Advertisement

Find answers, ask questions, and connect with our community around the world.

  • Deductibles discourage patients from diagnostic breast imaging

    Posted by jonquil on April 5, 2023 at 9:14 am

    I championed CONNECTICUT PUBLIC ACT 22-90, effective January 1st of this year, which mandates NO FINANCIAL BARRIERS for insureds to receive BOTH Screening and Diagnostic mammograms, breast ultrasounds and MRI’S for the Earliest Possible EARLY DETECTION of Breast Cancer, and early testing for Ovarian Cancer, without having to meet exorbitant deductibles, cost-sharing, co-insurance or co-pays.

    And much more !

    Insureds with either Individual or Group Health Insurance plans…the plans with the HIGH deductibles, etc.,…may receive the proper essential diagnostic follow-up testing without the burden of out-of-pocket cost.

    CONNECTICUT PUBLIC ACT 22-90 is now the Gold Standard in the nation of such legislation. I am proud that Connecticut has, once again, taken the lead in complete breast health care, as it did in 2010, with the first State legislation mandating Dense Breast Tissue Notification.

    It is my hope that CONNECTICUT PUBLIC ACT 22-90 will become the blueprint for Federal legislation.

    I admire and congratulate Dr. Michael Ngo of Boston Medical Center for his important research on this subject.

    BramWijngaarden replied 1 year, 10 months ago 10 Members · 18 Replies
  • 18 Replies
  • Melenas

    Member
    April 5, 2023 at 9:37 am

    Will you champion that for prostate screening? or colon cancer? no barrier? 

  • mario.mtz30_447

    Member
    April 5, 2023 at 12:12 pm

    Where does all the money to offer all these services come from?  
    Is a patient able to request a breast MRI and receive one for free (e.g. dense breasts)?  Yearly breast MRI screening?
     

    • mwakamiya

      Member
      April 8, 2023 at 4:00 am

      Why not free low radiation chest CTs for everyone!
      Whole body MRI screening exams for all beginning at 25 anyone? 
      If you want to save even more lives — cardiac CTA screening for any male over the age of 35. I personally know of 5 close friends that would have saved. 

      • btomba_77

        Member
        April 8, 2023 at 4:44 am

        Quote from PirateRad

        Why not free low radiation chest CTs for everyone!
        Whole body MRI screening exams for all beginning at 25 anyone? 
        If you want to save even more lives — cardiac CTA screening for any male over the age of 35. I personally know of 5 close friends that would have saved. 

        The [i]reductio ad adsurdum[/i] argument doesn’t really apply here.
         
        Nobody is advocating inappropriate screening that increases costs without providing public health benefit.
         
         
         
        The point being made is that if we had a healthcare system that really cared abut health, *appropriate* screening studies in *appropriate* populations would have a low enough cost and high enough access to make sure that the largest possible number of *appropriate* exams got done in order to give the largest increase in patient life years.
         
         
         
        We would certainly see more net public health benefit from doing screening CTs on all people who meet the risk/benefit criteria than if we, say, did 15 CTPE chests in every ED across the country every night on patients for whom there is little to no benefit.
         
        Same goes for breast imaging and any other *appropriate* screening study and *appropriate* follow on diagnostics and treatment.
         
        But I guess that all only applies if you want a healthcare system focused on the health of the public.

        • kayla.meyer_144

          Member
          April 8, 2023 at 5:13 am

          Did any of the braying nay-sayers bother to look up the act? Or just assume healthcare is totally free & is a zero-sum game & taking $ out of their pockets?
           
          Why not all those exams at affordable prices for everyone, ANYONE who needs the exams?
           
          The OPs own title of the thread already speaks about INSURED patients because deductibles do not apply to uninsured.
           
          [link=https://www.cga.ct.gov/2022/act/pa/pdf/2022PA-00090-R00SB-00358-PA.pdf]https://www.cga.ct.gov/2022/act/pa/pdf/2022PA-00090-R00SB-00358-PA.pdf[/link]
           
          CONGRATULATIONS! to the OP!

          • smfst7_929

            Member
            April 8, 2023 at 7:38 am

            I think we should give out free weight loss programs and gym memberships. That would reduce cancer more than this.

            • btomba_77

              Member
              April 8, 2023 at 8:38 am

              Quote from sartoriusBIG

              I think we should give out free weight loss programs and gym memberships. That would reduce cancer more than this.

              Agree … we should have a high quality and vastly expanded public infrastructure around exercise and nutrition/diet.
               
               
              Would be a huge bang for the buck.
               
               

              • Melenas

                Member
                April 8, 2023 at 9:33 am

                Last I check exercise doesn’t require money. A simple walk up and down a 5 story apartment works; walking around your neighborhood or park works; parking far away from the grocery store and walking far works; going to the basketball park on weekends works; hiking any number of trails in town works. 
                We don’t need to spend money on gym membership. 

              • Unknown Member

                Deleted User
                April 8, 2023 at 9:44 am

                Breast imaging is supported by strong political forces, who wants to deny our mothers and wives medical care? It doesn’t mean it is wrong, as long as it is appropriate.
                Once you pour money into segments of care, physicians and hospitals are drawn to it like flies and invariably it is exploited. There is no balance. Mammodonnas result, with increases in utilization ranging from procedures to hi tech MRI proliferating outside of any epidemiological justification. Let’s MRI every breast and and have 15% recall rates, because we are saving lives…and making a lot of money. Screening mammo reimbursement is way out of line compared with other imaging. 
                Institutional medicine takes discipline. There are imaging patterns that can be justified with data. But when profit is introduced; all sorts of sketchy justifications ensue. “We want to catch every cancer.” Well yeah, especially if it pays a lot.
                 

                • Unknown Member

                  Deleted User
                  April 8, 2023 at 9:56 am

                  I want to emphasize, I support high quality breast imaging. But as some rads become soley invested in it as a specialty, they lose sight of reality; and it becomes everything. The sky is the limit, they are saving lives. It’s not about subterfuge, but more about lack of adult supervision and myopia. No different than CTA’s on 90 year olds in the ED by PA’s, if it’s available it will be utilized.
                  There is a point of diminishing returns in all imaging and we as physicians are really bad at knowing where that is. We complain about it when it burdens us, like the ED. But when we are the benefits us; it’s OK.
                  It’s all out of control.

                  • Melenas

                    Member
                    April 9, 2023 at 8:28 am

                    boomer, well said. 
                    I think just simply saying we should save everyone and find every cancer and if you dont support that you are a bad person is cruel. 

                    • mircea.cg_544

                      Member
                      April 9, 2023 at 9:43 am

                      “if you want a healthcare system focused on the health of the public” certain things must be completed and others must be subsidized to be very low cost.   Most effective based on deaths per year:
                       
                      1) Outlaw Tobacco and alcohol. 
                      2) Free and unlimited clean water.  Adequate sewage handling.
                      3) Open access to healthy food (doritos, snickers, etc forced to change recipes to meet new standards).
                      4) Safe housing (no asbestos, mold, or natural gas) with at least 750 sq feet per occupant.
                      5) Maximum speed limit – 40 mph.
                      6) Genetic testing to earliest identify those at risk for high morbidity/mortality diseases.
                      7) Mandatory exercise and cancer screening.  You don’t do it, you pay extra taxes or lose social security benefits
                      8) Blood pressure and cholesterol meds open access.
                      9) Mandatory early identification of Alzheimer’s disease and early access to cutting edge medicine and Tau pet scans.
                      X factor) Government prepared for martial law in case epidemic outbreak occurs.
                       
                       
                       

                    • kayla.meyer_144

                      Member
                      April 9, 2023 at 9:50 am

                      And here I thought all the right wingers were complaining that it is the liberals & Democrats who support the Nanny State! Now I see Nanny being a right-winger.

                    • buckeyeguy

                      Member
                      April 9, 2023 at 12:01 pm

                      Quote from Frumious

                      And here I thought all the right wingers were complaining that it is the liberals & Democrats who support the Nanny State! Now I see Nanny being a right-winger.

                       
                      You really are dense.

                    • mircea.cg_544

                      Member
                      April 9, 2023 at 12:35 pm

                      Shhhdream run. Im huntin wabbits.

                    • buckeyeguy

                      Member
                      April 9, 2023 at 8:06 pm

                      Quote from xraygiggles

                      Shhhdream run. Im huntin wabbits.

                       
                      haha, indeed

        • buckeyeguy

          Member
          April 9, 2023 at 11:58 am

          Quote from dergon

          Nobody is advocating inappropriate screening that increases costs without providing public health benefit.

           
          Yeah they are.
           
          And by the way, I’m not arguing that the health care system is “all about health” either. People like you are all about 32 trillion in debt, though, and soon to be 50. Without any consequences, right Stephanie?

  • BramWijngaarden

    Member
    April 11, 2023 at 7:10 am

    Thanks for letting us know about this. I work for a radiology practice in Connecticut, and it will help our patients tremendously. And, as someone who has an ultrasound every year due to my own family history of breast cancer, this is welcome news.