Difference between Europe and North America
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David L
Well-known member
I chose my own hospital (Stanford) because of their experience with Marfans, which I didn't have, but I had a dilated aortic root, and AV regurgitation. My cardio chose my surgeon, as he knew him and his experience with my problem and his work with Marfan patients.I told him I wanted a tissue valve, so he installed a Medtronic Freestyle Valve. I was totally happy with both. If heaven were a 10, Stanford and Dr.R. Scott Mitchell would be a 9.5 in my book, even though I had to go 250 miles to get there. I had Medicare and my company retiree insurance, so that wasn't a problem!
ALCapshaw2
Well-known member
I suspect that the Vast Majority of patients (even in the USA) go to whatever Surgeon was recommended to them by their Primary Care Physician or their Cardiologist, at least the First Time.
I went to a Local Surgeon for my CABG. I knew 10 guys who had all had CABG locally and were doing fine.
I also suspect that most people just want to go to a Doctor / Surgeon and say "fix me up", without getting into the details...
...UNLESS or UNTIL there are complications and suddenly they develop an interest in 'what went wrong' or 'why is this progresssing'.
VR.com has / had thousands of members, but only a few who are regular and continuous contributers. Most of us/them are people who have had multiple heart / valve / tissue issues or continuing issues (such as anti-coagulation). Some of them came here AFTER their first surgeries / valves failed or they developed other problems.
I remember MANY members who came in, asked questions, learned about their condition, got fixed, and have moved on with their lives.
As I said, it's the multiple issue folks who really 'learn the ropes' and hang around to share their knowledge. (NO offense meant or intended for those who don't fit this profile. I know we have many single surgery contributors also and people still "in the waiting room").
Ged - you may find the stories in the Active Lifestyles Forum to be of interest, especially the ones from active athletes who have received Mechanical Valves and are on lifetime anti-coagulation.
'AL Capshaw'
I went to a Local Surgeon for my CABG. I knew 10 guys who had all had CABG locally and were doing fine.
I also suspect that most people just want to go to a Doctor / Surgeon and say "fix me up", without getting into the details...
...UNLESS or UNTIL there are complications and suddenly they develop an interest in 'what went wrong' or 'why is this progresssing'.
VR.com has / had thousands of members, but only a few who are regular and continuous contributers. Most of us/them are people who have had multiple heart / valve / tissue issues or continuing issues (such as anti-coagulation). Some of them came here AFTER their first surgeries / valves failed or they developed other problems.
I remember MANY members who came in, asked questions, learned about their condition, got fixed, and have moved on with their lives.
As I said, it's the multiple issue folks who really 'learn the ropes' and hang around to share their knowledge. (NO offense meant or intended for those who don't fit this profile. I know we have many single surgery contributors also and people still "in the waiting room").
Ged - you may find the stories in the Active Lifestyles Forum to be of interest, especially the ones from active athletes who have received Mechanical Valves and are on lifetime anti-coagulation.
'AL Capshaw'
Leeroy996
Well-known member
My Cardiologist is from New Zealand where the healthcare system is much less reliant on private sector. My Cardiologist recommend a St Judes but he sent me to a surgeon in Auckland that recommended the Ross Procedure. I had the choice to wait and have the surgery sceduled in the Public system or pay the full cost and decide on my date (same surgeon though). The cost quoted was $14,000 USD total.
Aetna my USD Insurance provider verified the NZ hospital within hours.
I chose to do the surgery at Mt Sinai and my insurance bill was 140,000. Interestingly it took a week for Aetna to verify coverage at Mt Sinai.
Both surgeon's were equally competent and gave the same recommendation. I find US surgeons have a superior attitude towards their patients but the nursing staff is inferior. The most significant difference is the cost. The US spends 17% of GDP on healthcare - no country comes close to that.
Aetna my USD Insurance provider verified the NZ hospital within hours.
I chose to do the surgery at Mt Sinai and my insurance bill was 140,000. Interestingly it took a week for Aetna to verify coverage at Mt Sinai.
Both surgeon's were equally competent and gave the same recommendation. I find US surgeons have a superior attitude towards their patients but the nursing staff is inferior. The most significant difference is the cost. The US spends 17% of GDP on healthcare - no country comes close to that.
L
Lisa in Katy
The latest data I have, which was for 2007, was 16.2%. Some of that is spent for research, for which the US spends way more than anyone else, but every other country in the world gets the benefit. (You're Welcome). The rate of growth in spending was slow for 2007 (it was 16% in 2006), with Home Health accounting for most of the minor growth. Interestingly enough, analysts think that can be at least partially contributed to Medicare fraud & abuse (a government financed program).
There is no doubt that the free market system of healthcare drives up costs in the US, but that is what the US is based on - opportunity for all to get as rich as the market will allow. Why do you think we have so many foreign educated doctors here?
I've never been in a hospital in another country, but have been in several in the US. I've had 1 nurse that I would rate as inferior, and she was trained in an African country, new to the US. I also had 1 "Nurse Ratchet" type, but I wouldn't say that she was inferior, just a little rough.
There is no doubt that the free market system of healthcare drives up costs in the US, but that is what the US is based on - opportunity for all to get as rich as the market will allow. Why do you think we have so many foreign educated doctors here?
I've never been in a hospital in another country, but have been in several in the US. I've had 1 nurse that I would rate as inferior, and she was trained in an African country, new to the US. I also had 1 "Nurse Ratchet" type, but I wouldn't say that she was inferior, just a little rough.
i live in the uk,for what its worth the treatment i recieved was first class,my cardio was first class and my surgeon like wise,i disscussed at length with him the type of valve i wanted,he was a loverly bloke who had been doing this op for 15yrs,he told me this choice is very personnel to each person,he was very much into what YOU wanted,he basically said theres pros and cons in whichever valve you pick,and in his opinoin i should get between 10 and 15 yrs out of my piggy valve,i think the treatment i received was first class,whoops have rambled on a bit sorry....................................
B
Bridgette
I get the impression that sometimes in the USA, where surgery, especially cardiac surgery, is big business, surgeons tell people what they want to hear - I mean, they are after your business aren't they, because they are competing in the "free market" economy?
I don't know - I think I'd rather have a surgeon "tell it to me straight" with no financial motivation behind what he/she is saying.......hmmmm, think kickbacks to surgeons from particular valve companies for promoting /using their valves....
I don't know - I think I'd rather have a surgeon "tell it to me straight" with no financial motivation behind what he/she is saying.......hmmmm, think kickbacks to surgeons from particular valve companies for promoting /using their valves....
L
Lisa in Katy
I'm not sure because there's always the even bigger business - malpractice suits!
wcasey5
Well-known member
The latest data I have, which was for 2007, was 16.2%. Some of that is spent for research, for which the US spends way more than anyone else, but every other country in the world gets the benefit. (You're Welcome). The rate of growth in spending was slow for 2007 (it was 16% in 2006), with Home Health accounting for most of the minor growth. Interestingly enough, analysts think that can be at least partially contributed to Medicare fraud & abuse (a government financed program).
There is no doubt that the free market system of healthcare drives up costs in the US, but that is what the US is based on - opportunity for all to get as rich as the market will allow. Why do you think we have so many foreign educated doctors here?
I've never been in a hospital in another country, but have been in several in the US. I've had 1 nurse that I would rate as inferior, and she was trained in an African country, new to the US. I also had 1 "Nurse Ratchet" type, but I wouldn't say that she was inferior, just a little rough.
I've used both the Canadian and U.S. health care systems extensively and in my experience, the actual health care itself is practically identical. No nurse practitioners in Canada is the main difference. And there is a greater volume of doctors and hospitals in the U.S. That goes along with the greater population, but I don't know if it is proportional.
I find that doctor/surgeon choice is more limited in the U.S. initially, but by arguing with the insurance company you can expand your choice. You do have to have the personality to do that. I also find that having insurance tied to an employer limits my freedom as to which employer I want to work for. In Canada, I just chose whatever doctor/surgeon I wanted, and like here in the U.S. you were scheduled acording to need and how busy the surgeon was. My AVR was delayed here in Baltimore because someone with greater need bumped me out of my spot.
As far as a comparison of doctors with Non north american roots, its about equal. And all countries do research, although to varying degrees. But the U.S. does do a lot of research in both medicine and drugs.
As far as cost goes, presious little in life is free. And unless you grew up in the shelter of a billionair family, you know there is no free lunch. Taxes were higher in Canada, overall. But if I separate the amount paid for health care vs my premiums/co-pays/deductible, I paid less in Canada. Maybe I work for a crappy company or something and others are luckier (I'll change jobs!) but that's been my experience. I am lucky that I can afford it, but it still get's me a little ticked to think about it.
The worst part about the U.S. system is that dealing with it is such a PITA. For my AVR last year, I got 11 bills for less than a dollar. It cost more for the postage that it did for the bill! I spent hours of time dealing with insurance companies that I could have used recovering from surgery, and I also spend a great deal of time each year making decisions about health insurance that has absolutely nothing to do with my health.
As far as the hospitals go, my seat of the pants comparison is that the surgeons are friendlier and more customer orientated in the U.S., the nursing staff is about the same (the real backbone of health care, and often underappreciated), the food is better in the U.S., the hospitals are cleaner in Canada, and the auxillary services (janitors etc) are better in Canada.
I think the essential point is that only negatives are promoted in home countries. For instance, my friends and family in Canada are scared to death of the american system. And as a system goes, It would not work in Canada at all. A lot of americans are scared to death of the Canadian system, and while I feel it has some great advantages, I don't think it would work in the U.S. Different countries/different cultures. I do find it interesting that if a politition or interest group wants to really get people in line in Canada, they threaten them with American Health Care. In the U.S., if a politition or interest group wants to really get people in line, they threaten them with Canadian health care.
Interesting eh?
Jkm7
Well-known member
Great post and interesting reading for sure, wcasey.
BUT, it is not the same for all of us.
Two OHS for me in four years. Both times I chose the hospital and surgeon of my choice. Same one each time. (Mass General in Boston.) Absolutely no hassle from my insurance company in either case. They paid every penny with no question, communication or aggravation.
Second surgery I got one bill from one provider weeks after I left the hospital. It was for a provider's co-pay and totaled $5.00.
In terms of choice of hospital and doctor, it could not have been easier on me. In terms of insurance coverage and payment, I never even saw a bill. I was interested and curious so found some info on line at their site but not detailed. Never got a thing in the mail or from the hospital at discharge. (Which is good and bad...... they could have charged for all sorts of things I never had and I never would catch the error. )
Not all our experiences are the same from city to city, state to state etc and probably in Canada, not everyone's experience is the same, city to city, provence to provence. Neither system is totally consistent it seems.
BUT, it is not the same for all of us.
Two OHS for me in four years. Both times I chose the hospital and surgeon of my choice. Same one each time. (Mass General in Boston.) Absolutely no hassle from my insurance company in either case. They paid every penny with no question, communication or aggravation.
Second surgery I got one bill from one provider weeks after I left the hospital. It was for a provider's co-pay and totaled $5.00.
In terms of choice of hospital and doctor, it could not have been easier on me. In terms of insurance coverage and payment, I never even saw a bill. I was interested and curious so found some info on line at their site but not detailed. Never got a thing in the mail or from the hospital at discharge. (Which is good and bad...... they could have charged for all sorts of things I never had and I never would catch the error.
)Not all our experiences are the same from city to city, state to state etc and probably in Canada, not everyone's experience is the same, city to city, provence to provence. Neither system is totally consistent it seems.
wcasey5
Well-known member
thanks
Absolutely!
I had a collegue who had AVR in 2000, and paid a total of $100 out of pocket, I paid $2500 max individual, plus everything for the rest of the family, not including perscriptions. Total for the family for the year was close to $6000, plus the premiums. Same company, same insurance, just 8 years apart. I'm trying a different plan this year and we will see what happens.
If I start looking for a new job, health care is a prime concern. Of course, it was when I took this one and look what happened
Not that I'm bitter, but I would be much less stressed to pay $100 rather than $2500. And even that is better than the approx $60000 total bill.
kfay
Well-known member
Great post and interesting reading for sure, wcasey.
BUT, it is not the same for all of us.
Two OHS for me in four years. Both times I chose the hospital and surgeon of my choice. Same one each time. (Mass General in Boston.) Absolutely no hassle from my insurance company in either case. They paid every penny with no question, communication or aggravation.
Second surgery I got one bill from one provider weeks after I left the hospital. It was for a provider's co-pay and totaled $5.00.
In terms of choice of hospital and doctor, it could not have been easier on me. In terms of insurance coverage and payment, I never even saw a bill. I was interested and curious so found some info on line at their site but not detailed. Never got a thing in the mail or from the hospital at discharge. (Which is good and bad...... they could have charged for all sorts of things I never had and I never would catch the error.
Not all our experiences are the same from city to city, state to state etc and probably in Canada, not everyone's experience is the same, city to city, provence to provence. Neither system is totally consistent it seems.
My experience was much the same. My share of the $120,000 bill from the Mayo clinic...$0! No hassle getting anything approved, no delays, I picked my surgeon, and my date. I did have to pay $60 copay for 2 office visits the day before my surgery. My first surgery at Duke, exactly the same. I will take the ability to chose to have my surgery at places like these anyday over any other system.
By the way, when we lived in Europe, the portion from my husband's pay for the NHS was more than we were paying at the time for our health insurance here in the US (which, by the way, we kept in force the whole time we lived there "just in case" because I knew if I needed any serious medical care, we would come home).
Kim
L
Lisa in Katy
I pay $15.70 every two weeks for health insurance for myself (not to give too many details, but less than 1% of my gross). Last year I had a full checkup at the Gyn and a full checkup with Echo at the Cardio. I paid nothing at either visit. The only other thing I paid for was my prescriptions $4 per month for Warfarin and $10 per month for blood pressure med.
If you read this forum you will see there is more complains about people wanting surgery, when their doctors are telling them to wait.
"My" cardiologist made the decision on the time for me to have AVR. (after 10 years) I asked him if he was going to have to have AVR where would he have it done. He said Cleveland or Houston. "I" picked Houston for it was only 550 miles. I told him the surgeon I wanted but the surgeon was booked up for months. He then recommended a surgeon that he knew. The surgeon wasn't real happy about using a mechanical valve for I had a history of bleeding duodenal ulcer. But he also didn't recommend a pig valve at my age.
My Cardiologist is also my primary care physician. He is also the Cardiologist of my choice.
I like the freedom of choice we have in the USA. I also hope and pray the liberals never change that.
pamela
Well-known member
Imagine being a minimum wage earner and needing valve surgery at a young age. You own no collateral and carry no insurance.
What are your options?
I know that here in Canada I present myself at the hospital and everything, including a choice of specialists and providers, will be taken care of as is my right. I won't have my wages garnished (sp?) nor carry the burden of a bill around until I pay it off. I do NOT disqualify myself for health care insurance for pre-existing conditions...
I like what I have.
What are your options?
I know that here in Canada I present myself at the hospital and everything, including a choice of specialists and providers, will be taken care of as is my right. I won't have my wages garnished (sp?) nor carry the burden of a bill around until I pay it off. I do NOT disqualify myself for health care insurance for pre-existing conditions...
I like what I have.
L
Lisa in Katy
In Texas, they can't garnish your wages to pay for medical bills. If you truly need surgery, you will get it. You can either get on Medicaid, get in the high risk pool, go to one of the safety net hospitals, or show up as an emergency at any hospital and have it done. The hospital can bill you and turn you over to collections, but if you can't pay, you can't pay. Eventually, they will write it off. Even with no money, we have choices. It's not a great system, but it's really not as bad as some would have you believe.
wcasey5
Well-known member
Actually, getting a bill and then waiting for it to be written off, and have it effect your credit and all, is pretty bad. I think it works the same in this state, where the costs of people who don't have health insurance or are unable to pay are pushed off as higher health care costs for the rest of the health care consumers. Everything gets paid for one way or another.
In any case, I must be doing something wrong because I have all these co-pays and deductibles and you all don't. I work for a company that makes billions and employs 300,000 people. This truely sucks and now I want to work for someone else that has better health care!
If that were possible I guess
Wise
Well-known member
These are my thoughts. Since I'm not always sure who is a conservative or liberal anymore, I'll say I hope it isn't changed by politicians.
L
Lisa in Katy
Yes, it will mess up your credit, but that's easy enough to explain if you get in a situation where someone questions it. My SIL was without insurance when she had hand surgery. She ignored the collectors for about 6 months and then got a note from the hospital saying her account was written off. It didn't keep her from running up her credit to about $25,000 and buying a new car that she couldn't afford a year later. The bankruptcy that she then filed messed her up worse! Some people just don't know when to say no!
B
Bridgette
Yeah, I do read this forum actually Olefin, and the recurrent theme is that the cardiologists are the ones telling the patients to wait while the surgeons are saying that they need surgery now. I've read that lots of times on here.
It's great that you are happy with your health system. That's good.
I'm happy with my treatment and the system in general in my country. I guess most people are content with what they know and are used to?
Bridgette
PS: I did use the word "sometimes" - I didn't say I think this happens "all the time"....
