Insurers again say "discomfort" should not be covered for colonoscopies

Dec/28/2007 11:58 Filed in: Insurance Coverage
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A few years ago Katie Couric had a colonoscopy on national TV to raise awareness of this procedure that could save a lot of lives. I recently had one and since I was put to sleep during the procedure it was easy and painless. Now Aetna is refusing to pay for anesthetic during colonoscopies and this will surely lead to a drop in screening which in turn will lead to increased health costs and more lives lost to colon cancer.



Aetna feels that the use of propofol during colonoscopies is "medically unnecessary" and will effect about 16.6 million people. Since physicians that conduct colonoscopies are not trained in using propofol an anesthesiologist is usually required which can add anywhere from $300-$1000 to the bill. However having an invasive procedure is scary to a lot of people and the use of a drug to "put you out" might be of comfort to patients and thus lower barriers to getting this procedure. The more people that get this procedure the more that can be treated and saved by early detection. I have had colonoscopies while both being asleep and in a twilight state and I can tell you for sure that being asleep is a LOT more desirable.


So another insurer, looking to trim costs, has decided that it's members can stand some discomfort and that they should not pay because people want to be asleep while their lower intestines are explored with a hose. This is surely going to lead to some people saying no to colonoscopies and as a result the rate of colon cancer may increase. The real power of what patients receive in their healthcare choices is coming down to a balance sheet and options are gradually being eliminated to save money. Patients are going to find out soon that their health choices, physicians, and medicine are not determined by what is good for them but what costs the least.
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