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Let's (Not) Get Physicals

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FOR decades, scientific research has shown that annual physical exams — and many of the screening tests that routinely accompany them — are in many ways pointless or (worse) dangerous, because they can lead to unneeded procedures. The last few years have produced a steady stream of new evidence against the utility of popular tests:

The New York Times has more...

 

 

High Cost of Colonoscopy Anesthesia

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From the New York Times.

Patients who undergo colonoscopy usually receive anesthesia of some sort in order to “sleep” through the procedure. But as one Long Island couple discovered recently, it can be a very expensive nap.

Both husband and wife selected gastroenterologists who participated in their insurance plan to perform their cancer screenings. But in both cases, the gastroenterologists chose full anesthesia with Propofol, a powerful drug that must be administered by an anesthesiologist, instead of moderate, or “conscious,” sedation that often gastroenterologists can administer themselves.

And in both cases, the gastroenterologists were assisted in the procedure by anesthesiologists who were not covered by the couple’s insurance. They billed the couple’s insurance at rates far higher than any plan would reimburse — two to four times as high, experts say.

But there’s a bigger problem for consumers here, too. Many physicians who are not the primary contact with patients — like pathologists and radiologists as well as anesthesiologists — do not participate in health insurance plans. When they provide medical services at hospitals or outpatient centers, their charges may not be covered, or may be only partly covered, leaving even well-insured people with large, unexpected bills.

So, what to do if you need a colonoscopy?

CONSIDER ALTERNATIVES Other recommended colon cancer screening methods include the fecal occult blood test, which involves collecting stool samples at home, and sigmoidoscopy, in which a long, flexible tube with a tiny video camera is used to examine the lower colon. Indeed, a study published in The New England Journal of Medicine last week found that patients who underwent sigmoidoscopy had lower rates of colon cancer and lower cancer death rates.

 

Swiss Health Care

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It is useful to look at other countries health systems for examples of how they can achieve high quality health care at lower cost.

I would prefer to take a systems view where we look at other complex systems which have approached this problem more successfully.  We can look at the health system of all of the other OECD "developed" countries as well as a few "developing" countries for examples of how to achieve better health at much lower cost.
For instance, Switzerland has a health system that is similar to what we are trying to create in the US.  They have mandatory coverage through private insurers.  However, they also have strong regulation of prices and services which keeps their costs at less than half of ours with much better access and quality.

 

 

International Federation of Health Plans 2010 Price Report

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The International Federation of Health Plans (ifhp.com) is an organization of over 100 health plans in more than 30 countries.  They have just presented their annual price report.  The US comes out number one (and that is not a good thing).  The US costs are much greater for all of the items and the costs are many times that of the next most expensive countries.

We have serious problems of cost which must be addressed.  We also don't get good value for this high cost as our health indicators are below (less healthy) than all of these other countries.

Here are a few samples from the report:

Last Updated on Wednesday, 24 November 2010 02:55 Read more...
 

Why myCarePrice?

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Health care costs in the US are about twice those of other developed countries.  Unfortunately, this does not translate into better health since the US is close to the bottom of a list of 21 developed countries in health status.

There are many reasons for the high cost and low effectiveness of health care services in the US.  Some of these are high prices for services and drugs and unnecessary and duplicate services.

Everyone in the US pays for these high costs either directly or through insurance.  Unfortunately, health care pricing is not transparent.  There are many different prices and most of the time, these prices are not published.

This web site gives you the tools you need to understand pricing; know what is a reasonable charge for a service; and understand if you need a service.

Last Updated on Monday, 22 November 2010 19:39