Co-Pays for Mammograms

I’ve blogged before about the correlation between high co-pays for mammograms and the increasing incidences of breast cancer due to lower incidences of preventive screening. This article points out that it is medically unsound, financially irresponsible and even morally wrong to force mammograms to be thought of as a discretionary expense, especially for lower/fixed income women. Like the authors of this article, I found it incomprehensible that any insurance carrier would even offer this as an option and that employers would make a conscious decision to choose a plan that imposed a co-pay for such an important and even life-saving test.

Until I had a chance to examine my businesses’ health insurance premiums as part of our annual renewal process.

Just like any business owner, I always look for ways to reduce my overhead costs. Health insurance is a huge expense for my business – as it is for most businesses – and gets more expensive each year. Given the projected rate increases, I took the opportunity to shop around my policy. What I got back was really interesting. Without going into a lot of detail, the plan that had a co-pay for tests like mammograms, CT and PET scans was dramatically cheaper than plans that did not. Dramatically cheaper, as in 35% cheaper.

I have to admit, the savings were compelling – and had I not had been personally touched by the need to eliminate impediments for mammograms, especially in a firm that is dominated by women, I would have opted for that package. I did not, and while my bottom line won’t be as healthy, I hope that my team will be.

This is all to say that the problem may not necessarily rest with the “employers” who are in many cases are simply looking at numbers and not the significance of the stories behind the numbers. It is very easy to see why an employer would opt for a policy with a co-pay given the savings. The fault is in our health care system, which seems less aware of the importance of funding prevention. It is a fact that regular mammograms can detect cancers at an early enough stage that their chance of recurrence is reduced; saving our health care system tens of thousands of dollars per patient. That battle is a long and hard one to fight and even all of the politicians talk about “fixing the health care system” won’t address it, at least in the short term.

What can be done is to have employers think more creatively about their health care options. Some employers opt for a cheaper plan with a co-pay for mammograms, but create a fund that reimburses women for the cost of the screening. They still save a boatload and don’t deny women in the process.

What do you think?