No, we don't have the best healthcare system

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radnyc
Posts: 299
Joined: Tue Apr 06, 2010 6:32 pm

No, we don't have the best healthcare system

Postby radnyc » Fri Jun 01, 2018 5:00 pm

Same results, half the cost.

http://www.fredhutch.org/en/news/center ... comes.html

"Among patients newly diagnosed with metastatic colorectal cancer, the study found average per-patient costs across all chemotherapy treatments were $12,345 per month in Western Washington state and $6,195 per month in neighboring British Columbia. The poster notes that “overall survival was no different between the two locations.”

There's something really wrong here...
DX Jan '10, at 47
Feb - colon resection - 2/17 nodes
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April '11
HAI Pump removed Dec '15

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Fri Jun 01, 2018 5:19 pm

radnyc wrote:Same results, half the cost.

http://www.fredhutch.org/en/news/center ... comes.html

"Among patients newly diagnosed with metastatic colorectal cancer, the study found average per-patient costs across all chemotherapy treatments were $12,345 per month in Western Washington state and $6,195 per month in neighboring British Columbia. The poster notes that “overall survival was no different between the two locations.”

There's something really wrong here...


Those are retail rates. Negotiated insured rates are far lower.

I had one infusion that was billed at $11,000. The insured cost was $1,000.

I've negotiated on healthcare bills for my mother (when she didn't have sufficient Medicare coverage) - hospitals will often take much smaller payments if you do actually pay them. Because there are lots that don't pay. So they raise retail prices to compensate for those that don't pay.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

SteveNZ
Posts: 140
Joined: Tue Apr 24, 2018 4:21 pm
Location: New Zealnd

Re: No, we don't have the best healthcare system

Postby SteveNZ » Sat Jun 02, 2018 12:04 am

NHMike wrote:
radnyc wrote:Same results, half the cost. ........There's something really wrong here...


Those are retail rates. Negotiated insured rates are far lower.
I had one infusion that was billed at $11,000. The insured cost was $1,000.

I've negotiated on healthcare bills for my mother (when she didn't have sufficient Medicare coverage) - hospitals will often take much smaller payments if you do actually pay them. Because there are lots that don't pay. So they raise retail prices to compensate for those that don't pay.

I find this interesting living in another country.
It really does sound like a good insurer does all of this background work to supply good health at a good deal.

Interestingly here in New Zealand (population 4.7 million) our 'compulsory health insurance via taxes' has a similar effect. One of the health departments jobs is to negotiate good bulk deals on all medical based supplies. Which I have concluded works well. This goes right down to basics such as transport (health board negotiated taxi deals) which are required at times. Yes there are issues (such as longer waiting lists for non urgent issues when the economy is down :( ) but my cancer was found and is being sorted out fast. :D
Aged 56 - I feel really young...
Colo-Rectal Cancer T2 N1 M0
March 2018 - Diagnosis
April-May 2018 Radiation+Chemo then a TIA (Minor Stroke). - Stopped Chemo.
June 2018 - Sitting it out before operation. ....Pretty Miserable- emotions gone weird....?!
*Decided to live to 100 as I will get a telegram from Her Majesty the Queen when 100yrs old. I so, so want one.
Am a Salvation Army chap so I complete 'knee drill' (prayer) to the Commander in Chief often. For myself personally this helps me through.

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LPL
Posts: 410
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: No, we don't have the best healthcare system

Postby LPL » Sat Jun 02, 2018 6:33 am

NHMike wrote:
I've negotiated on healthcare bills for my mother (when she didn't have sufficient Medicare coverage)

One thing that I have thought about after reading posts is that when you get a bad diagnosis there are so many things to learn & deal with & worry about :( Adding negotiating bills to that sounds extra hard!
We live in France and when DH got his diagnosis his GP gave him a paper stating that husband’s (own direct) medical cost was ’reduced’ by 100%. (We normally pay around €25 for a GPdoctor visit). The now ’no cost’ also includes taxi/transport if he want (we have 150km one way to the cancer clinic where he has gone for treatments and for scans & Dr appointments). Blood tests ordered can he take close to home, they are also without direct costs. I have often also asked for tests to be added and he also get those without being charged.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Sat Jun 02, 2018 7:21 am

In the US, there are four levels of coverage for Medicare and my mother dropped three of them as she didn't want to pay the premiums. The premiums are fairly low. So she wound up with large costs at retail rates because she didn't have coverage. So I was asked to pick up the costs. This was some time after the services had been rendered.

There is great variance in coverage between Medicare, Medicaid, the Exchanges and Private insurance. I have received vouchers for taxi rides from the hospital in the past but I usually just took care of transportation myself. I'm most familiar with private insurance. With private insurance, you typically fill out a survey at the end of the year to rate the insurance. If there were a lot of demand from employees for a particular service, then it wold likely get added to coverage or there would be an additional coverage benefit. One of our cafeteria plans offers health coverage for pets now. We have a plan for student college costs, legal insurance, dental coverage, vision coverage, etc. If there were employee demand for medical transportation services, then it would be added to health insurance or it would be added as a separate benefit. That's how things work at my company.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

KimT
Posts: 598
Joined: Sat Feb 20, 2010 8:53 pm

Re: No, we don't have the best healthcare system

Postby KimT » Sat Jun 02, 2018 9:24 am

My cousins wife is a pathologist at a university hospital near me. She explained why healthcare billing is the way it is. It’s all about what the insurance will pay. A hospital will make their rates, and insurance companies come back and might declare, we will pay 30%. A year later they might decide they will only pay 25%. So hospitals raise rates to get the same payment as before. This is why bills look so high and actual payments paid by insurance is so low. I have noticed in the past few years how hospitals are getting sneaky about trying to squeeze more money out of patients. They will call before your operation or procedure and say this is what you owe according to your insurance plan. We will give you a 10% discount if you pay now. It sounds good but they are billing you according to what they charge and not the rate your insurer pays. If you are responsible for say 20%, you owe 20% of what your insurance agrees to pay, not 20% of what they charge.
2/10 dx colon cancer
right hemicolectomy 3/19/10
Stage 2a 0/43 nodes
Lynch syndrome
3/14/10 colon resection/ removal of metal clips
Nov 11 dx ovarian cancer

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Sat Jun 02, 2018 10:10 am

KimT wrote:My cousins wife is a pathologist at a university hospital near me. She explained why healthcare billing is the way it is. It’s all about what the insurance will pay. A hospital will make their rates, and insurance companies come back and might declare, we will pay 30%. A year later they might decide they will only pay 25%. So hospitals raise rates to get the same payment as before. This is why bills look so high and actual payments paid by insurance is so low. I have noticed in the past few years how hospitals are getting sneaky about trying to squeeze more money out of patients. They will call before your operation or procedure and say this is what you owe according to your insurance plan. We will give you a 10% discount if you pay now. It sounds good but they are billing you according to what they charge and not the rate your insurer pays. If you are responsible for say 20%, you owe 20% of what your insurance agrees to pay, not 20% of what they charge.


I have seen various ways that vendors try to get around insured rules to get your business - and the insurance companies usually go after those eventually. One recent example was pharmacy loyalty cards where the patient can essentially get a kickback for using a particular pharmacy.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

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LeonW
Posts: 347
Joined: Sun May 03, 2015 4:59 pm
Location: Amsterdam, Netherlands

Re: No, we don't have the best healthcare system

Postby LeonW » Sun Jun 03, 2018 9:37 am

Expensive?
NYTimes - Jan 2018 wrote: A large part of the answer can be found in the title of a 2003 paper in Health Affairs by the Princeton University health economist Uwe Reinhardt: “It’s the prices, stupid.” . . . people in the U.S. typically use about the same amount of health care as people in other wealthy countries do, but pay a lot more for it.

. . . .spends almost twice as much on health care, as a percentage of its economy, as other advanced industrialized countries — totaling $3.3 trillion, or 17.9 percent of gross domestic product in 2016. But a few decades ago American health care spending was much closer to that of peer nations.

https://www.nytimes.com/2018/01/02/upshot/us-health-care-expensive-country-comparison.html

Effective?
NYTimes - May 2018 wrote:Medical Mystery: Something Happened to U.S. Health Spending After 1980
The spending began soaring beyond that of other advanced nations, but without the same benefits in life expectancy.

https://www.nytimes.com/2018/05/14/upshot/medical-mystery-health-spending-1980.html
Dec 2012 CC (7 cm mass), 2 unresect liver mets, CEA 41.8 (MM @65yrs)
Jan 2013 colectomy @ spleen, 2/26 nodes IVa T3N1bM1a MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, shrinkage from #3
Sept - 2x failed PV embolization
Oct 2013 - R liver resect 28 hosp days (delirium, liver failure, emboli, encephalopathy) pCR - no cancer cells
2014/15 - recovery; scopy finds polyp
2016 - new town, new life
June 2018 - 5 yr mark, 2 polyps
clean CTs and (1.3-1.4) CEAs: 4x2014, 6x2015-17, 1x2018; next June 2019

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Sun Jun 03, 2018 12:01 pm

LeonW wrote:Expensive?
NYTimes - Jan 2018 wrote: A large part of the answer can be found in the title of a 2003 paper in Health Affairs by the Princeton University health economist Uwe Reinhardt: “It’s the prices, stupid.” . . . people in the U.S. typically use about the same amount of health care as people in other wealthy countries do, but pay a lot more for it.

. . . .spends almost twice as much on health care, as a percentage of its economy, as other advanced industrialized countries — totaling $3.3 trillion, or 17.9 percent of gross domestic product in 2016. But a few decades ago American health care spending was much closer to that of peer nations.

https://www.nytimes.com/2018/01/02/upshot/us-health-care-expensive-country-comparison.html

Effective?
NYTimes - May 2018 wrote:Medical Mystery: Something Happened to U.S. Health Spending After 1980
The spending began soaring beyond that of other advanced nations, but without the same benefits in life expectancy.

https://www.nytimes.com/2018/05/14/upshot/medical-mystery-health-spending-1980.html


One thing that I noticed when I was checking in for surgery at Brigham and Women's Hospital - there were a lot of people that traveled from other countries to get surgery here. Brigham and Women's has an international admissions office. I would assume that Mass General does as well as I've read article in the NY Times and WSJ about international medical tourism to the United States and Boston in particular. Folks from other countries have to pay the full retail rate and they very well may not be reimbursed for care here from their home insurance systems.

Can you get an HAI pump outside the US? Could you get Tumor Infiltrating Lymphocytes treatment outside of the US a year ago? Does your local hospital have a cell manufacturing center (Dana Farber just built one)? Could you get Next Gen Genomic sequencing back in 2012 from your hospital? Does your insurance cover it? I think that the US system, for cancer, is quite good, if you know how to use it, and if your insurance is good enough to access the best care in the US.

Mas General Hospital and Brigham and Women's charges rates about 60% higher than other Boston hospitals and they are already expensive. Yet the demand for services at those two hospitals is quite good. Are they making a lot of money? No, they aren't (I read their financial reports). So they can charge a lot, have a lot of customers, provide world-class services, and still not make a lot of money at it.

https://www.nytimes.com/2017/05/29/busi ... pital.html
https://www.wsj.com/articles/desperate- ... 1409959941

If we look at world rankings, we find that 17 out of the top 20 hospitals are in the United States with the United States also holding the top 7 spots.

http://hospitals.webometrics.info/en/World

There are a lot of areas in the United States where care is difficult to find. And great care even harder to find. And these areas drag down national statistics. But there are also areas with great care available. The other side of the healthcare coin is the level in which people take care of themselves and we do not do well there. We were in Costco this morning and that was a sad reminder of this.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

SteveNZ
Posts: 140
Joined: Tue Apr 24, 2018 4:21 pm
Location: New Zealnd

Re: No, we don't have the best healthcare system

Postby SteveNZ » Sun Jun 03, 2018 6:09 pm

One thing that works well here in New Zealand is also a strong input into preventative medicine. Being the role of the national health department.
For example for a while there was concern at the rate of deaths from prostate cancer. So a nationwide system to inform folk and get medical checks was set in place. Including pretty good advertising (in the middle of TV news or ball games), a few celebrities came on board to help and there was offered subsidised initial checks (meaning zero cost, in most GP's).

A while ago we had a similar thing for Rubella and also warnings about coughs in children.
I am not sure how common this type of thing is in other countries. We are of a size (think of a single small state) that this is logistically easy to do.

Do insurance company's push preventative medicine for customers? It saves money in the long term.
Aged 56 - I feel really young...
Colo-Rectal Cancer T2 N1 M0
March 2018 - Diagnosis
April-May 2018 Radiation+Chemo then a TIA (Minor Stroke). - Stopped Chemo.
June 2018 - Sitting it out before operation. ....Pretty Miserable- emotions gone weird....?!
*Decided to live to 100 as I will get a telegram from Her Majesty the Queen when 100yrs old. I so, so want one.
Am a Salvation Army chap so I complete 'knee drill' (prayer) to the Commander in Chief often. For myself personally this helps me through.

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Sun Jun 03, 2018 7:34 pm

SteveNZ wrote:One thing that works well here in New Zealand is also a strong input into preventative medicine. Being the role of the national health department.
For example for a while there was concern at the rate of deaths from prostate cancer. So a nationwide system to inform folk and get medical checks was set in place. Including pretty good advertising (in the middle of TV news or ball games), a few celebrities came on board to help and there was offered subsidised initial checks (meaning zero cost, in most GP's).

A while ago we had a similar thing for Rubella and also warnings about coughs in children.
I am not sure how common this type of thing is in other countries. We are of a size (think of a single small state) that this is logistically easy to do.

Do insurance company's push preventative medicine for customers? It saves money in the long term.


It varies all over the place. Insurance companies can use a combination of carrots and sticks to influence employee behavior. I recall stories of some companies requiring employees to quit smoking. The company would offer a smoking cessation program. We have some employers that require employees to get flu vaccine. My company has two gyms and an open area with table tennis and foosball and this in a building for about 400 people. Our headquarters has a fitness facility the size of our building - and it includes daycare and a large swimming pool. We have one or two health seminars a month (and lunch is served). Most of the folks that already workout never go to the seminars because they are busy working out at that time.

We have a contest that starts tomorrow: the goal is to walk or run 12,000 steps per day during the week - that works out to 4+ to 6 miles a day depending on your stride. The contest runs for 12 weeks. We also have free classes doing a variety of exercise approaches. The company puts out newsletters on ways to improve fitness, nutrition and health. It has had giveaways of wrist-based tracking devices to encourage walking. The company provides sit-stand desks to anyone requesting it and newer offices have this built-in to the desks. So my company provides a lot of carrots for people to improve health, fitness and nutrition. But the person has to want to change - and that's a really hard thing. I've seen divorces occur when one spouse gets fit and the other watches and tries to sabotage the progress of the other.

I understand the power of government marketing on health issues. We used to do Public Service Announcements on television and other media outlets. These stopped sometime in the mid to late 1990s - I would guess because of commercial influences. Singapore has emphasized health for kids and adults. They use more coercive approaches with kids and encouragement for adults - and you get a kind of peer pressure to make health choices. Some of my in-laws and wife's friends spend quite a lot of money there for health-related products.

http://www.mobihealthnews.com/content/u ... ss-program
https://www.benefitscanada.com/news/emp ... vey-115052
https://www.reuters.com/article/us-heal ... SKCN1GS1Y5
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

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LeonW
Posts: 347
Joined: Sun May 03, 2015 4:59 pm
Location: Amsterdam, Netherlands

Re: No, we don't have the best healthcare system

Postby LeonW » Mon Jun 04, 2018 6:38 pm

NHMike wrote:There are a lot of areas in the United States where care is difficult to find. And great care even harder to find. And these areas drag down national statistics. But there are also areas with great care available. The other side of the healthcare coin is the level in which people take care of themselves and we do not do well there.

NYTimes came up with a follow-up publication tonight, that also contributes part of the rising costs to (lack of) programs to promote health. But they also mention that deregulation lead to 'for-profit health care companies".
NYTimes, tonight wrote: experts suggested two main reasons: The United States didn’t impose the same types of government cost controls on health care that other nations did, and we invested less in social programs that also promote health.
and . . .
Investor-owned, shareholder-driven, for-profit companies became common in health care for the first time. They focused on revenue and profit maximization, not cost control.

https://www.nytimes.com/2018/06/04/upshot/reagan-deregulation-and-americas-exceptional-rise-in-health-care-costs.html?em_pos=small&emc=edit_up_20180604&nl=upshot&nl_art=1&nlid=83773013emc%3Dedit_up_20180604&ref=headline&te=1
Dec 2012 CC (7 cm mass), 2 unresect liver mets, CEA 41.8 (MM @65yrs)
Jan 2013 colectomy @ spleen, 2/26 nodes IVa T3N1bM1a MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, shrinkage from #3
Sept - 2x failed PV embolization
Oct 2013 - R liver resect 28 hosp days (delirium, liver failure, emboli, encephalopathy) pCR - no cancer cells
2014/15 - recovery; scopy finds polyp
2016 - new town, new life
June 2018 - 5 yr mark, 2 polyps
clean CTs and (1.3-1.4) CEAs: 4x2014, 6x2015-17, 1x2018; next June 2019

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Mon Jun 04, 2018 7:14 pm

LeonW wrote:
NHMike wrote:There are a lot of areas in the United States where care is difficult to find. And great care even harder to find. And these areas drag down national statistics. But there are also areas with great care available. The other side of the healthcare coin is the level in which people take care of themselves and we do not do well there.

NYTimes came up with a follow-up publication tonight, that also contributes part of the rising costs to (lack of) programs to promote health. But they also mention that deregulation lead to 'for-profit health care companies".
NYTimes, tonight wrote: experts suggested two main reasons: The United States didn’t impose the same types of government cost controls on health care that other nations did, and we invested less in social programs that also promote health.
and . . .
Investor-owned, shareholder-driven, for-profit companies became common in health care for the first time. They focused on revenue and profit maximization, not cost control.

https://www.nytimes.com/2018/06/04/upshot/reagan-deregulation-and-americas-exceptional-rise-in-health-care-costs.html?em_pos=small&emc=edit_up_20180604&nl=upshot&nl_art=1&nlid=83773013emc%3Dedit_up_20180604&ref=headline&te=1


I'm not really aware of for-profit hospitals in my region and I do know that hospitals aren't doing all that well financially. The only area that I see doing well is the insurance companies though I actually like the insurance company that we use in that they've been more than helpful in finding services when we couldn't. Do they take too big a piece of the pie? I don't know. I do like how they've treated me over the decades though.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

Utwo
Posts: 211
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: No, we don't have the best healthcare system

Postby Utwo » Mon Jun 04, 2018 7:29 pm

NHMike wrote:If we look at world rankings, we find that 17 out of the top 20 hospitals are in the United States with the United States also holding the top 7 spots.

http://hospitals.webometrics.info/en/World

This is similar to what my doctor told me: "Best hospitals in the US are better than best hospitals in Canada".

So US patients who can get access to MD Anderson, Cleveland, Massachusetts General, Memorial Sloan Kettering etc. are getting the best treatment that can't be received anywhere else in the world (Canada, NS, Australia, Europe etc.).
58 yo male at diagnosis - T1bN0M0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: No, we don't have the best healthcare system

Postby NHMike » Mon Jun 04, 2018 7:34 pm

Utwo wrote:
NHMike wrote:If we look at world rankings, we find that 17 out of the top 20 hospitals are in the United States with the United States also holding the top 7 spots.

http://hospitals.webometrics.info/en/World

This is similar to what my doctor told me: "Best hospitals in the US are better than best hospitals in Canada".

So US patients who can get access to MD Anderson, Cleveland, Massachusetts General, Memorial Sloan Kettering etc. are getting the best treatment that can't be received anywhere else in the world (Canada, NS, Australia, Europe etc.).


And then you have the NCI which can develop treatments that even the top cancer hospitals in the US don't have. Yet. The NCI treatments will eventually go out to the US major cancer centers and then to the rest of the world. Dana Farber has ramped up their cell manufacturing center. I think that MSK may have something here too.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal


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