Do borders really exist in medicine, where the mere act of crossing political boundaries changes what screening programs are recommended? It seems that they do exist, and they’re well guarded.
Generating numerous headlines in major Canadian papers such as the National Post, The Toronto Star, Globe and Mail and Reuters, the Canadian Task Force on Preventive Health Care came out this week with new recommendations on colon cancer screening, essentially saying that routine colonoscopies were not justified. By contrast, in the United States, the U.S. Preventive Services Task Force (USPSTF) 2015 guidelines say that adults aged 50–75, should have a colonoscopy every 10 years; FIT (fecal immunochemical testing) or gFOBT (guaiac fecal occult blood testing ) annually or flexible sigmoidoscopy every 10 years plus FIT annually.
For this age group the Canadian Task Force says there is insufficient evidence to justify using colonoscopy for routine screening for colorectal cancer. They recommend patients should undergo the fecal occult blood testing every two years or flexible sigmoidoscopy – a procedure which examines the lower part of the colon and rectum every 10 years. These colon cancer screening guidelines, published in the Canadian Medical Association Journal, are for low-risk people: asymptomatic adults, aged 50 to 74 who have no prior history of the disease, no family history or symptoms such as blood in the stool, or a genetic disposition to the disease.
As we enter 2012, many patients will be changing to new insurance plans.
And for a few, deductibles will be rising.
One thing that’s emphasized in the Affordable Care Act, however, is that preventive services would remain “free.”
However, consider this story of a man, who thought he wouldn’t have to pay for his screening colonoscopy, instead was charged over $1,000 for the procedure.
From USA Today,
Bill Dunphy thought his colonoscopy would be free.
His insurance company told him it would be covered 100 percent, with no copayment from him and no charge against his deductible. The nation’s 1-year-old health law requires most insurance plans to cover all costs for preventive care including colon cancer screening. So Dunphy had the procedure in April.
Then the bill arrived: $1,100.
The reason? During the procedure, polyps were found and rightfully removed. But in doing so, it changed the colonoscopy from a screening procedure to a diagnostic procedure, thus making it applicable to the patient’s deductible.
Such semantics are important, as insurance companies will seize them at every opportunity to pass on costs to both patients and hospitals….
- Preventive care: It’s free, except when it’s not (goerie.com)
- Preventive care: It’s free, except when it’s not (usatoday.com)
- Loophole in U.S. law means not all preventive care free (ctv.ca)
- Preventive care: It’s free, except when it’s not (sfgate.com)
- Preventive care: It’s free, except when it’s not (seattlepi.com)
- Preventive Care Is Free — Except For When It’s Not (huffingtonpost.com)
- Preventive Care: It’s Free, Except When It’s Not (maboulette.wordpress.com)
- Preventive care: It’s free, except when it’s not (mysanantonio.com)
- Preventive care: It’s free, except when it’s not (seattletimes.nwsource.com)
- Know What to Expect From Colonoscopy Prep (everydayhealth.com)