consultation fees

[laid up doc]

Harrison -

obviously i don't speak for everyone, but the roots of the reasons I had to go overseas are patent laws, my insurance company, and the FDA... had nothing to do w/ the surgeons in the US. I couldn't have a Prodisc, period... and my insurance wouldn't cover fusion for discogenic pain/DDD. i posted in this forum about what it would have cost me out of pocket to pay for fusion here... about 4x the total cost of my surgery and all other associated expenses in Spain.

you want to talk about $$$ getting better healthcare - the most striking example is here in the US. i could write a novel, but it's absolutely true. I paid about $28,000 (plus travel expenses) for all surgical costs - a bargain for a procedure that it looks like will allow me to return to my 6 figure job.

Do i feel badly that this option isn't available to everyone? of course i do... but the same can be said for all sorts of medical issues in the US. and for the record, i have had better dealings w/ Dr Clavel than with any surgeon in the US... especially when you factor in that he is a very skilled neurosurgeon. it's my job to call surgeons and whatnot about all kinds of things, and he's right at the top.

but to blame is all on the $$ is leaving out huge parts of the decision-making process. (stenum and any other dr/clinic who uses "brokers" and the like heavily, excepted, of course).

[Shay]

Boils down to inadequate health care coverage here in the US.
You all make good points.
I have learned that there are many qualified surgeons in the US that are held back by the FDA and insurance coverage issues from gaining experience in ADR, hybrids and multiples.
I would have surgery with Dr. Chapman in a second if my health care covered either fusion or ADR for my condition.
Due to Milliman guidelines criteria changes my condition is left out in the cold, and my only option is to wait for things to get worse or pay for the surgery myself.
Dr. Chapman would prefer I not go out of the country, but also knows I could not afford to stay here for the surgery.
It is about the money, but the bigger issue is how health insurance companies who employ for-profit consulting firms to lend validity to medical policies that are NOT "standard medical treatment," or labeled "experimental."
To me this is the real battle. If ADR was considered non experimental, within a few years we would see a shift in treatment protocol and more options for spine patients here in the US.
We should continue to bring awareness to underlying issues that prompt these severe decisions, not fight each other.
Just my 2 cents.

[annapurna]

I'll add to your points by pointing out that a great deal of the better treatment that those of us who've been treated outside of the insurance system stems from the simple fact that we, not the insurance company, are paying the doctors in that situation. If you work within the insurance system, the doctor's ultimate customer is the insurance system, who pays most of his/her fee, not the patient who pays barely enough to justify opening the building and turning the lights on. If you go to a self-pay situation, that changes and the doctor is now morally, professionally, AND financially motivated to work with the patient. The same argument applies to much of the experimental/non-experimental decisions for treatments and availability of those same treatments.