Cancer Log 206: Considering co-pays and health

Cancer log 206: Tomorrow morning at 5:30 a.m. (gah) I go in for an exploratory surgery procedure. They’ll be doing a D&C in order to recover a sampling of the endometrium to hopefully determine the cause of abnormal uterine bleeding.

In theory, I’m in early menopause (post-chemo), according to my bloodwork, so they’re fretting because once in a great while, I still seem to have a period. Which is probably nothing, but in case it’s something, it’s better than they catch it early and deal with it. With people who have had cancer, they’re extra-careful with screening such things, which I generally approve of. I am all for an abundance of caution.

That said, the lady from the hospital who called me to get my co-pay in advance (without which, they won’t do the procedure, apparently), said that it would cost $8000 (with anesthesia, surgery itself, recovery, etc.). So I am glad that my HMO co-pay is only $250.

And yet I can’t say that I’m glad I have insurance, because I just went and checked, and as far as I can tell, the same procedure in Canada, including the use of fast-acting anesthesia, is $347. The paper I looked at seemed to think the procedure should cost about $1500 in the US, which made me think I had misheard the phone lady, but then a google search indicated the national average was in fact closer to $8000.

Now, the Canadian paper doesn’t take into account hospital overhead costs, which do need to be paid for, so fine, that’s some of the discrepancy. I do think we should compare apples to apples.

But it does cover all the direct costs for the surgeon, the anesthesiologist, the nurses, the medicines used in the procedure, etc. And $347 to $8000 is a massive jump. I’m super-curious whether Blue Cross / Blue Shield HMO actually pays that $8000, or whether that’s a paper number there only for the patients without insurance, who have to pay it all up front. I’m guessing BCBS has negotiated a much smaller rate — maybe closer to $1500? Or less?

So you know, that’s some nonsense right there. American healthcare system = nightmare mess. Let’s fix it.

https://www.jogc.com/article/S0849-5831(16)31318-0/pdf

https://www.mdsave.com/proc…/dilation-and-curettage/d482fecf

For the record, if I didn’t have insurance, I would certainly pay $347 for this procedure myself. I would not pay $8000; I would skip the procedure, and hope it didn’t cost me everything in the long run.

Leave a Reply

Your email address will not be published. Required fields are marked *