Allen Wastler Commentary:
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An insurance rear guard action
It's nice to know that what's good for the patient will be good for the CEO too.

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NEW YORK ( - "Mr. Insurance Company CEO ... when you get your colonoscopy, are YOU going to go without the sedative?"

That was the question I came up with after reading a news report about a move by insurance companies to stop covering the use of anesthesia, specifically Propofol, during colonoscopies.

Other middle-aged guys reading the Wall Street Journal probably paid attention to that story too. You see, that test looms large in the male rites of passage to the Golden Years.

Colon cancer is the second most common type of cancer in men. About 145,000 Americans are diagnosed with it in a single year and more than 56,000 of them die, according to the American Cancer Society.

A colonoscopy can catch the cancer early. And we've all been told that early detection can mean the difference between you beating cancer and cancer beating you.

But like a veritable Greek tragedy, there is a price for this test that lets you get a jump on death: It involves pain and humiliation. After all, they're poking a camera where it generally remains unpoked. Sure, it's a small camera on the end of a flexible tube, but still...

Now, the medical folks have been using sedatives and such to take the sting out of the procedure. And the drug of choice is becoming Propofol, from the fine folks at AstraZeneca.

Unlike other sedatives that put you into "conscious sedation," Propofol apparently takes your mind out of the procedure altogether. I can't speak from experience, but that seems like a good thing to me. About one in four colonoscopy patients are apparently taking it.

But Propofol is enough of a heavyweight drug that it requires an anesthesiologist to be present. And that costs. Hence, insurance company objections. Why should they have to pay extra just because you don't like the feel of that "small" camera?

Wellpoint Inc. (Research) is leading the charge. It is taking the position that having an anesthesiologist around isn't "medically necessary" for your run-of-mill colonoscopy and hence, it won't pay for it. A spokeswoman I contacted at the company noted there are exceptions to this rule.

Fine. I guess a little novocaine on the tooth for root canal isn't necessary to get the job done either, but it sure makes me feel better.

So will the CEO of Wellpoint, Larry Glasscock, forego the Propofol? And the other senior executives and employees covered by the company's insurance program?

"They'll be covered by the same clinical guidelines," the Wellpoint spokeswoman said.

Nice to know we're all biting the bullet together, so to speak.


Allen Wastler is Managing Editor of and appears on CNN's "In the Money." He can be emailed at Top of page

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