The Patient Protection and Affordable Care Act (ACA) promised Americans free preventive care, including colon cancer screenings. However, a widely circulated Associated Press article by Carla K. Johnson shows consumers are routinely being charged for routine preventive care.
In the article, Johnson, a board member of the Association of Health Care Journalists, reveals how doctors, hospitals, and other medical care providers circumvent the letter of the law and charge consumers for preventive care. "[C]olonoscopies can go from free to pricey while the patient is under anesthesia," says Johnson.
[T]he greatest source of confusion is colonoscopies, a test for the nation's second leading cancer killer. Doctors use a thin, flexible tube to scan the colon and they can remove precancerous growths called polyps at the same time. The test gets credit for lowering colorectal cancer rates.
So if the doctor sees nothing, the colonoscopy is free. But if the doctor removes any polyps, the patient pays full price because the colonoscopy becomes a medical procedure rather than a preventive screening.
Johnson's article also talks about the confusion over mammograms. The service is free if it's a "screening mammogram" but is charged for it it's a "diagnostic mammogram." Confusion reigns over other preventive treatments, such as stop-smoking drugs. Should the drugs be free, or only the physician consult resulting in a prescription? And what does it take to change the law or the way it is interpreted? Here's Johnson on the subject of colonoscopies:
Doctors and prevention advocates are asking Congress to revise the law to waive patient costs — including Medicare copays, which can run up to $230 — for a screening colonoscopy where polyps are removed.
Will we need Congress to revise the health care law for every minor decision, such as whether aspirin taken for a heart condition is preventive and should be free? Given the speed with which Congress tackles such major issues as the debt ceiling, do we really want to be running to Congress every time we're charged for a test?
Under the federalization of health care, that's the kind of bureaucracy we can expect to deal with on a daily basis. Under the Health Care Compact, these decisions would be made at the state level. While not perfect, it's a lot faster tweaking state law than it is getting an act of Congress passed.
Source: "Preventive care: It's free, except when it's not," USA Today Dec. 28, 2011.
Image courtesy of Kitt Foo used under its Creative Commons license.
Steve O'Keefe is a freelance writer, author, and book editor whose writing has appeared in numerous libertarian publications.