Sunday, January 11, 2004

NYT: Insurance pays $2000 for smoking cessation advice

Focus on ’Prevention’ Divides Cancer Experts: "The 2,000 people, the worried well, who come each year to Memorial Sloan-Kettering's cancer prevention center will learn that many cancers can, in fact, be prevented, and that it is up to them to have the appropriate medical tests and to live right.

For their $2,000 fee, most of which is paid by health insurance, they may be steered to smoking cessation sessions, or watch a cooking demonstration and hear a talk by a nutritionist. They will learn the early signs and symptoms of cancer and they almost certainly will have a cancer screening test.

... Cancer prevention has become a buzzword these days, with some medical centers, like M. D. Anderson Cancer Center in Houston, planning entire buildings just for prevention. Its center will open in about a year, big as eight and a half football fields.

We used to give away this advice for free, at the end of the much-derided annual "physical exam". Apparently at $2000 a pop, paid by health insurance (!?!) it's much more effective. It must come as a shock to patients to learn they can reduce their cancer risk by not smoking.

This fits perfectly with marketing and economics research on pricing theory. If the patients/students were paying out of pocket I'd say this was "medical infotainment" -- marginally useful information that has a high entertainment value. But their insurance companies are paying?! There's something wrong here.

As for Sloan-Kettering and MD Anderson -- this is a variant of what they've done for years; live off the worried well. To some extent this may be subsidizing other care and research they provide.

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