Scan this!

December 13, 2012 -- Today I got a Heartscan. No, there's nothing wrong with my heart (this was confirmed in the test results) but I wanted to see what this wonderful technology can do.

The machine is an Imatron and it does Electron Beam Tomography (EBT), sort of like CAT scanning but with only a tiny fraction of the CAT scanner's radiation. The study that was done on me is called Cardiac Calcium Scoring. It reveals any build-up of calcium plaque in the vessels that supply the heart muscle. This is the precursor for atherosclerosis which, with time, can occlude those vessels, starve the muscle, and cause a heart attack. Indeed, this is the most common cause of heart attacks, and heart attacks are the deadliest disease in America today.

Because the radiation is so little, you could get this test annually yet remain within FDA limits. That is a good idea for people with family history of heart disease or other risk factors. The disease could be caught before it turns deadly. Then it could be treated with radical lifestyle modification, statins, angioplasty, or whatever the cardiologist deems appropriate. The point is, prevention is always the preferable option.

There's just one little problem: insurance companies don't reimburse for this procedure. That makes no sense; you'd think they'd understand that preventing a heart attack is cheaper than treating it. But insurance company "logic" doesn't work that way. I saw this when I was a smoking cessation counselor: the insurance companies wouldn't pay for smoking cessation but somehow they were ok with paying (a whole lot more!) for lung cancer, emphysema, etc. Similarly, they won't pay for an EBT scan but they will pay to treat a heart attack... assuming the patient survives it.

Here's how that "logic" works: a dollar saved today is a dollar added to the bottom line in the current quarter. It makes them heroes because they hit their target even though it means they will pay out a hundred times as much a few years from now. Not to worry... they will deal with that when the time comes. What's best for the patient? Who cares? That's not a factor in insurers' calculations.

But it is a factor for me, and for any consumer of health care. In other words, everybody. Perhaps when we finally achieve single-payer health care financing, the short-term "logic" will at last be abandoned. In the meantime, get your Heartscan!

In the SF Bay Area:

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