11 replies to this topic

[egeefay]

Are medical cost in the US getting out of hand?
If my experience today is any indication, the answer is "probably"

Ten years ago my Thai wife had a heart pacemaker implanted in a California hospital as part of an emergency medical procedure when her heart failed.

A couple of weeks ago she went in for her regular pacemaker test and the specialist indicated that the pacemaker batteries were running down and she would have to have the pacemaker replaced.

We both went to the heart specialist today to find out a little more about the procedure.
The nice doctor said that replacing a pacemaker was a routine outpatient procedure and my wife would be in and out the same day.  The doctor mention that one of the two leads might have a faulty connection and if that were the case she would have to have the bad lead replaced as well and  that would mean a stay overnight in the hospital.

Because we are self employed we carry only major medical insurance to cover us in case of an emergency.  Everything else we pay out of pocket.
So I asked the doctor : "How much does it cost to have a new pacemaker inserted?"
There was a pregnant moment of silence and then he asked politely "Why do you want to know?"
"Because I have a high deductible insurance policy and I usually have to cover the costs myself," I replied.
"I guess that the pacemaker might run about $4000, but I don't know what the hospital charges are.  You'll have to go to the hospital and inquire" he said.
The doctor wrote out a request for a quote on the same  kind of paper they use to write prescriptions and instructed me where to find the billing department of the hospital.
We drove over to the hospital and on the way speculated at how much we might have to pay for the new pacemaker and the new lead.  Our guess was around $10,000.  $4000 for the pacemaker, maybe $2000 for the overnight stay at the hospital and the rest for the doctor's fees.
How ignorant we were.

At the billing desk our request for a quote was met with total amazement.
"Why do you need to know the cost.  Doesn't your insurance cover it?" asked the clerk.
I explained again that we pretty much pay for everything up to $10,000 at which point insurance kicks in.
She grudgingly went to her computer and began hunting around.
"Single or double chamber pacemaker?" she called out to us over her shoulder.
"Not sure" I replied, "Give me the cost for both!"
After a few minutes she came back.
"I don't have an exact price," she stated "It would depend on if they ran into any complications.  But to put in a new pacemaker, a new lead , and a night in the hospital will run between $28,000 to $58,000."
I tried not to appear shocked and asked "Does that include the doctor fees too".
"No. The doctors fees aren't included."

We walked out of the hospital in silence.
Fortunately we have major medical insurance .  We would have to pay the first $10,000 but the insurance would cover the rest of the costs.
Still both my wife and I were shocked. $58,000 is more than what many people earn in an entire year!!!  You could buy 2 or 3 brand new cars with that.  That's what two years in  college  including tuition , room and board cost for my daughter.  All for a routine procedure and one nights stay in an American Hospital.  And that's just the hospital bill!!   I am afraid to know what the doctor fees are.

We haven’t decided what to do.  My wife still has a few months before the batteries run out.  But on the way home we discussed finding out how much it would cost to have the same procedure done at a Thai hospital like  Bumrungrad International.  I’m guessing but I think for the money we could save we could have a nice vacation and visit the relatives while we are there. The doctor said that putting in a new pacemaker is a routine procedure.  I’m sure they can handle it in Thailand

So my question is: Can anybody recommend a good heart hospital and maybe a good heart specialist in Thailand?

Edited by egeefay, 2006-08-04 05:54:51.

[Phil Conners]

Medical prices in US have been out of hand for many years.

In Thailand hospitals like to compare their prices with US prices to show how inexpensive they are, and when I point out the prices in Europe that are usually a fraction of this they refuse to believe me.

I blame the US lawsuit mentality. Of course when every 10'th operation results in a frivilous lawsuit for millions due to customer stupidity (caution, hot coffee) those who are being sued have to get that cost covered somehow.

[peterjackson]

Hey

I don't know if your major Medical Policy will cover for you to have the procedure done out of state, but it is generally regarded that California is one of the nations most expensive places to have medical procedures done....viz a viz the reason given above. But either way, I don't think the price will reduce below your $ 10k deductible.

I was in my local hospital recently and they asked me was my procedure going to be cash or Insurance. I enquired flipantly why don't tell me I get a discount for cash.....surprisingly, the answer was yes, 40% off if payment was not through an insurance carrier.

This either means 1 of 2 things. The insurers get massive discounts on the 'List Prices' for their patronage and a 40% cash discount is still more than they would receive from the insurance carrier, or they are 'ripping' off the insurance carriers....either way, I was shocked.

Regards

Peter

[Thaiquila]

Very odd. Most hospitals charge double or more to people without insurance in the US. Not that they ever usually collect this, but the charges are generally much higher because insurance companies are group plans so they negotiate special rates. So it often means bankruptcy and/or ruined credit for the uncovered (or death because care isn't sought in time due to the cost). The US health care system is the most expensive in the world, and about 45 million Americans have no access to the system. Don't get me started ...
The priority is of course "the war on terror" rathole. Health care be damned.

Edited by Thaiquila, 2006-08-04 09:42:02.

[peterjackson]

Hey

I can only speak of the System I went to which was Orlando Regional Healthcare and the discount was offered for payment at the time of the procedure, as opposed to being billed later.

My procedure was inexpensive and therefore below my deductible, so I opted for the payment with cash discount. Actually I paid for it on a Credit Card.

I believe from what I have heard, the other main Healthcare system here, run by the Seventh day Adventists and called Florida Hospital, also offer similar 'cash' discounts.

Maybe it's a case of 'a bird in the hand is worth two in the bush'.

Like Thaiquila, I too could go off on one about US Healthcare, but I'll exercise restraint.

Regards

Peter

[Thaiquila]

I truly think your experience of discounts for the uninsured is anecdotal and does not reflect the more common experience of the uninsured being charged MUCH, MUCH more.

Evidence:
http://www.cbsnews.c...in1362808.shtml

Quote

Hospitals charge uninsured patients two, three, four or more times what an insurance company would pay for the same treatment. And, when the uninsured can?t pay, they often find themselves the target of collection agencies or in bankruptcy court.

For American farangs who complain about tiered pricing policies for health care in Thailand, I would submit we have no business being critical, considering where we come from.

Edited by Thaiquila, 2006-08-04 11:43:13.

[billd766]

egeefay, on 2006-08-04 05:37:59, said:

Are medical cost in the US getting out of hand?
If my experience today is any indication, the answer is "probably"

Ten years ago my Thai wife had a heart pacemaker implanted in a California hospital as part of an emergency medical procedure when her heart failed.

A couple of weeks ago she went in for her regular pacemaker test and the specialist indicated that the pacemaker batteries were running down and she would have to have the pacemaker replaced.

We both went to the heart specialist today to find out a little more about the procedure.
The nice doctor said that replacing a pacemaker was a routine outpatient procedure and my wife would be in and out the same day.  The doctor mention that one of the two leads might have a faulty connection and if that were the case she would have to have the bad lead replaced as well and  that would mean a stay overnight in the hospital.

Because we are self employed we carry only major medical insurance to cover us in case of an emergency.  Everything else we pay out of pocket.
So I asked the doctor : "How much does it cost to have a new pacemaker inserted?"
There was a pregnant moment of silence and then he asked politely "Why do you want to know?"
"Because I have a high deductible insurance policy and I usually have to cover the costs myself," I replied.
"I guess that the pacemaker might run about $4000, but I don't know what the hospital charges are.  You'll have to go to the hospital and inquire" he said.
The doctor wrote out a request for a quote on the same  kind of paper they use to write prescriptions and instructed me where to find the billing department of the hospital.
We drove over to the hospital and on the way speculated at how much we might have to pay for the new pacemaker and the new lead.  Our guess was around $10,000.  $4000 for the pacemaker, maybe $2000 for the overnight stay at the hospital and the rest for the doctor's fees.
How ignorant we were.

At the billing desk our request for a quote was met with total amazement.
"Why do you need to know the cost.  Doesn't your insurance cover it?" asked the clerk.
I explained again that we pretty much pay for everything up to $10,000 at which point insurance kicks in.
She grudgingly went to her computer and began hunting around.
"Single or double chamber pacemaker?" she called out to us over her shoulder.
"Not sure" I replied, "Give me the cost for both!"
After a few minutes she came back.
"I don't have an exact price," she stated "It would depend on if they ran into any complications.  But to put in a new pacemaker, a new lead , and a night in the hospital will run between $28,000 to $58,000."
I tried not to appear shocked and asked "Does that include the doctor fees too".
"No. The doctors fees aren't included."

We walked out of the hospital in silence.
Fortunately we have major medical insurance .  We would have to pay the first $10,000 but the insurance would cover the rest of the costs.
Still both my wife and I were shocked. $58,000 is more than what many people earn in an entire year!!!  You could buy 2 or 3 brand new cars with that.  That's what two years in  college  including tuition , room and board cost for my daughter.  All for a routine procedure and one nights stay in an American Hospital.  And that's just the hospital bill!!   I am afraid to know what the doctor fees are.

We haven’t decided what to do.  My wife still has a few months before the batteries run out.  But on the way home we discussed finding out how much it would cost to have the same procedure done at a Thai hospital like  Bumrungrad International.  I’m guessing but I think for the money we could save we could have a nice vacation and visit the relatives while we are there. The doctor said that putting in a new pacemaker is a routine procedure.  I’m sure they can handle it in Thailand

So my question is: Can anybody recommend a good heart hospital and maybe a good heart specialist in Thailand?

I don't know the price of a pacemaker but I was in the BAngkok Heart hospital http://www.bangkokhearthospital.com/
at the end of June to have 2 angioplasty balloons done and 2 stents fitted and the bill came to about $7,500 which included all the doctors fees, medicine and 2 nights stay.
The doctor Dr Witaya Jongsupangkarat and I think he did a good job.
I have to go for my 2nd checkup on Sunday and if you want to pm me I will see what I can find out. Alternatively you can go to the website and probably find out from there.
I thought that the surgery was good and the medicines were expensive as this is Thailand so I check with my local pharmacy and they carry the same medices but much cheaper.
I feel lucky as the really nice nurse apologised because she knicked me 5 times while shaving me from knee to navel. Why lucky? She was using an electric shaver and not an open wet razor or I may have been a 120kg katoey.

[uhuh]

billd766, on 2006-08-04 22:27:37, said:

egeefay, on 2006-08-04 05:37:59, said:

Are medical cost in the US getting out of hand?
If my experience today is any indication, the answer is "probably"

Ten years ago my Thai wife had a heart pacemaker implanted in a California hospital as part of an emergency medical procedure when her heart failed.

A couple of weeks ago she went in for her regular pacemaker test and the specialist indicated that the pacemaker batteries were running down and she would have to have the pacemaker replaced.

We both went to the heart specialist today to find out a little more about the procedure.
The nice doctor said that replacing a pacemaker was a routine outpatient procedure and my wife would be in and out the same day.  The doctor mention that one of the two leads might have a faulty connection and if that were the case she would have to have the bad lead replaced as well and  that would mean a stay overnight in the hospital.

Because we are self employed we carry only major medical insurance to cover us in case of an emergency.  Everything else we pay out of pocket.
So I asked the doctor : "How much does it cost to have a new pacemaker inserted?"
There was a pregnant moment of silence and then he asked politely "Why do you want to know?"
"Because I have a high deductible insurance policy and I usually have to cover the costs myself," I replied.
"I guess that the pacemaker might run about $4000, but I don't know what the hospital charges are.  You'll have to go to the hospital and inquire" he said.
The doctor wrote out a request for a quote on the same  kind of paper they use to write prescriptions and instructed me where to find the billing department of the hospital.
We drove over to the hospital and on the way speculated at how much we might have to pay for the new pacemaker and the new lead.  Our guess was around $10,000.  $4000 for the pacemaker, maybe $2000 for the overnight stay at the hospital and the rest for the doctor's fees.
How ignorant we were.

At the billing desk our request for a quote was met with total amazement.
"Why do you need to know the cost.  Doesn't your insurance cover it?" asked the clerk.
I explained again that we pretty much pay for everything up to $10,000 at which point insurance kicks in.
She grudgingly went to her computer and began hunting around.
"Single or double chamber pacemaker?" she called out to us over her shoulder.
"Not sure" I replied, "Give me the cost for both!"
After a few minutes she came back.
"I don't have an exact price," she stated "It would depend on if they ran into any complications.  But to put in a new pacemaker, a new lead , and a night in the hospital will run between $28,000 to $58,000."
I tried not to appear shocked and asked "Does that include the doctor fees too".
"No. The doctors fees aren't included."

We walked out of the hospital in silence.
Fortunately we have major medical insurance .  We would have to pay the first $10,000 but the insurance would cover the rest of the costs.
Still both my wife and I were shocked. $58,000 is more than what many people earn in an entire year!!!  You could buy 2 or 3 brand new cars with that.  That's what two years in  college  including tuition , room and board cost for my daughter.  All for a routine procedure and one nights stay in an American Hospital.  And that's just the hospital bill!!   I am afraid to know what the doctor fees are.

We haven’t decided what to do.  My wife still has a few months before the batteries run out.  But on the way home we discussed finding out how much it would cost to have the same procedure done at a Thai hospital like  Bumrungrad International.  I’m guessing but I think for the money we could save we could have a nice vacation and visit the relatives while we are there. The doctor said that putting in a new pacemaker is a routine procedure.  I’m sure they can handle it in Thailand

So my question is: Can anybody recommend a good heart hospital and maybe a good heart specialist in Thailand?

I don't know the price of a pacemaker but I was in the BAngkok Heart hospital http://www.bangkokhearthospital.com/
at the end of June to have 2 angioplasty balloons done and 2 stents fitted and the bill came to about $7,500 which included all the doctors fees, medicine and 2 nights stay.
The doctor Dr Witaya Jongsupangkarat and I think he did a good job.
I have to go for my 2nd checkup on Sunday and if you want to pm me I will see what I can find out. Alternatively you can go to the website and probably find out from there.
I thought that the surgery was good and the medicines were expensive as this is Thailand so I check with my local pharmacy and they carry the same medices but much cheaper.
I feel lucky as the really nice nurse apologised because she knicked me 5 times while shaving me from knee to navel. Why lucky? She was using an electric shaver and not an open wet razor or I may have been a 120kg katoey.

Although they are a good hospital overall, I would not recommend Bangkok International Hospital  for heart problems. I am a medical doctor and speak from the experience of working together with their cardiologists.
I do recommend Bumrungrad, e.g. Dr Sureerat.

[egeefay]

Quote

Although they are a good hospital overall, I would not recommend Bangkok International Hospital  for heart problems. I am a medical doctor and speak from the experience of working together with their cardiologists.
I do recommend Bumrungrad, e.g. Dr Sureerat.

Can you be more specific.  I am interested in why you would not recommend them.   They seem to have an extensive list of doctors, many of them trained in the US and Austrialia
You can email me direct rather than post your reply here.
Thanks

[egeefay]

This evening we called Bangkok Heart Hospital and Bumrumgrad International Hospital and inquired about the cost of replacing my wife's pacemaker.
Both hospitals were not shy about outlining the various costs involved and giving us an estimate. Both hospitals had about the same figures give or take
In Thailand The cost of putting in a new pacemaker and replacing one lead was quoted at between 200,000-250,000 baht.  (about $5000-$6500).  

Compare that to the $28,000-$58,000 the hospital in California quoted me and there definitely is a BIG difference in costs. (and that's BEFORE the doctor fees are added on)

I agree with several posters that hospital sticker prices are often inflated for  people without insurance because insurance companies have enough clout to tell the hositals what to do with their outrageous charges.   This double standard has led to lawsuits filedby the uninsured who claim that they paying far more that those with insurance for the same procedures .

Still self employed Americans are trapped between high medical charges or high insurance premiums.

I'll let you know what we decide to do after I've called my insurance carrier, Blue Shield tomorrow.

Edited by egeefay, 2006-08-05 12:41:24.

[cathyy]

egeefay, on 2006-08-03 22:37:59, said:

Are medical cost in the US getting out of hand?

"I don't have an exact price," she stated "It would depend on if they ran into any complications.  But to put in a new pacemaker, a new lead , and a night in the hospital will run between $28,000 to $58,000."

Dude. That's cheap. My father-in-law had a pacemaker-defibrillator inserted a year ago. The pacemaker-defibrillator alone was $135,000. The hospital bill was over a quarter of a million dollars. This was not in California. There were no complications. He was only in the hospital 3 or 4 days.

Get it done in Thailand.

[PeaceBlondie]

I'm covered by the U.S. federal govt.'s employee health plan, and I understand that most HMO's extract an automatic discount, perhaps 40%, from the doctor's price.  So, an office appointment that nominally charges $100 will pay maybe $60.

I'm sure, from a cost accounting point of view, that the official price has to be inflated for discounts and non-payments, as well as malpractice insurance.

I just sent in an insurance claiml to have my upper arm re=opened and cleaned out by two surgeons.  It took them two hours, and I was in a good hospital private room for 4 nights.  Total cost, 49,500 baht.  I have no idea what the bill is in Texas, but I suspect it's closer to 49,500 dollars.