Who’d Have Thought Colonoscopies Could Explain it All

We’re glad that John Green directed us to this New York Times article from June. A story of Deirdre Yapalater’s colonoscopy illustrates many of the market failures driving up healthcare costs in America. The publication was kind enough to create an interactive map that lets you compare the average cost of a colonoscopy across the country, too. Very cool.

“… Ms. Yapalater recalled, she did not ask her doctors about the cost of her colonoscopy because it was covered by insurance and because ‘if a doctor says you need it, you don’t ask.’ In many other countries, price lists of common procedures are publicly available in every clinic and office. Here, it can be nearly impossible to find out.”

Yet again, we see the rebellious nature of our direct care model. Given, we aren’t performing colonoscopies here at Atlas MD, we ARE ADVOCATES FOR OUR PATIENTS, and will get in the trenches and negotiate fair prices. It’s in patients’ interest, and our interest, part of the beauty of the free market. But there’s more the article considers…

“Consumers, the patients, do not see prices until after a service is provided, if they see them at all.”
Again, direct care works quite the opposite. We tell patients what EVERYTHING COSTS and WHAT THEY GET WITH THEIR SUBSCRIPTION. From there we offer additional labs and prescriptions at set prices.

“Even doctors often do not know the costs of the tests and procedures they prescribe.”
This differs in our case. One, we know what we charge (and don’t charge for) and we will find out the cash prices of procedures we coordinate for our patients such as MRIs, CT-scans and more.

“Payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.”
This is true. And this is part of what patients get when they form a relationship with a direct primary care physician, an advocate fighting for their bottom line.

“It all comes down to market share, and very rarely is anyone looking out for the patient,” said Dr. Jeffrey Rice, the chief executive of Healthcare Blue Book.
This attitude is exactly why we started the practice we did, and why we want more doctors to adopt it. Because our job should be to look out for the patient, not have to craftily maneuver just to protect our own bottom line.

Check out the complete article for a breakdown of market failures. One, there is the “Katie Couric” effect, where patient demand increased because she lost her husband to colorectal cancer in 2010, and had a colonoscopy on television that year. Two, this should have pushed prices down. But instead the opposite happened. And, a new problem was introduced because of the inexplicable spread in prices for the procedure. Companies like Costco couldn’t justify the difference in quality for a screening that cost ~$800 versus +$5,000, so guess what? They decided that employees would get ~ $1,200 to spend on the procedure through employee-insurance coverage, and then have to foot the rest of the bill. Hence walking us back to our original problem: many people don’t know what things costs, and most often don’t bother asking.

One thought on “Who’d Have Thought Colonoscopies Could Explain it All

  1. Pingback: How badly is our #healthcare market failing? Just… « Hippocrates Shrugged

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