Author Topic: Cellar Scribblings  (Read 8738667 times)

Online serious crayons

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Re: Cellar Scribblings
« Reply #14260 on: February 12, 2016, 10:30:39 am »
Don't medical staff in the US take holidays?  Here medical centres (except for emergencies) are closed on public holidays.

Here they're closed for the big ones -- Easter, Fourth of July, Thanksgiving -- but President's Day isn't a big one. All that closes on the minor holidays are government services and, sometimes, banks.

Quote
I had my yearly skin cancer checkup on Tuesday. He took one biopsy just in front of my ear and I complained (not to him) about the cost $415.
He rang me yesterday, It is a basal skin cancer. Quite common for me. Last year, one on my arm cost just over $800 to remove. Because of the location on my face, this one will need a full day in surgery as he takes the minimum area then does the lab tests on site before closing the wound.
Estimated cost $3000.  I am not a happy chappy.

That's interesting. I had two surgeries in 2015 for minor skin cancer -- one basal and one squamous. The first skin cancer surgery was $2,400 and I assume the second was a similar price. I had to pay for them, but I used up my $6,500 deductible between the two surgeries and other random medical expenses, so I capitalized on the situation and got cataract surgery, knowing I'd need it eventually, basically for free.

Both surgeries were on my head, so I feared winding up with a bald spot. But the surgeon used something called the Mohs technique, the standard for skin-cancer surgeries here. They cut out the cancer and then pull a V-shaped flap of other skin over to cover the wound (sorry if this is too graphic). The result is that you can barely see any scar from the surgery -- certainly none that a casual observer would notice.

Anyway, when I had to pay for the surgery out of pocket I went on Facebook to complain and ask friends in other countries (mostly Brokies!) what they would have to pay for something similar. They all said the surgery would be free, or close to it.

As my doctor performed the surgery we got to drinking and talking about politics (you're totally awake throughout) and he turned out to be pretty left-leaning. I mentioned the thing about how I'd have to pay for this surgery out of pocket, but my Facebook friends from Europe and Australia all said they wouldn't have to.

That's true, the doctor said, but they wouldn't have gotten the Mohs technique.  :o :o :o I don't know if that's true or not. In this case, though, while I don't have a lot of extra cash lying around, I'd rather scrape together $2,400 and not wind up with a bald spot.

So brian, I'm interested to hear about your situation: a) That you do have to pay for things and b) Do they do the Mohs technique there? From your description (take a minimum area, lab tests on site) it sounds like it.



Offline brianr

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Re: Cellar Scribblings
« Reply #14261 on: February 12, 2016, 01:50:57 pm »
Yes, it is the Mohs technique that I am having and my doctor is one of the few in the country (according to his advert) that does it. I could have it done at the public hospital for free but would not know how long I would wait and not the mohs technique. My doctor told me I could have the cheaper method but if he does not get it all I would have to go back (that happened on my back a few years ago). Being on my face he does not want to take more skin than necessary. About 10 years ago, I had one removed from my forehead and have a v shaped scar as the doctor (then in Australia) told me that otherwise I would have a permanently raised eyebrow. I can pretend I am Harry Potter  ;D

In Australia I had hospital insurance which I took out when I started teaching in 1966 so was covered for everything. Also medicare covered skin surgery (I paid a little bit as it pays the basic price and I wanted a good specialist)  In Australia, medical insurance is not allowed to put up prices for age. When i moved to NZ and applied for insurance, due to my history of skin cancers and arthritis they would not cover me for those so not hip/knee replacement. It is also high due to my age. Very few of my friends who are all retired have health insurance here in NZ. My sister has had several melanomas removed and I had one incipient melanoma about 20 years ago. We apparently have bad skin for living in the sub-tropics although we have brown eyes and (had) very dark hair. So I like to have a good specialist.
Unfortunately when I was young it was not cool to wear skin cream.

I also have cataracts growing, My right eye is completely covered and everything is fuzzy for reading  but does not affect my driving. My left eye is still good. The optometrist has told me to wait until the left eye gets a bit worse and then I might get one cataract removed for free. The government never pays for 2. I am going back after I return from Europe in June. They could each cost $5000 otherwise. (Note NZ$5000 is only US$3300)

That was why I cancelled any plans (only in my head) to go to the UK in August/September and withdrew some of my term deposits a few weeks ago before they rolled over. Also because, while my superannuation funds (in Australia) went up 9% in 2014/15 they have gone down 2% since. It was because they went up so much that I began to plan to go to Europe twice this year. Australia rules are that, at my age, I must take out 5% per year to avoid any tax. The NZ government has ruled that if they are not taxed in Australia they will not be taxed here. The joys of working all one's life in one country and retiring to another.
My sister has suggested going back to Oz and staying a few months with her and having my cataracts done for almost free but I do not think I could stand that. 8 nights at Christmas were more than enough.

Offline Penthesilea

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Re: Cellar Scribblings
« Reply #14262 on: February 12, 2016, 02:45:33 pm »
That's true, the doctor said, but they wouldn't have gotten the Mohs technique.  :o :o :o I don't know if that's true or not. In this case, though, while I don't have a lot of extra cash lying around, I'd rather scrape together $2,400 and not wind up with a bald spot.


Well, I don't have any idea about skin cancer and operation methods, but a quick search for "Mohs Technik" on the German Google site brought up lots of (German) sites about skin cancer. Turns out the Mohs technique is called MKC in Germany: Mikroskopisch kontrollierte Chirurgie = microscopically controlled surgery.

I also found an article basically saying "Mohs technique has been the standard for [specific kinds of] skin cancer for some years but now there's a new technique coming up yada, yada, yada [...]" (translation by me).

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Re: Cellar Scribblings
« Reply #14263 on: February 12, 2016, 10:00:28 pm »
Thanks for the thorough explanation, brian.  :)

When i moved to NZ and applied for insurance, due to my history of skin cancers and arthritis they would not cover me for those so not hip/knee replacement. It is also high due to my age. Very few of my friends who are all retired have health insurance here in NZ.

Wait, so

a) You can't get insurance if you have a preexisting condition? That used to be standard here, but Obamacare outlawed it, which in itself is huge.

b) People of retirement age have no health insurance? So if they get something catastrophic and hugely expensive -- cancer, heart disease, etc. -- they're out of luck? Or can they still get inexpensive treatment somehow, or what?



Online serious crayons

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Re: Cellar Scribblings
« Reply #14264 on: February 12, 2016, 10:03:19 pm »

Well, I don't have any idea about skin cancer and operation methods, but a quick search for "Mohs Technik" on the German Google site brought up lots of (German) sites about skin cancer. Turns out the Mohs technique is called MKC in Germany: Mikroskopisch kontrollierte Chirurgie = microscopically controlled surgery.

I also found an article basically saying "Mohs technique has been the standard for [specific kinds of] skin cancer for some years but now there's a new technique coming up yada, yada, yada [...]" (translation by me).

Thanks, Chrissi. So do you interpret that to mean that if someone in Germany needed skin cancer removed they would most likely get Mohs and it would be free or close to it?

I liked my surgeon and mostly agreed with his politics. But I've mentioned Obamacare to a couple of doctors now, and both reacted negatively. That could be partly because Obamacare puts a lot more pressure on the healthcare industry to keep costs down while providing good patient outcomes.




Offline brianr

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Re: Cellar Scribblings
« Reply #14265 on: February 12, 2016, 10:28:27 pm »
Thanks for the thorough explanation, brian.  :)

Wait, so

a) You can't get insurance if you have a preexisting condition? That used to be standard here, but Obamacare outlawed it, which in itself is huge.

b) People of retirement age have no health insurance? So if they get something catastrophic and hugely expensive -- cancer, heart disease, etc. -- they're out of luck? Or can they still get inexpensive treatment somehow, or what?



You do not need insurance for something catastrophic or rather life threatening.
It has always amused me about the time I went to hospital with chest pains. My GP did not  find anything wrong but suggested I go to the hospital. When I arrived and told them I had chest pains they rushed me into a wheel chair and to Emergency although I had run across the road for the taxi.
After attaching me to monitors they then filled in forms and asked if I had medical insurance. This was back in Australia so I said yes. Later that night they transferred me out of emergency as it was Friday night and soon to become busy with drunks.  The monitor had shown all clear. In fact the specialist later told me I had very little chance of a heart attack. My mother's heart kept her going to 96 despite the rest of her body falling apart. My father died of a heart attack at 66  but was a heavy smoker. I have never smoked.
Anyway the next morning I received a newspaper, those around me without insurance did not. Then, on discharge, I was given a taxi voucher back to the train station because I had insurance.

So in both Australia and NZ I will receive excellent treatment in case of anything life threatening. However I will have to wait for an eye cataract removal (and only one) and will probably wait a year or 2 if I need a hip or knee replacement. In Australia I would have gone private but arriving in NZ at age 66 and admitting I had arthritis, i could not get cover. Fortunately I have money (declining due to world economy but hopefully that will change)
I also have an inguinal hernia. I could have had cover for that. I have twice been to the hospital but as I am not in agony, It just hurts now and then they will not put me on the waiting list. I can go to the private hospital and pay $9,000. If it strangulates, I would be rushed into the public hospital and operated on for free.

Last  year while in Vienna, I got a jolt and thought OMG not now. This year I told my travel insurance and have had to pay $300 extra for my travel to Europe in April/May.

Chuck , you must love having your blog filled with my medical details  ;D

Online serious crayons

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Re: Cellar Scribblings
« Reply #14266 on: February 13, 2016, 01:41:22 pm »
I will have to wait for an eye cataract removal (and only one)

Well, there's one small advantage to Obamacare. When I realized my skin cancer surgeries etc. would use up my whole $6,500 deductible, I scheduled an eye checkup, which I was way overdue for anyway. And I remembered that when I'd last seen the eye doctor three years earlier, he said, "Good news! You have cataracts!" When I asked why that was good news, he explained that the surgery was a lot like getting Lasik only it was covered by insurance. But if I'd had the surgery in an otherwise healthy year it would have cost close to or all of the $6,500. Last year, it would be free.

So I told everyone at the ophthalmologist's office why I wanted to get the surgery in 2015. They all understood, but the ophthalmologist said that unfortunately only one eye had gotten bad enough for the insurance to cover. Then I was led in to see the surgeon, who said he could do both of them anyway, because doing one at a time can sometimes be problematic, and assured me that the insurance company would go along with his recommendation. And they did.

I would go into more details about the pros and cons of cataract surgery, but I don't want to turn Chuck's whole blog into the brian and Katherine medical blog.  :laugh:



Offline Jeff Wrangler

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Re: Cellar Scribblings
« Reply #14267 on: February 13, 2016, 02:01:48 pm »
And I remembered that when I'd last seen the eye doctor three years earlier, he said, "Good news! You have cataracts!" When I asked why that was good news, he explained that the surgery was a lot like getting Lasik only it was covered by insurance.

If they tell you that you won't need eyeglasses after the surgery, be skeptical. You may not need them--or you might, though maybe just for reading. My experience from going through my dad's experience last spring is that eye doctors tend to make promises about cataract surgery that they have no business making. Also be prepared for a recovery period that may, or may not, be a real nuisance, with all kinds of eye drops to be put in at different times. That might depend on your eyes, or your surgeon, but for my dad, it was a nightmare.

I'm not trying to scare you off the surgery. Just be prepared for all sorts of possibilities.

After what I saw my dad go through, I wouldn't have the surgery myself unless the cataracts were really creating a problem for my vision. I won't do it just on the hope of not needing eyeglasses any more. But, hey, I've been wearing eyeglasses since 3rd Grade, so what's the rest of my life?
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Offline brianr

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Re: Cellar Scribblings
« Reply #14268 on: February 13, 2016, 07:20:21 pm »
My mother, sister and brother-in-law have all had cataracts done,. Mum was a long time ago and she was kept in overnight both times. However I know all about the eye drops which is what worries me most, living alone. My sister now just buys $2 glasses which she leaves all over the house for reading.  Although she is 10 years older than me, I now am the one wearing glasses. I began with reading glasses in my late 40's then full glasses in my late 50's
Now that one cataract covers my whole right eye, I cannot read with that eye, everything is blurred and glasses cannot fix it,  so when both are fully developed I would be helpless.  Apparently the type I have does not affect my driving. I am thinking of buying a patch to watch TV as I can see it better if I cover my bad eye. I will need to go to a shop where they sell pirates costumes  ;D

Online CellarDweller

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Re: Cellar Scribblings
« Reply #14269 on: February 13, 2016, 09:04:05 pm »
Chuck , you must love having your blog filled with my medical details  ;D

I would go into more details about the pros and cons of cataract surgery, but I don't want to turn Chuck's whole blog into the brian and Katherine medical blog.  :laugh:


There are days I feel like I'm talking to myself  here, so anytime anyone wants to come here and discuss anything, I'm fine with that.  :)


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