Cost of Hyperbaric Oxygen Therapy and the Insurance Dilemma

Hearing that a doctor had prescribed hyperbaric as a “last resort”, really got me thinking… Why is it that hyperbaric is the “Last Resort” in many indications.  Is it because it is likely ineffective?  Doubtfully so!  A more likely reason would have to do with cost of treatment vs. patient necessity.  In regards to wound care, it really is a last resort.  Wounds must become extremely problematic before they classify under the definitions that would make them a billable indication.  When undergoing CHT (Certified Hyperbarics Technician) training I had asked one of the instructors if hyperbaric would be beneficial during the earlier stages in wound care management.  His response was to the tune that it certainly would; however, he also stated that good medicine must both be effective and affordable.  So, according to this instructor… hyperbaric is certainly effective, just not affordable.  Only when the patients life and limbs (literally) come into play does hyperbaric become a prominent treatment.

Why are insurance companies so reluctant to pay for hyperbaric?  I can not say for sure as I am not the head of one of these agencies; however, I would assume if hyperbaric treatments were 1/10th of what is currently billed, the list of approved indications would go through the roof.  Many would say running hyperbaric treatments at 1/10 the cost is absurd, unrealistic, or impossible; yet I just watched a video in which a UK gentleman being interviewed via a panel admits that treatments in their multi-place chambers average about $8.

I will wait while you pick up your jaw…

Polar opposite of this is a hospital local to me that charges $2,300 for a single session in their multi-place chamber.  Hmm, so if I have a copay of 10 or 20% then I am still responsible to pay $230 or $460.. Glad I have insurance!  Seriously though, these are real world examples of what a facility is billing an insurance company.  I have to believe with bills like those, that insurance companies would have pretty strong lobbyist action to prevent any further indications from being approved.

I don’t often like to get deep into “conspiracy theory” but have you ever heard of the phrase, “sick but alive”.  This refers to a medical model in which everything is done to keep patients alive, but does not focus on wellness.  When we are healthy and well, the current medical establishment stands to make little.  But when we are sick and diseased, they stand to make a lot.  Should we die… they make nothing!  In fact, they may even get sued!  So, it makes sense to save the dying people at whatever cost possible.  Sick… but alive!

Please understand that I am not writing this to infer that an evil dark cloud is governing our medical establishment, I just find it interesting when reality begins to sound like conspiracy theory.  In my heart I believe our medical system consists mostly of noble individuals each trying to make a difference in the health of our nation and people.  I believe medicine continually evolves and improves.  I also believe that it could evolve much faster and that not all things are so complicated.  Sometimes answers to complicated questions can be quite simple.

In conclusion, I agree that good medicine should be affordable and effective.  Well, if hyperbaric is effective as it has been demonstrated; all we need to do is make it affordable.  That shouldn’t be too hard!

Greg Harris - Hyperbaric Warrior 

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