Sunday, October 14, 2007

Where the Money Goes

We visited Harry and Louise (not their real names), both in their 80's, here in California and what follows is a small excerpt of our conversation:

“You know, I had an examination by a physician here in Calistoga, California, and he has never removed my clothes. It is so interesting, he just stands me on a scale and has me grip these two side bars, and then he gets this big print-out on me. I think I’ve seen him five times and he’s yet to completely examine me. But boy, do I have a lot of bills from the lab company. He gets blood work on me every three months.”

"Could I see the information that he gets on you?"

“Sure. Here it is.”

I looked and it contained her weight and body fat measurement, calculated from an impedance measurement taken from each arm.

“Who pays for these evaluations?”

Blue Cross and Blue Shield."


“Yeah. They pay for all of these checkups. They call it their “wellness” examinations. And my doctor, well, he specializes in Preventative Medicine.”

“And Blue Cross pays him for these evaluations?” I asked.

“Yep. I have a great policy.”

"Louise, have you ever thought of getting a general internist or family practice physician?"

Great indeed. That is until Louise gets sick. Then the insurer won’t be able to find the money to pay for her care once she gets sick.


Because they’ve spent too much money reimbursing unproven technologies called impedance measurements that have little data to support their effectiveness. Will a change in bioimpedance discover a growing skin cancer or the breast mass? Is it really proper to reimburse physicains who never examine a patient?

In an era where precious healthcare dollars are not available for millions of uninsured, I was appalled to learn of this practice of reimbursing such technologies in California, all in the interest of “wellness,” a medical misnomer unto itself.


1 comment:

Howard Luks MD said...

Every few days I see a patient or two who present me with their findings on their spine ULTRASOUND. These are performed and read by radiologists at the direction of chiropractors. These same offices bill for an EMG with three surface electrodes.