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Two Hours on the Operating Table

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My best wishes for a speedy recovery to Barbara. Gene. (Life has intruded and I've been off the forums for awhile.) I completely understand what you're saying about the ACA. We lost our "group" policy because of the new regulations for "family" companies, and it's been a nightmare, so far. I do think it's a disgrace that the USA is the only developed country that treats health care for its citizens as a "privilege" not a right. So sad.
 
An update on Barbara:

She continues to go to a physical therapist twice weekly. He knee motion is about 85% of normal, which is good, but it's not certain if she'll ever get past the 90% point because of all the repair work that had to be done on the operating table. Her next doctor visit is July 14.

She's given up the walker, and is using a cane, at least half the time, so it's actually quite a bit better. But her knee becomes painful after walking or standing for a while.

I'm not focusing on the mounting bills right now.
 
Gene Steinberg said:
I just can't imagine charging $32,678 for the OR, for somewhat over two hours. And this is knee surgery, not a heart transplant.
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At point of service, this would be 100% free in the UK - of course if you pay taxes, that is your 'insurance' but even if you have never, ever had a job and never paid a penny in taxes, it would still be free.

I'm glad it wasn't too serious, medically, but I wonder what the bill would be after a bad traffic accident?

(just today I happened upon two 8-yr old girls who were hit by a car. I was literally the first person on the scene, I checked out the closest one to be reassured nothing serious had happened, only to look up and see the other one about 30 feet away had broken her lower leg very badly, it was bleeding and totally floppy where it should have been rigid bone. I took hold of the leg parts and held them in place for around 10 mins, while trying to soothe the girl who mostly screamed for her mom. Luckily, a former nurse happened by and between us we managed to get a basic bandage on to help stem the blood, and we both in tandem did our best to retain a proper shape (sharp fragments can tear arteries) and we did our best to minimise the pain by her incessant wish to move her upper leg.

Thankfully, I don't think she knew the extent of her injuries. Soon enough, a couple of paramedics arrived to take over and administer Entonox and put the leg in a temporary splint.
I'll take it as a compliment that the nurse assumed I was medical too - I've done a number of first-aid/trauma courses and thankfully it all came back. I was cool as a cucumber during it all but 15 mins later I felt pretty shaky about the whole thing. Because I was close to the ER anyway, I popped in to check on her to be told she was in surgery but she'd be in hospital for some days yet.)

Wishing Barbara a speedy recovery. Who'd have thought a wee doggie could cause all that?
 
Goggs Mackay said:
Wishing Barbara a speedy recovery. Who'd have thought a wee doggie could cause all that?
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The bills remain horrendous, but she graduated from walker to cane and now she can walk by herself, though still limping. She has physical therapy for another couple of weeks, and then she's on her own. She won't be wearing heels or jumping up the stairs for a while, and the doctor doesn't guarantee full recovery.

It wasn't the dog but one of his toys that she tripped over. But he's a character.
 
Last year I had a total knee replacement on my left knee. The total bills topped out at around $100k. I ended up paying a little over $1500 dollars. I felt pretty damn lucky for that sum of money, especially because the right knee needs to be done next year.

One thing I learned Gene. After the official therapy is done you still need to do your daily therapy exercises at home. Most people like to blow this off but many people end up with problems afterwards because therapy is hard and it hurts and the patient tends to get lazy.
 
For those wondering about insurance coverage, she's too young for Medicare, and her coverage may have lapsed for various reasons.

It's a considerable amount of money, and the bills will only grow.

You see, Barbara may need another surgical procedure, having developed a possible infection in her knee. She will be visiting the doctor to see, but is taking a powerful antibiotic for now to see if it kills the infection.
 
I'd like to add that here in Florida there is no Obama care exchanges so people who are unemployed and have no private health care coverage have NOTHING but the local hospitals emergency room as primary care. I had chest pains a little over two months ago and drove myself to the emergency room only to find I had a heart attack and they also found I was type two diabetic...7 days later 4 in intensive care my bill was $59k dollars FOR JUST THE EMERGENCY ROOM!!!

The doctor bills are starting to roll in but in the mean time a few weeks back I had severe stomach pain with vomiting so the trip back to the emergency room...this time my hernia was strangulating my lower bowels...back to surgery to repair. Then my right foot was swollen and painful for about 3 weeks and had them look at it.The Dr. took a sample and a scan was taken...a bone infection was found at and below my right toe which was operated on and removed with part of my foot below where my right toe use to be.

I've only been out of the hospital for a few days and the bills from this round in the hospital haven't come in but I'd have to imagine both hospital stays plus the two operations might be in the $100s of thousands of dollars. How on God's green earth do I climb out of this disaster?
 
Yes, the Federal Affordable Care Act (Obamacare) exchange works in Florida. It's run by the Federal government, not the state. Check: Get 2015 health coverage now. Health Insurance Marketplace for information.

But I realize that doesn't help your situation. Health care is nightmarish in the U.S. for those who don't have a good insurance plan.

They are also barring Medicaid in Florida, which means people without enough income to buy an insurance plan are dying because of lack of care.
 
Gene Steinberg said:
This is about how messed up the health care system remains in the U.S., even though the controversial Patient Assistance and Affordable Care Act (Obamacare) has sharply reduced the number of the uninsured.

So Barbara is playing with our Bichon, Teddy Bear, when she trips over one of his toys in the kitchen, which has a filed floor.

She hoped the bone wasn't broken, but when the pain in her left knee persisted, I took her to the Emergency Room, where she was diagnosed with a multiple fracture. When it was clear it wouldn't just heal by itself after she was fitted with a special bandage, she underwent over two hours of surgery at a local hospital.

The other day we got the bill:

Screen Shot 2015-05-24 at 7.40.04 AM.png

This bill doesn't include the original Emergency Room visit, the surgeon, the anesthesiologist (the physician sends a separate bill), or the months of physical therapy she must undergo to regain full use of her leg.

It's a preliminary bill and doesn't reflect what the insurance will cover, but copays and deductibles will still be huge.

And this is just for a broken knee. Now imagine anyone confronting a serious disease with long-term hospitalization or outpatient treatments, and you can see how far out of control things have gotten.

What would such treatment cost individuals in Canada, UK, Germany? You get the picture.
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I hope I live to see the day that all insurance companies go down in flames. Glad to see that the U.S. is pretty much the only country that runs on this scam system. It's disgusting.
 
I am currently battling stage 4 small cell lung cancer which has metastasized, spread to my bones, etc.

Being 65 years old my drugs are all paid for and the numerous cat scans, radiation treatments and chemotherapy sessions have all been fully covered.

I thank God every day that I was born in Canada and not the USA.

My prayers go out to you and your wife Gene.
 
Wasn't it Ronald Reagan who worked very hard to turn American medical care into a "revenue center" for profit business? He told the American people that competition would lower prices. Of course, instead the industry just colluded to ensure they all got a huge piece of the pie. I am not some leftist just trying to blame Republicans. This is actual history. I find it hard to believe that people in the USA may have to actually choose death because treatment is just too expensive. But at least we have predatory capitalism with few regulations and no socialism! WE ARE FREE! As my parents said when I was a boy "Better dead than red!"
 
beyondthestargate said:
Wasn't it Ronald Reagan who worked very hard to turn American medical care into a "revenue center" for profit business? He told the American people that competition would lower prices. Of course, instead the industry just colluded to ensure they all got a huge piece of the pie. I am not some leftist just trying to blame Republicans. This is actual history. I find it hard to believe that people in the USA may have to actually choose death because treatment is just too expensive. But at least we have predatory capitalism with few regulations and no socialism! WE ARE FREE! As my parents said when I was a boy "Better dead than red!"
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My dad was the executive director of a regional state agency in the 70s and early 80s and saw the transition of the US healthcare system into one in which profit became the overriding objective. The task of his agency was policy and economic research primarily. He and his staff would investigate whether, for example, if a new private hospital was proposed for a local area, would it actually lead to better service or was it likely to drive up costs and degrade service.

The free market advocate would automatically assume that competition and the magic of the market would lead to lower costs and higher service. But the picture in healthcare is much more complex and mixed than “free market” theory would suggest. As my dad discovered time and again, instead of competition lowering costs it raised them. Investors, seeing your health needs as opportunities for profit, would for example build needless hospitals and purchase duplicative expensive equipment, resulting in higher costs overall in the system. Innovation in healthcare doesn’t necessarily lead to better outcomes, but it can easily increase cost.

Once Reagan came into office the religion of the market was ascendent. My dad’s agency was prohibited from lobbying. But for-profit healthcare ventures were not. Thus, at least at the state level where my dad worked, speculators and investors could get their voices heard on healthcare policy, but the best objective research in the state had a much harder time. Money trumped evidence in many cases. As a result, considerations of rationality and efficiency were shoved aside in the rush for profit.

I highly recommend the 2008 documentary Sick Around the World. One of its virtues is that it shows just how backwards and irrational our healthcare system is in the US compared with other countries. Uwe Reinhardt, a healthcare economist (_not_ quoted in the film if I remember) has said that when one attends international conferences on healthcare policy, it’s generally understood that when one refers to the ‘American system’ that one means a system that doesn’t work particularly well.
 
When you look at the stats, patient outcomes are better elsewhere than the U.S. Although you can get great care in the U.S. if you have the money, or a top-notch insurance plan, the cost of delivering identical or superior services in other parts of the world are much lower. The cost of drugs is far less.

So opening the market to profit-making companies only made matters worse. Greed is NOT always good.

That explains the absurd $53K bill we saw for Barbara's hospital visit, and the loads of other independent charges added to the bill. There's no one charge, alas. Each provider, including the anesthesiologist, is an independent contractor with their own pricing and billing. Even if you have insurance coverage, there will be multiple co-pays and deductibles unless you have a "Cadillac" plan.

This is nonsensical. Who benefits by getting a dozen bills for one operation, other than a bunch of separate businesses that are looking for profits?

Barbara has a minor side-effect of the operation that may require some extra treatment in the hospital. She appears to be healing slowly, but the doctor continues to push towards the second procedure, even if it's not immediately necessary, or will ever be necessary. The system forces him to see the extra procedure as a source for additional revenue, even though it should be considered a part of the original treatment.

It's a mess. It needs to be fixed. Obamacare helped by eliminating lifetime limits (hit by a serious illness or injury) or rejecting claims or applicants for preexisting conditions. Millions more are covered, and the price increases are less. But it's just putting a bandage on a bad system. It has to go, but the politicians don't have the guts to do the right thing. Too many still believe that health care is a profit-making business and not a necessity and a right. Too many think they will gain by lying about Obamacare and claiming they'll repeal it without a better plan to offer. (Obamacare was and is a Republican plan, originally devised before 1990 by the conservative Heritage Foundation, and uses the free market to provide coverage and services.)
 
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