Ways to improve Connecticut health care should not be overlooked — or taxed!
A recent study showed that, relative to a comparison group, the rate of colonoscopies increased by 5.6 percentage points among Connecticut state employees over age 50 participating in a voluntary wellness program. While that’s a step in the right direction, there’s still a long way to go: In the general population, we estimate 30 to 40 percent of those who should have a colonoscopy actually do. In any case, these statistics underscore the need to remove any and all obstacles to get people screened for colorectal cancer.
As state employees and other Connecticut citizens become better-informed consumers of health care – and understand the long-term value of diagnostic and preventative procedures such as colonoscopies — they will likely consider having those procedures performed on an outpatient basis.
Instead of hospitals, more and more people are choosing to schedule their colonoscopies in ambulatory surgery centers – same-day outpatient surgical centers that provide high quality services at a lower cost and closer to home. Making colonoscopies accessible and affordable is critical – patients don’t need any more excuses for avoiding them.
Colonoscopies reduce cancer and mortality rates, a just-published study in the American Journal of Gastroenterology has underscored, and there has indeed been a steady decline for the past decade in colorectal cancer, the third most common cancer and the second leading cause of cancer-related deaths in the United States.
Consider this: Our state is home to more than 1.2 million people over 50, the age when a screening colonoscopy is advised for all of “average risk” for colorectal cancer. If just 2 percent of the over-50s in the state had their colonoscopies in ambulatory surgery centers instead of hospitals they would collectively save about $20 million in health care costs.
There is perhaps no better demonstration of the tremendous value – in terms of health, and cost – of affordable and accessible health care provided by ambulatory surgical centers, where today about half of all colonoscopies are performed.
All of this makes the Connecticut state legislature’s last-minute decision in 2015 to target these outpatient surgical facilities with a burdensome new health care tax a distressing example of an industry taking one significant step forward, only to be pushed two steps back. It is the wrong direction for a state that desperately needs to bring health care costs in check.
The substantial and increasing impact of ambulatory surgery centers in improving health care and reducing health care costs should not be overlooked, nor should it be overtaxed.
Ambulatory surgery centers operate like small businesses. Unlike other health care facilities that benefit from numerous state, local and federal tax exemptions, ambulatory surgery centers pay income taxes, sales taxes and property taxes.
The new additional tax, a “top-line” gross receipts tax, translates to an effective income tax rate of 30 percent. The net effect is to take money that would otherwise have been invested in medical innovation and patient care and redirecting it to state coffers. The tax does nothing to improve the health of Connecticut citizens, and potentially limits patients’ choices.
Ambulatory surgery centers have a proven track record in providing quality health care at lower costs. Isn’t that what we are trying to achieve, as a state and nation?
By imposing the unfair and arbitrary additional tax, legislators have unwittingly undercut health care access and affordability in Connecticut. They now have an opportunity to correct this mistake by repealing this health care tax.
The case is compelling. Ambulatory surgery centers should not be penalized for making health care more affordable. Neither should Connecticut residents be denied access to convenient, high quality outpatient surgery options.
We should know better than to throw the baby out with the bathwater, even in challenging fiscal times.
Dr.Thomas A. Rockoff is a practicing gastroenterologist in Waterbury.