Insurance companies, Medicare, and public health authorities haven't yet sorted out the complexities of the survival benefit found in the Lung Cancer Screening Trial. The number needed to screen to prevent a death was ~300; ~40% of patients had at least one false positive scan, 95% were false positives overall, and overdiagnosis was very likely present. Until that's all more settled, payers aren't paying for CT screening. But that hasn't stopped our competitive, financially-driven medical care system from offering a private sector "solution."

Hospitals across the U.S. are exploiting public awareness (or is that fear) in the wake of the NLST, promoting cash-only $99 CT scans to get well-heeled smokers in the door. (When Best Buy does this, it's called a "loss leader.") Presumably, they expect these new customers, ahem, I mean patients, will generate downstream revenue with more CT scans (which likely are reimbursable, since they'll be for follow up of the abnormal findings present in a large proportion of smokers), clinic visits, and procedures.

What's not to love here, or at least laugh about: the $40,000 in additional medical care costs each abnormal CT scan produces (Otis Brawley, American Cancer Society). Not that I would ever advocate rationing -- that would be un-American. (Sorry, this one made me push the sarcasm button.)

Read more at Kaiser Health News.