April 11. 2014 11:53PM

Mike Cote's Business Editor's Notebook: Shopping for a colonoscopy


X-RAYS! CHEAP! CHEAP! Colonoscopies? We're giving them away! Some restrictions may apply.

While sipping my morning coffee Friday, I heard a radio commercial for a local imaging center that was pitching its lower prices as compared with its rivals. The characters in the commercial were talking about how they needed to be watchful of the price due to the high deductibles in their insurance plans.

If only all of our health-care choices could have that level of competition.

The 30-second spot reminded me of the impassioned speech Nick Vailas gave Thursday to about 160 people gathered at Southern New Hampshire University during a 3 1/2-hour forum on the Affordable Care Act and how it is changing the health insurance marketplace.

Most of that marathon meeting went off as you might expect: Representatives from health insurance companies and a couple of government officials talked about what business owners need to know to comply with the massive changes coming in federal health care law. Northeast Delta Dental, Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, the New Hampshire Insurance Department, the U.S. Small Business Administration.

PowerPoints and more PowerPoints. Bagels, muffins, coffee and bleary eyes. People glancing down at their smartphones. And I wasn't the only one. This is health care policy, after all, not a sales expo in Vegas. Like so much in life this is a subject of the utmost importance - and dreadfully boring.

So when Vailas came to the podium and got lost in his enthusiasm long enough to accidentally bang the microphone with his hand while emphasizing a point, he changed the rhythm for 10 or 15 minutes (as did Tom Boucher, owner of Greater New Hampshire Restaurants. More on him next week.)

For small businesses in the Granite State, health care is a major factor driving up the high cost of doing business, stripping away the so-called New Hampshire advantage, Vailas said.

"In New Hampshire we have the distinction of being one of the healthiest populations in America; that's the good news," said Vailas, the board chairman for Compass Healthcare Advisors. "The bad news is we also have one of the highest premium rates in America. There is an inverse relationship here. New Hampshire is the poster child for what is wrong with health care."

The founder and CEO of the privately owned Bedford Ambulatory Surgical Center said patients who have skin in the game will make better choices. The Affordable Care Act is forcing people to take greater responsibility over their health care, Vailas said.

If you know you can save several hundred dollars on an MRI - the price in Manchester can range from $700 to $2,600, Vailas says - you're more apt to do some research and shop for a provider.

"With higher co-pays and deductibles, you will start caring because you can get ripped off," he said.

That is, if you can get your hands on that kind of information.

Try finding out in advance what your out-of-pocket expense will be for a common surgical procedure, as I tried a couple of years ago in Colorado, when I was told repeatedly by the surgeon's office that such information is different for every case. Sadly, that was largely the truth since the price varies based on the patient's insurance company, coverage plan, negotiated price for the procedure, deductible, etc.

The high costs such a system has created are shouldered both by patients and the employers who subsidize their health insurance.

"The delivery of health care is totally devoid of the laws of economics," Vailas said. "The cost of health care is going through the roof because there is no pressure to push it down."

What we need, he said, is greater transparency.

And on that note, I turned 51 this year and am overdue for a colonoscopy. Know where I can get one cheap?

Mike Cote is business editor at the Union Leader. Contact him at 668-4321 ext. 324 or mcote@unionleader.com.