Americans take colonoscopies each year, at an annual cost of $10 billion. Tests may help a doctor avoid litigation, later, but that doesn’t mean the test ordered was needed or was best for the patient. Doctors must, of course, work to prevent lawsuits, so it is understandable why they might order conoloscopy for anyone over, say, 50, or anyone suffering from anything a coolonoscopy may be able to help diagnose. Understandable, but that still doesn’t mean colonoscopy is in the best interests of ten million people every year.
Colonoscopies sold with Fear
Colonoscopies, says Dr. Ardell, are marketed by fear. The high possibilities of horrific torment and premature death from colon cancer are sometimes described with almost wicked delight by colonoscopy counselors. But other tests for colon cancer are much less invasive than conoloscopy, less expensive and just as effective, according to federal experts.
We’ve defaulted to the most expensive option for screening colon cancer, with little supporting data, according to Dr. H. Gilbert Welch, professor of medicine at Dartmouth Institute for Health Policy and Clinical Practice.
Dr. Ardell says that for most people, regular testing for blood in the stool will suffice if one wants to avoid a costly, unnecessary colonoscopy.
“Unfortunately for unwary, easily intimidated patients,” says Ardell, “settling for this low cost option is difficult,” and one is likely to be bullied or cajoled by a medical practitioner to take the colonoscopy. Stool testing is not a big moneymaker for the colonoscopy industry.
Colonoscopy Patient Beware
The same New York Times report also stated that studies have not clearly shown colonoscopy prevents colon cancer or death better than other, less expensive and less invasive screening methods. Some recent papers even suggest that it does not, in part because early lesions may be hard to see in some parts of the colon.