-- True, actually. The point is, unless you messed around, sexually, with your brothers' wives, your wife isn't barren and, if you don't shoot blanks, one or more of your abominations came to fruition, your peculiar line will end when you die.
-- Yes, of course. American English.
-- I daresay that, in your case, those conclusions could be easily arrived at by any casual bystander without waiting until you turned 80.
-- And what\'s wrong with that? Advances in medicine (or anything else) don\'t come about because people are afraid to take risks, and whose business is it what people do with their own bodies?
Impossible! He would have to be adequate, first. If he was adequate, he wouldn't need the stinking puppets.
-- Service to my country? Been there, Done that, and I\'ve got my DD214 to prove it. Member of DAV #85. Michael A. Terrell Central Florida
-- Yes, of course. Yours is Australian, no?
-- It\'s not that I don\'t understand your posts, it\'s just that you\'re so predictably repeatable that there seems to be little need to read you other than to stir you up every once in a while.
-- That you _work_ on??? LOL, not lately, and every day you let slip by puts you farther in the past technologically. Pretty soon you\'ll be so retro all you\'ll be fit for is 555 design work!
-- If they do, they\'ll blame us even more for supporting the Jews.
No. You are. That is what it is called, dumbfuck.
You're an idiot.
Read the remark that I responded to, you retarded f*ck. They were most certainly talking about taxes at that point, so f*ck off, and YOU were not even part of it, so using the term "we" is as retarded as anything else you post on your weekly f*ck over of the groups.
Fuck off and die, KeithTard.
I note in your post, a lot of skeptical comments about US doctors, but I want to comment only on this paragraph I split.
Tests are required to satisfy the doctor that surgery is required, not, as you put it, to "assure the financial provider...." Elevated PSA can result from causes that *may* go away. For a more complete view of a prostate condition, a more complex blood test may be requested, bringing the total test so far to two. In my recent case, the latter test guided the doctor to decide the elevated PSA was *very possibly* a result of recent chemotherapy, and we should adopt a wait-and-see posture for 6 weeks, which we did. An invasive biopsy was not justified. All of this was to benefit ME, not an insurance company.
The next complex PSA blood-work showed a remarkable improvement and I'm now back to getting a simple PSA test included in my annual general exam, which is recommended for men over about 50. Had there been no improvement, or if the PSA level had got higher, other tests would have been called for.
I hope you can see that there are good reasons for a doctor (in this case the Urologist) to call for reasonably required tests, and then to wait and see or to advance other tests in preparation to a potential biopsy and/or prostate surgery. Insurance companies DO NOT get to say whether such required tests or surgery are done.
In fact, some surgeons use expensive, minimally invasive robotics in the surgery even though this more expensive process is not covered by insurance. It greatly benefits the patient's speed of recovery, while reducing the doctors earnings.
And finally, to complete this blog; in my opinion, a doctor who has diagnostic tools available, but does not use them when they are called for, is dangerous to your well being. But if you want fast, reduced cost doctoring, you may find a surgeon who will remove your prostate without discovery of to what extent it may be needed, and with little delay. Hopefully though, not in the U.S.
In your actual experience, what's the typical time duration between referral by a family doctor to a specialist and surgery? (including wait for an appointment, tests, pre-surgery assessment(s), further tests, and scheduling of actual surgery? Assuming worst case ("elective" surgery, which presumably might get bumped for people with life-threatening conditions).
Best regards, Spehro Pefhany
-- "it's the network..." "The Journey is the reward" speff@interlog.com Info for manufacturers: http://www.trexon.com Embedded software/hardware/analog Info for designers: http://www.speff.com
I think that the word "peculiar" may be outside of his and Keith's comprehension.
You're an idiot. His forefathers' genes would be found, and that would have to be from two generations back, minimum!
I first saw the hip surgeon on August 8, scheduled surgery for October
31, so it can take some time.In between though, I had an extensive cardiac evaluation, and then a complete general physical with tests for _everything_.
Total tab, ~$80K. Looks like my out-of-pocket will be $156 for lab tests that Medicare deemed to have been previously done less than a year ago.
...Jim Thompson
--
| James E.Thompson, P.E. | mens |
| Analog Innovations, Inc. | et |
| Analog/Mixed-Signal ASIC's and Discrete Systems | manus |
| Phoenix, Arizona Voice:(480)460-2350 | |
| E-mail Address at Website Fax:(480)460-2142 | Brass Rat |
| http://www.analog-innovations.com | 1962 |
America: Land of the Free, Because of the Brave
I had a benign tumor in a salavary gland. Once the ENT saw it, I had a head MRI and two biopsies within about 3 weeks, and surgery 2 weeks after that, when all the lab results were in. It cost $44K, of which I paid about 3%.
If someone is diagnosed with an invasive cancer, it's common to have surgery in a day or two. I'm seeing about 2-3 weeks average to see a doctor or get a major procedure. Basic lab stuff is walk-in.
That's on my wife's Blue Cross, which is actually pretty bad. My employees are on the Kaiser HMO, and Kaiser is amazing. You visit a doctor there and if, say, you need an xray or a lab workup, they often do it on the spot. I had one of those pre-cancerous skin things, a karatitus (rotten Irish skin and too many sunburns) and showed it to my Kaiser doc; she called in a dermatologist, they discussed it, and he blasted it with LN2, all in about 10 minutes. I'm dumping Blue Cross and going back to Kaiser soon; they take full systems responsibility.
John
Spehro Pefhany hath wroth:
I have no idea how long it would "typically" take. I only know of my own experience and those of a few others in the local prostate cancer support group:
My guess is that I could obtain a doctors appointment within about a month, emergency service in a few days, and non-emergency service in about 2 months[1].
My situation was also not typical as I was paying cash. The situation was so unusual that the hospital had serious difficulties dealing with me and accepting payment. For example, when I finally wrote the big check, the self inking rubber stamp used to authenticate the paid-in-full receipt was clogged and would not function. Apparently, it had not been used very often. So, I asked and was informed that the cashier had been at the hospital for 4 years, and it had been used twice.
My PSA chart may offer a clue. See:
The large "peak" in the middle was the result of a kidney stone (ouch). My decision to do the surgery was when the trend line continued upward in mid May. The actual surgery was on Aug 2, a 3 month delay. Two of the three reschedules were voluntary on my part to make the operating room available for emergencies, as my case was allegedly not time sensitive. When the last PSA test was run in mid July, it was obvious that I could no longer wait, and no further rescheduling was attempted.
One of the major benefits of paying cash is the ability to select my own doctor, surgeon, and hospital. I extended this to also selecting my own procedures, treatment, and timing. Everything, and I do mean everything, was negotiated. After 3 false starts, I wisely selected a good urologist and surgeon, who turned out to be an excellent doctor, but was rather awful at running the office. Your assumption that the pre-surgical tests and procedures were performed in an organized manner were derailed by version of do-it-myself medicine. Instead of the doctor, insurance company, or government agency making the major decisions, I made them, which included the timing. The price of such control was several months of almost continuous self-education and self-evaluation.
[1] In 2002, I survived a triple heart bypass operation. I had no idea that I had a serious problem. From the initial diagnosis, a visit to a cardiologist, failing a treadmill test, angiogram, and surgery, the elapsed time was 6 days. That's really fast. Meanwhile, I know of a person in Canada, that has a cancerous tumor, that had to wait 4 months for an oncologist appointment, and now estimates she will be waiting another 4 months to start treatment (surgery plus radiation).Good, fast, cheap medicine. Pick two.
-- Jeff Liebermann jeffl@cruzio.com 150 Felker St #D http://www.LearnByDestroying.com Santa Cruz CA 95060 http://802.11junk.com Skype: JeffLiebermann AE6KS 831-336-2558
I get those, too. Go see the doc, "OK, I'll be right back", with his little LN2 apparatus, zap, zap.
...Jim Thompson
--
| James E.Thompson, P.E. | mens |
| Analog Innovations, Inc. | et |
| Analog/Mixed-Signal ASIC\'s and Discrete Systems | manus |
| Phoenix, Arizona Voice:(480)460-2350 | |
| E-mail Address at Website Fax:(480)460-2142 | Brass Rat |
| http://www.analog-innovations.com | 1962 |
America: Land of the Free, Because of the Brave
Don Bowey hath wroth:
You misread my comments. I have the highest respect for American and foreign doctors. As individual doctors, they are the best. However, as members of an increasingly dysfunctional medical system, which is dominated by financial concerns, rather than medical priorities, much of their talent and dedication is seriously compromised. Whatever concerns I have about the doctors are primarily financial, not medical.
True. I had a kidney stone in the middle of all this. See graph at:
The month long peak was caused by the stone. Incidentally, PSA tests were costing me $40, so I ran tests far more often than would normally be necessary.
Sure. I had a needle biopsy in Dec 2006 that indicated cancer. In order to make sure there were no complications, the doctor ordered a broad spectrum blood test essentially looking for trouble. Fortunately, none was found. That's not over-testing.
Incidentally, the needle biopsy showed 40% involvement on one side, and none on the other. The post-surgical pathology report showed 80% on both sides. The consensus is that someone screwed up big time on the initial needle biopsy.
Sounds like you have a winner. Typical cost for a needle biopsy is billed at perhaps $2000 to the insurer, which pays perhaps 1/3 of that. I paid cash at about $1200 (including the evaluation). Those are not huge amounts and generally do not get the attention of the insurers. However, the hospital billed me $53,000 for the surgery, which I negotiated down to $20,000 cash. Those numbers will get the insurers attention. If I had required chemo or radiation, the price would have been 2-3 times higher, which also would have created a problem with the bean counters.
Very nice. I wish I had been in your situation. However, mine was an almost continuous increase, with only one decreasing value. Additional tests would only confirm the initial diagnosis.
Yep. Testing is always a good idea. Incidentally, some prices on common blood tests:
It's been my limited experience that they are directly involved in approving large expenditures but tend to ignore small ones. However, since my last to medical adventures did not involve insurance companies, I can only base my observations on comments from others.
I was offered the option of either laparoscopic surgery or robotic surgery. I chose laparoscopic over robotic even though it would have reduced the cost about $3000 because the surgeon I had been working with more experienced with laparoscopic and that the local hospital did not own a DaVinci robot. Had I been dealing with an insurance company, I suspect that I would not have had a choice only the cheaper alternative would have been offered. The fee to the surgeon would have remained about the same for both procedures.
Nope. Surgeon's charges would have been about the same. However, the robotic procedure takes less time, so the hospital operating room charges would have been less.
I also exercised those options. I hired an online medical tourism travel agent:
and ran the preliminaries to having the surgery done in India and Mexico. I had several conversations with doctors and officials and was satisfied that the medical arrangements would have been adequate. I was not so sure about the non-medical arrangements. The surgery turned out to be a rather small part of the cost, while everything else was constantly climbing in both cost and complexity. When I gave up, India was $15,000 and Mexico $19,000 as compared to a total of $27,000 I spent locally. That's for literally everything. Lead time was much less, at about 2-3 weeks maximum.
Incidentally, I had a very interesting discussion with a local insurance agent. We both expect insurance companies to fund offshore medical tourism in order to reduce costs.
-- Jeff Liebermann jeffl@cruzio.com 150 Felker St #D http://www.LearnByDestroying.com Santa Cruz CA 95060 http://802.11junk.com Skype: JeffLiebermann AE6KS 831-336-2558
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