(See part 1, part 2, and part 3.)

What is interesting about my experience is that even physicians whom I know personally and to whom I have told this story are surprised that whether I am charged for a colonoscopy depends on whether any polyps are found.

I also spoke about my experience at a health care panel a couple of years ago. Another panelist, a professor at another university, said that he thought that it was perfectly reasonable for us to treat health care like any other commodity and that consumers should shop around for the best deal. I responded that this was absurd. Health care is not a commodity to be compared like buying detergent. People often confront the health system in situations where they are deeply troubled or their plight is urgent or where they have few choices.
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(See part 1 and part 2.)

By now I am fed up with all this back and forth and decide that I will schedule the colonoscopy anyway and deal with being charged afterwards. I call the doctor’s billing office again to get the final ok and learn something new. They say that the colonoscopy is considered ‘routine’ and thus free not only if there were no prior indications of cancer but also only if the doctor finds absolutely nothing. If the doctor finds even a single benign polyp (which is not uncommon), then it ceases to be routine (and free) and I have to pay the full amount, which is about $1,500. The insurance company had not told me this piece of interesting news nor is it spelled out in their policy. So whether I pay nothing or whether I pay about $1,500 depends not on the procedure itself but on what they find during the procedure! In other words, I have no idea going in what it is going to cost me coming out.
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In my first post in this four-part series, I pointed out that the choice of doctors and hospitals is very limited in the US. But as I continue to look further into my ‘free’ colonoscopy I discover more pitfalls.

I know that insurance companies try to find ways to avoid paying so I analyze my policy carefully and call the insurance company and ask what the word ‘routine’ means, since only those kinds of colonoscopies are free. I am told that the colonoscopy is considered routine if it is done as part of a regular check-up and not because of any symptoms that might suggest that I may actually have colon cancer.

This strikes me as bizarre, that the procedure is free only if there are no indications at all that I have any problem. The slightest hint of a symptom and bang, I am on the hook for well over a thousand dollars, the cost of the procedure.
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(For previous posts on the issue of health care, see here.)

In anticipation of Obama’s speech on health care this week and as a coda to my long series on health care, in a four-part series I am going to write about a recent experience I had with the bureaucracy of the health care system in the US, not for any serious illness, but to get a ‘routine’ colonoscopy.

I recount my story in detail not because it is tragic (it isn’t) but to show how even seemingly simple things are made enormously complicated because of the private profit-seeking system that we have. The absurdity of it is that what I went through is so common in the US that people think that it is the only way to do things, unaware that in other developed countries, people do not have to go through this nonsense.
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