Battenfeld: Massachusetts health insurer restricts anesthesia for colonoscopies, doctors object [Boston Herald]

One of the state’s health insurance giants and its corporate bean counters are making it more agonizing to get a colonoscopy – like that’s even possible.

Blue Cross Blue Shield of Massachusetts is cutting back on full anesthesia for thousands of colonoscopy and endoscopy patients in a move that has some doctors calling foul.

It’s a classic story of the well-compensated corporate giant against the average person – some of whom doctors fear may now skip getting the critical procedure rather than be conscious for it.

Maybe all that money Blue Cross is spending on Michelle Wu’s beloved blue bikes is finally taking its toll.

Colonoscopies are already one of the most dreaded procedures in medicine. If drinking that foul solution to clean your insides wasn’t bad enough, then you have to endure the actual exam, which we don’t need to describe here. But colonoscopies, now recommended for people 45 and older, are the best way to detect colon cancer.

Doctors’ groups oppose the BCBS cost-saving maneuver to use “conscious sedation,” saying it will likely discourage people from getting colonoscopies if they know they won’t get full sedation.

The anti-consumer, anti-health change took effect Jan. 1 for patients who get their BCBS insurance through their employer.

“Sedation choices should be determined by patient and their physician, not dictated by insurance,” the Massachusetts Gastroenterology Association said in a strong statement.

The MGA also noted that there are concerns about increased risk of failed procedures, pain and nausea due to inadequate sedation.

“Conscious sedation will require training of nurses and GI physicians (recent graduates) who lack sufficient training, in the setting of a significant labor shortage in the healthcare industry,” the organization said.

BCBSMA’s politically connected and well-compensated board of directors, who include well-known players such as UMass President Marty Meehan, should be advocating for the insurance giant to change its new policy and reverse the decision by Blue Cross Blue Shield’s bean counters. But don’t hold your breath. Meehan and the other directors don’t exactly represent the average working person.

A Blue Cross Blue Shield of Massachusetts spokesperson did not respond to a Herald request for comment and a list of what board members are paid.

A spokesperson told Fierce Healthcare that people can still get full sedation if they have medical reasons for needing it, such as those with chronic conditions or a fear of medical procedures.

But the move to restrict full sedation will surely make it more difficult on patients who can’t prove they need it.

“This is all about money for the payer,” Scott Ketover of the Digestive Health Physicians Association told Fierce. “This is not about quality of health care.

Well, maybe Wu, who got BCBS of Massachusetts to fork over all those blue bikes, can get Blue Cross to be a good corporate citizen and rethink its new policy.

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