My colonoscopy

Jeff vonKaenel

I have played a small part in escalating the cost of health care in America, and I am not happy about it.

That’s one reason I was pleased to see the Trump administration, citing the “secretive nature of pricing in the health care market,” suggest requiring doctors, hospitals and insurance companies to tell patients what they are charging us—before they perform procedures.

Yes, I used the words “pleased” and “Trump” in the same sentence!

I would certainly take information on what procedures cost into consideration before selecting doctors, choosing hospitals or undergoing procedures. It would definitely be a factor. And with this information, I believe millions of Americans who do not like wasting money could rein in wasteful spending.

Let me give you a personal example. In 2001, at age 50, I dutifully signed up for a colonoscopy at Kaiser Permanente. It was not that bad. It was an office visit, and took about 15 minutes. It was interesting to see the inside of my colon on the computer monitor.

Ten years later, our company had switched to Sutter Health. It was time for another colonoscopy. But this time, for reasons that were not explained to me, I was signed up for a surgery center, where I was knocked out with anesthesia, with a longer recovery time. My wife had to pick me up. It was quite a hassle.

Was there colon cancer in my family history? No. Was there a stool sample taken to see if there was a potential problem? No. Did I ask for the more invasive, more expensive procedure? No. Was I told what the procedure would cost me? No. Was I told what the doctor would charge or what the anesthesiologist was charging or what the surgery center facility would cost? You already know the answer to that question. No.

As far as I can tell, the only condition I had that would warrant such a procedure, which costs thousands of dollars, was an insurance policy that was willing to pay for it. According to Elisabeth Rosenthal, a Harvard-trained doctor and former New York Times reporter, in most developed countries, colonoscopies cost a few hundred dollars and are performed at a simple office visit.

Rosenthal reports that over the last several years, “the high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue.”

I do not know what my bill was, but I would guess somewhere around $6,000, or maybe more.

I do not know what my doctor’s annual income was, but gastroenterologists earn an average of $433,000 a year, according to Merritt Hawkins & Associates, a medical staffing firm.

At age 65, now on Medicare, I switched back to Kaiser. Near my 65th birthday, my Sutter doctor sent me a letter suggesting that I come in for another high-priced colonoscopy. Why wait 10 years when I could come in at five? I ignored this email.

Instead, each year, I mail Kaiser my stool sample. If they find anything abnormal, I will go in for more tests.

With the transparency on health care costs that the Trump administration is proposing, I believe I would have been a more effective advocate for reasonable healthcare.

In other words, I would have told my Sutter gastroenterologist where to stick it.

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About the Author

Jeff vonKaenel
Jeff vonKaenel is the president, CEO and majority owner of the News & Review newspapers in Sacramento, Chico and Reno.