A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Am I Part of the Health Spending Problem? Reflections on My Colonoscopy

Am I Part of the Health Spending Problem? Reflections on My Colonoscopy

May 13, 2005

The most convincing explanation for horrendous annual increases in health costs and premiums is the relentless pace of new tests and technologies used by all of us. Today I was part of this as I celebrated my first colonoscopy. In truth, it wasn't an eager embrace. My doc told me to do it two years ago and I avoided it like the plague; only later did he take away my choice in the matter and schedule it for me. And like a good boy, I did it.

My insurer is Harvard Pilgrim and I use Harvard Vanguard's Kenmore Center which has a spanking new endoscopy/colonoscopy center on the first floor. And are they busy! 50 a day, 250 a week, 13,000 a year! 13 docs and several dozen nurses. I don't know the charge, but it's got to be a pretty penny, especially times 13,000.

Is all this really necessary? Yes. Colon cancer is the second most common cancer after lung (breast cancer is second among women, prostate second among men -- but colon cancer is third among both genders so it's the second most common overall). And it's totally preventable. So an expensive procedure that prevents many cancers also adds many dollars marbled into our health insurance premiums. Five years ago, hardly any one was getting this procedure. Yes, the cost effectiveness of this procedure has been verified in numerous studies (click here to see a few), but those savings offsets occur years into the future while the cost of testing happens today.

The event itself? The prep the day before is nasty. The procedure is, well, kind of groovy. If you want enough drugs, you won't remember a thing except a blissful feeling; if you take a little less, you can see and recall a televised "fantastic journey" into your you-know-where in dazed marvel. (Guess which I chose.) It's worth the trip, for all of us.

By the way, I asked the doc to check if he could find any sign of my head up there, since so many folks have wondered over the years if that's where it's most often located. No sign of it, he told me.