Not So Free

One of the selling points for the healthcare act has been that it will save money for patients and for insurance companies by emphasizing prevention. For example, screenings for colon cancer and breast cancer would have to be paid for by insurance companies, but early detection would save the insurer down the road because early detection means less expensive treatment. That's fine in theory, but that's not how it sometimes plays out, according to an AP report published by the Sacramento Bee.

If a woman has had a positive mammogram in the past, even if it was a false-positive, the next mammogram is a diagnostic, not a screening test. Similarly, during a colonoscopy, if a doctor finds a polyp and snips it out, insurers maintain the test is no longer a screening but rather a diagnostic procedure. Neither scenario is covered by the prevention provisions of the act, so the patient at the very least has a copay to make. If the patient has a high-deductible policy, he or she may very well have to foot the entire bill. That's hardly a healthy incentive to have the testing performed. And that effectively defeats one of the provisions for reducing health care costs.

You've got to hand it to health insurance companies: they have a penchant for finding ways to save money. Unfortunately for policy holders, that cost savings too often has a negative impact on their health care needs.

The more things change ...