The marketplace reality, though, is that older women who want the old-fashioned technology can hardly find radiologists who still use it.' ' Eight years ago, 96 percent of all mammograms were done with garden-variety film; three years ago 47 percent were.' That number continues to drop.' 'Over time, film mammography will cease to exist,' said Anna Tosteson, the lead researcher on the NCI study, told the Center for Public Integrity, which published a fine story about the marketing of digital mammography that should be required reading for women.' 'One thing that's certain'there is no evidence that one should pay a premium for digital mammography,' Tosteson said.
The Center's investigation showed how clever marketing, public relations, and campaign contributions by imaging machine makers have so far triumphed over science, and succeeded in raising the price of mammography.' That, of course, boosts the national health care tab.' Medicare pays the bills for women 65 and older, reimbursing doctors $78 for film mammograms and $129 for digital ones.' ' So it's not hard to see why film mammograms are buggy whips of the 21st century.' It doesn't matter that Medicare beneficiaries don't benefit much from digital technology.' There's big money to be made from using it.
So what's a consumer to do?' I recently faced that dilemma when I phoned the radiology practice I like to use for my yearly mammograms.' It provides patient-centered care for a procedure that ties me in a pretzel for days before the test.' Over the years I have valued their consistent kindness and access to trusted and quick results.' So even though this practice doesn't take my insurance, I pay out of pocket.' ' That's my choice.'
Recently, I phoned for my annual appointment and learned that a mammogram would now cost $400, a 60-percent increase over what I last paid.' ' 'We've gone digital,' the receptionist said. That put me in a quandary.' I knew what the evidence suggested.' Digital mammography was not cost effective and probably wasn't worth the higher price tag.' I could call all over New York City trying to 'shop' for a practice that not only uses old-school film but also accepts my insurance' If I found one, I might not like how its doctors treated their patients.' That would stress me even more.' In the end, I stayed with what I knew, liked, and trusted.' The heck with the money.
So how can you be an informed consumer and affect the health care marketplace?' You can't, despite what those advocating a market approach to medical care promote.' The rapid diffusion of digital mammography into common medical practice shows just how powerless patients are likely to be at slowing escalating costs and determining the delivery of care in America. ' My little tale is another example of why health care is not like cell phones.