The one thing Cindi dislikes most about her job, she says, is "insurances," because companies frequently see nuclear imaging as "medically unnecessary" and refuse payment. In addition, because of cutbacks to Medicare and other insurance payments in her state, "patients aren't getting what they need." For example, Cindi recalls a breast cancer patient who had a CAT (computer-assisted tomography) scan first but was denied authorization for the PET scan her physician ordered. "These scans are very expensive," Cindi explains, but they are such valuable diagnostic tools that insurance companies should be reimbursing for them. Another patient had a lung mass revealed in a CAT scan, and his physician recommended surgery. The patient knew the value of a PET scan and insisted on one, which his physician finally reluctantly ordered. The PET scan showed widespread metastatic cancerous growths, which meant surgery was not recommended.

From Cindi's perspective, nuclear medicine provides valuable diagnostic and treatment tools that insurance companies should reimburse. Her attitude is summed up by her statement: "When patients don't get what they need, it's painful."

The patients Cindi sees probably appreciate her perspective, and apparently many recognize the value of PET scans in diagnosing and treating their illnesses.

Cindi opposes the perspective of "insurances" whose executives often see PET scans as too expensive to reimburse, thereby limiting the advanced diagnostic tools available to physicians.

Answer these questions:

1. As health care moves into the twenty-first century, insurance will become increasingly important and probably increasingly controversial. When technological tools such as nuclear medicine procedures are available, in your opinion should all insurance organizations reimburse for their use? Explain your answer.
2. Do you see a solution to the high cost of new health care treatments and procedures as we continue to develop them?