Preventing Regrets More Painful than Colonoscopies

While the medical field is working hard at opening more opportunities for patients with cutting edge research, Medicare has recently taken a step in the opposite direction. An article in the New York Times informed that Medicare, the governmental insurance program, made a decision, although not final, to no longer pay for virtual or CT colonoscopies. In contrast to the traditional colonoscopy, the virtual colonoscopy is not only noninvasive, but also more affordable. “Dr. Perry J. Pickhard, …professor of radiology at the University of Wisconsin,…said the virtual colonoscopy was ‘better, safer, faster, cheaper’ than conventional colonoscopy.” So what could have prompted Medicare’s decision?

Medicare believes that these virtual colonoscopies may not “improve outcomes in Medicare beneficiaries.” It is reported that people who undergo virtual colonoscopies fall under an age group that is more prone to developing polyps. Because of the weak effectiveness of virtual colonoscopies in detecting small polyps, the larger polyps detected would warrant another traditional colonoscopy for radiation treatment. As argued by Dr. John Petrini, president of the American Society for Gastrointestinal Endoscopy, “Why do a test that will pretty much require another test to be done?”

But is it ethical to limit patients to the traditional colonoscopy as a result of this decision? Virtual colonoscopy is viewed as “a more tolerable alternative to conventional colonoscopy in screening for colon cancer.” Minimizing the choices can hinder individuals from performing colonoscopies, especially for those who do not want to go through the uncomfortable process of the traditional colonoscopy, “in which a probe with a camera on its ends is snaked through the rectum and colon.” This notion can negatively influence the welfare of the Medicare beneficiaries by limiting their sources. It is also particularly interesting to note the emphasis Medicare placed upon how “less cost-effective” the procedure is in making its decision. As less effective at detecting smaller polyps as it is, opening up opportunities for polyp detection, which is the key to successful prevention and treatment of colon cancer, should be the priority. We certainly should prevent regrets such as an increase in colon cancer cases among the Medicare beneficiaries that could be more painful than the conventional colonoscopies.

Sources:
http://www.nytimes.com/2009/02/13/health/policy/13colon.html?ref=health