I missed a big article in today's Hartford Courant. It reports that Anthem BCBS of Connecticut is offering its members a rebate if they go to lower cost doctors. Anthem affiliates in other states are experimenting with this, too (so why is this not even hinted at in national press today?). Shop around for lower cost MRIs, colonoscopies and you get payback from Anthem.
Let me tell you a little story. My Crohn's expert is in Manhattan. A colonoscopy and upper endoscopy costs about $5000. Anthem thinks it should cost about $1500. I can't really afford to pay the difference over and over again, so for my last scopes, I tried another doctor in Connecticut. I thought if I went to someone at Yale, they ought to be good enough, right? Well, instead of twilight anesthesia which leaves you somewhat awake (for me, wide awake), they used propofol, which knocks you completely out. I had my scopes, went home, thinking the whole thing had been relatively uneventful. Until the next morning when I woke up with fingerprint bruises all over my neck. Come to find out that I stopped breathing during my scopes so they had to manipulate my airway -- and nobody was planning to tell me about this.
I was (and am) outraged. And this is what happened when I went to a doctor that Anthem wanted me to go to. So here's my response to Anthem: Screw you! My health matters more than you getting to save a little money. But the upshot? I haven't had scopes in over 2 years at least in part because I can't afford to have them done in New York and I'm afraid to try anybody in Connecticut ever again. So in the end, Anthem wins -- and I risk colon cancer because I am not being screened. Is this really what Anthem wants?
I've gotten to know a few high-ranking insurance company executives -- although not at Anthem. But they are decent people. They would want me to get screened. But would they pay for it? Probably not any more than Anthem would. Jennifer