Re: Insurer considers drop of sedation in colonoscopy

On Wed, 27 Feb 2008 21:21:15 -0800 (PST), lhamo55
<lhamo55@xxxxxxxxxxxxx> wrote:

On Feb 27, 8:15 pm, Mike Berkowitz
<mkb...@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx> wrote:
On Wed, 27 Feb 2008 18:14:11 GMT, "OldGoat"





<oldgoatm...@xxxxxxxxxxxxxxxxxx> wrote:
Well isn't this a fine kettle of fish?

Every time someone has a colonoscopy without anestesia, a member of the
board of directors of Aetna, should have one without it. How many people
could they save with their brave example? How many people will they kill
with their cowardly penny pinching?
Here's a fine example of the type of health care quaility we can expect when
either party of the government gets their hands on it. You'll be the most
healthy person alive, wishing that you were dead.

From Yahoo News--og:

Aetna postpones sedation policy change

AP Business Writer 26 minutes ago

Aetna Inc. said Wednesday it will delay a proposed policy that would stop
covering the cost of using anesthesiologists during colonoscopies.

The policy had been opposed by a group of New Jersey doctors who said
denying coverage of anesthesiologists to anxious patients would lead to
fewer cancer screenings.

The Hartford-based insurer's policy was to take effect Apri1 1. Aetna said
it will now be implemented after the U.S. Food and Drug Administration
approves other forms of sedation.

"Implementation of our policy on April 1 would inconvenience our members ...
and potentially depress cancer screening rates in the short term," said Dr.
Troyen Brennan, Aetna's chief medical officer.

Aetna initially announced its policy in December in an attempt to address
questions about the medical necessity of an anesthesiologist's services
during routine upper and lower endoscopic procedures, such as colonoscopies.
Aetna would still cover anesthesiologists for high-risk patients.

The change was opposed by the Medical Society of New Jersey, which said
patients should be assured that their insurance coverage includes the cost
of anesthesiologists who administer propofol, an anesthesia the doctors say
is effective and comfortable.

A call was placed to the group seeking comment.

Aetna has said moderate sedation works just as well and does not require an
anesthesiologist, which can drive up the cost of the procedure by between
$200 and $1,000. Gastroenterologists generally decide whether to use
propofol or moderate sedation.

Aetna said it hopes delaying the policy will allow adequate time for new
"attractive, patient-friendly alternatives to anesthesiologist-monitored
sedation services" to be approved by the FDA.

New medical devices, as well as new sedatives, are expected on the market
during the late summer and are in review with the FDA now, Aetna said.

Once that occurs, Aetna will implement its policy, Brennan said.

Colorectal cancer is the second leading cause of cancer death in the United
States and regular screening could eliminate as many as 60 percent of deaths
each year, according to the U.S. Centers for Disease Control and Prevention.

My colonoscopy was performed with conscious sedation. I am not sure
exactly what drugs were used or if an anesthesiologist was involved. I
know Versed was used for sure but propofol might have been added to
the cocktail. I do not remember any pain yet I know I was able to
follow instructions given me by the doctor. Done right, conscious
sedation can be as effective as full blown unconscious sedation. We
are not all the same so options need to be available at the doctor's
discretion for people with a history of bad reactions to conscious
sedation.

Mike- Hide quoted text -

- Show quoted text -

In my state conscious sedation must be performed by a licensed
anesthesiologist.
renee

I can't tell from the original statement if all forms of sedation were
to be disallowed or just full anesthesia. There is a big difference in
monitoring and with some anesthesia assisted breathing is required.
The cost difference discarding the anesthesiologist's fee must be
sizeable.

I know that one surgery clinic I visited would not allow propofol to
be added to versed stating an anesthesiologist is required for
propofol but not versed. In my case my surgeon was an
anesthesiologist. They didn't know what to say then.

Mike
.

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