Home » Sedated upper endoscopic procedures waste $15B a year

Sedated upper endoscopic procedures waste $15B a year

Sedated upper endoscopic procedures waste $15B a year                                                                                           ISTOCK/Tom Wang
Members of the medical community, certain medical device manufacturers and government regulatory agencies are allowing patients to spend an extra $15 billion dollars a year by allowing unnecessary, sedated upper endoscopic procedures.All of these groups have turned a blind eye on complete waste, fraud and abuse in our healthcare system. There are about 10 million upper endoscopic procedures performed each year, which screen for and detect esophageal cancer, Acid Reflux Disease, Barrett’s Esophagus, vocal chord disorders and many other conditions.

These critical procedures are regularly performed with an endoscopic probe through the mouth under complete patient sedation.

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Unfortunately, 0.5% of these procedures result in cardiac complications including heart attack, stroke and death; 50,000 patients per year suffer some type of medical failure during a routine upper endoscopy.

There is a better solution. Roughly half of the patients do not have to be sedated and can have a five-minute procedure known as TNE (Trans Nasal Esophagoscopy).

A TNE procedure examines the throat, esophagus and stomach using a spaghetti thin camera and scope going through the nose, and the patient is not sedated.

It is an equally effective procedure as traditional sedated upper endoscopy, without the risk of sedation, and the patient will not miss a full day of work.

In order to see how easy a TNE exam is, we videotaped a live procedure.

Why doesn’t the medical community regularly perform TNE procedures on patients?

There are 30 billion reasons why.

At ten million upper endoscopies every single year, the facility fee by sedating patients and scoping through the throat equates to $3,000 reimbursement to the doctors. The reimbursement fee for a TNE exam is about $200.

This practice of sedating five million patients every single year, for no medical reason, is an example of the practice of intellectual dishonesty.

The medical community is routinely risking the lives and safety of patients in exchange for billions of dollars. This is completely unconscionable and an unacceptable result of a profession that basically self-governs its practices, because doctors know best.

The medical community will never govern itself properly and will not replace a procedure that reimburses $3,000 with an easier, cost effective procedure at a $200 reimbursement.

We need regulations and laws to address this greed to save the healthcare system $15 billion dollars a year!

This is not an indictment of individual doctors; rather, the medical profession globally. The problem begins in medical school because TNE is not taught.

Furthermore, medical societies counsel the various agencies on proper procedures. The government must act in order to save lives and save the system billions of dollars that is unnecessarily going into the pockets of the medical community.

United Healthcare is reporting a $1 billion loss this year, which can be remedied by mandating TNE in those procedures where it can be performed.

Instead of ripping apart Obamacare, which is the law of the land, we need to uncover the fraud, waste and abuse in a system where it is prevalent. This is just one niche area of medical practice where we can save billions of dollars, and if we focus on how much money is wasted at the treatment level, then we can solve our healthcare crises.

We can do better as a country than to risk 50,000 lives every single year and waste billions of dollars because of intellectual dishonesty.

David Schwartz has spent his entire career practicing law as a litigator and for the past decade as a lobbyist and advocate on behalf of businesses, trade associations, not-for-profits and individuals as a founding partner at Gotham Government Relations. Whether it is in the courtroom defending and advocating on behalf of litigants in high-profile criminal and civil cases or in the halls of the Capital, the same philosophy and attitude exists which is to advocate as aggressively and passionately for the client.

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Name: Richard Billies

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