Paying for surgeries 100% cash

[Chuck C]

From what I understand, the TAVR valve itself costs substantially more than the tissue or mechanical valves. I do not know how the cost of the actual procedures differ, but would imagine that they are comparable, with possibly SAVR a little more.
I believe in the US the hospital stay itself is the biggest number of all, when you add up every little line item:
They do a chest x-ray on me every day
They run tons of labs on me every day- they charge a lot for these
I expect they charge every time they take your vitals
I expect they are charging me every time the cardiologist or the surgeon drop in to see how I'm doing
They ran an ultrasound to see how the valve is doing.
The rate for the room itself, before adding in all the other charges is $ 1,800 per night for ICU- not sure about the step down ward.

So, the surgery procedure itself may be similar, but TAVR should cost a lot less for the much shorter hospital stay, at least in the US. I think that the increased cost of the TAVR valve will end up being more than surpassed by the drastically increased cost of the SAVR hospital stay.

Here is one way to know for certain: Which direction is the insurance industry trying to push things? If they are saving a lot on TAVR, which I expect that they are, they likely will be trying to influence this as the procedure of choice.

 

[newarrior]

From what I understand, the TAVR valve itself costs substantially more than the tissue or mechanical valves. I do not know how the cost of the actual procedures differ, but would imagine that they are comparable, with possibly SAVR a little more.
I believe in the US the hospital stay itself is the biggest number of all, when you add up every little line item:
They do a chest x-ray on me every day
They run tons of labs on me every day- they charge a lot for these
I expect they charge every time they take your vitals
I expect they are charging me every time the cardiologist or the surgeon drop in to see how I'm doing
They ran an ultrasound to see how the valve is doing.
The rate for the room itself, before adding in all the other charges is $ 1,800 per night for ICU- not sure about the step down ward.

So, the surgery procedure itself may be similar, but TAVR should cost a lot less for the much shorter hospital stay, at least in the US. I think that the increased cost of the TAVR valve will end up being more than surpassed by the drastically increased cost of the SAVR hospital stay.

Here is one way to know for certain: Which direction is the insurance industry trying to push things? If they are saving a lot on TAVR, which I expect that they are, they likely will be trying to influence this as the procedure of choice.

TAVR cost the most and has a lot of negatives such as stroke risk, a less active life, cost etc..Mechanical is cheaper than tissue

 

[newarrior]

Have you considered India?

to what I see they have an acceptable standard of OHS

could well be cheaper than Thailand ....

I have considered India

 

[rich01]

TAVR cost the most and has a lot of negatives such as stroke risk, a less active life, cost etc..Mechanical is cheaper than tissue

$35K in Israel. Stroke risk is minimal. I think you are looking at the earlier TAVR valve statistics. I would say either equal active life or better. I was driving within a week. If a person is over 65, the main reason I can see not to have TAVR is if there are other problems that can only be resolved through surgery.

 

[newarrior]

ok

 

[newarrior]

I assume you are a U.S. citizen. Would you be enrolling in Medicare at age 65? (Please, no comments about stability of funding for Medicare or Social Security) If so, you may want to investigate having surgery in the U.S. (and have a Medicare Advantage plan vs. Original Medicare and supplemental). However, Original Medicare does not cover most, if not any, procedures done outside the U.S. (There are some geographic exceptions along the US-Canada border and perhaps the US-Mexico border.)
I have several ex-pat friends living in Thailand, Finland and elsewhere in Europe who are 65 or over. The one in Thailand has been in an ICU for pneumonia; I do not know what type of medical coverage he is using there.

But, in short, planning ahead and having several contingencies is best. Valves can go downhill PDQ. Mine did.

Great advice especially But, in short, planning ahead and having several contingencies is best. Valves can go downhill PDQ. Mine did.

 

[newarrior]

I

$35K in Israel. Stroke risk is minimal. I think you are looking at the earlier TAVR valve statistics. I would say either equal active life or better. I was driving within a week. If a person is over 65, the main reason I can see not to have TAVR is if there are other problems that can only be resolved through surgery.

am 58 so too young for that

 

[newarrior]

A

The thing about insurance is that the insurance companies have an agreement with the hospitals and physicians about rates. If you don't have insurance there is no agreement and the rates can be anything. When a patient sees the bills these are not usually the agreed upon rates but whatever the hospitals want to put down. So a $300,000 bill that you see may actually have been $75,000 in real dollars. The other issue with not having insurance is that if something happens that requires say another operation then the cost could double. So having insurance is more important than just thinking it pays for things.

Agreed--I am trying to avoid a costly, unpleasant reboot start over in the states from ground zero, solo at age 58 no career, family, partner, housing etc in the USA--tough call

 

[newarrior]

In the US the cost of most procedures is determined by contractual agreements between the medical providers and the various insurance carriers. Medicare or private. If you don’t have insurance the price can be anything. So insurance protects by controlling the costs and by paying for them. It is the wild west without insurance coverage.

agreed

 

[newarrior]

Move to the UK.

US Citizen---Not applicable to me

 

[newarrior]

Newarrior, given the costs of the surgery in the US, I wonder what the cash price might be in Thailand. Maybe that's a better option for you?

12,000 to 40,000 in Thailand for mech valve with no complications..Free in USA but cost of living here is so low that I am better off here

 

[Superman]

12,000 to 40,000 in Thailand for mech valve with no complications..Free in USA but cost of living here is so low that I am better off here

Then it’s a simple cost benefit analysis. A basic managerial account question of a significant capital outlay up front vs continuous higher operating expenses (not to mention logistics and costs of moving) over time. Build a spread sheet.

Cost of living where I am, $10,000 annually. Pay $25,000 for surgery. Cost of living in the US, $25,000 annually. No cost for surgery. Two years and surgery pays for itself in Asia, all else equal.

Just spitballing numbers. Use what you know.

 

[newarrior]

Then it’s a simple cost benefit analysis. A basic managerial account question of a significant capital outlay up front vs continuous higher operating expenses (not to mention logistics and costs of moving) over time. Build a spread sheet.

Cost of living where I am, $10,000 annually. Pay $25,000 for surgery. Cost of living in the US, $25,000 annually. No cost for surgery. Two years and surgery pays for itself in Asia, all else equal.

Just spitballing numbers. Use what you know.

Issue is with heart things many unknowns..Complications op or post op, repeat surgery, may need mitral valve repaired or replaced, heart failure, afib issues extending out to the worst case (pacemaker), stroke, heart attacks, screenings, meds, etc etc...Strangely heart attacks and strokes are covered under my current plan...all else cardiac is not

 

[pekster11]

US healthcare amazes me tbh
Here in the UK, we don't have to worry about things like how to pay for heart surgery thank F

 

[newarrior]

On USA side of things the unknown is what kind of work if any I could get and if/when/how much I could get for disability. Medical is free for me in USA...Housing---if/when I buy a house I must pay cash and anything over 150K I need pay 30% taxes when I sell investments..I do know housing and rental prices in Cali..

 

[newarrior]

US healthcare amazes me tbh
Here in the UK, we don't have to worry about things like how to pay for heart surgery thank F

I don't live in the US so what you said above does not apply to me.

If I go back to the USA I have free healthcare so I don't know where you are getting your data.

Regardless I live in Asia...It's 100% free market capitalism...China is WAAAY more capitalistic for example than any Western country where the government steps in with humane support.

It's worse if you live overseas as an expat..Unless you have a job ALL things pre existing are NOT covered...The USA is still better than most countries with the affordable care act. Insurance is 100% profit driven like any business. If the insurance companies had their way ZERO of the people on this board would be insured as we are high risk. The governments of places like the USA, UK etc force insurers to covers us which they hate because we lose them money.

As an insurance agent here in Thailand said, "Private insurance/insurance is a dirty business--pure profit driven".

You are blessed that the government steps in and covers you. in Asia it is dog eat dog--money rules and you would be forced to pay 100% of all of your pre existing conditions via cash or credit card.

 

[Superman]

I don't live in the US so what you said above does not apply to me.

If I go back to the USA I have free healthcare so I don't know where you are getting your data.


Regardless I live in Asia...It's 100% free market capitalism...China is WAAAY more capitalistic for example than any Western country where the government steps in with humane support.

It's worse if you live overseas as an expat..Unless you have a job ALL things pre existing are NOT covered...The USA is still better than most countries with the affordable care act. Insurance is 100% profit driven like any business. If the insurance companies had their way ZERO of the people on this board would be insured as we are high risk. The governments of places like the USA, UK etc force insurers to covers us which they hate because we lose them money.

You are blessed that the government steps in and covers you. in Asia it is dog eat dog--money rules and you would be forced to pay 100% of all of your pre existing conditions via cash or credit card.

To add to all of the above, whether it’s taxes or premiums or deductibles, we’re all paying.

 

[newarrior]

To add to all of the above, whether it’s taxes or premiums or deductibles, we’re all paying.

true that