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The Cost of an ACL Injury

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Re: The Cost of an ACL Injury

#31

Post by apendleton »

twoodfin wrote: post #21
apendleton wrote: post #12

Earlier quoted context omitted.

We hear about medical tourism from the US to India, Thailand, etc., but with these kinds of price discrepancies between the US and UK private practices, I wonder why there aren't more Americans who go to the UK for surgery?

The fraction of patients without insurance but with enough cash and motivation to fly to the UK purely to seek savings on medical treatment has got to be fairly tiny. My impression is that medical tourism from the U.S. is not typically for cost savings, but rather because particular procedures are either completely unavailable (experimental stem cell treatments) or could require long wait times (liver transplants). I…

Were we looking at the same Wikipedia article? Its first sentence is "Medical tourism (MT) is patient movement from highly developed nations to other areas of the world for medical care, usually to find treatment at a lower cost." Later: "[I]n the US, the main reason is cheaper prices abroad." And while I agree that it's not especially well-written, it does provide some hints as to why even insured people might like to go: elective cosmetic surgery, elective orthopedic procedures that may not be necessary but may improve quality of life (knee replacements, etc.), or reproductive procedures like IVF, all of which may not be covered by insurance.

Re: The Cost of an ACL Injury

#33

Post by stonemetal »

tomwalker wrote: post #23

Wow, so much of that is overpriced. The medication costs, especially the fluids, are much higher. I checked a UK pharmacy for costs for buying small amounts so the discount they get for buying in bulk suggests a very large mark up in price.

Did you include the cost of having a trained medical professional administer them? The cost of hospital aspirin isn't the pill it is the doc deciding to give them to you and the nurse who dispenses the pills( don't forget the billing person who charged you for the pills, the staff lawyer who was retained just in case you sue over the aspirin, and the payout to the last guy who sued and won).

As with every service industry from the local pizza joint on up COGS(Cost Of Goods Sold) is one of the smallest parts of the pricing puzzle.

Re: The Cost of an ACL Injury

#34

Post by DanBC »

stonemetal wrote: post #33
tomwalker wrote: post #23

Wow, so much of that is overpriced. The medication costs, especially the fluids, are much higher. I checked a UK pharmacy for costs for buying small amounts so the discount they get for buying in bulk suggests a very large mark up in price.

Did you include the cost of having a trained medical professional administer them? The cost of hospital aspirin isn't the pill it is the doc deciding to give them to you and the nurse who dispenses the pills( don't forget the billing person who charged you for the pills, the staff lawyer who was retained just in case you sue over the aspirin, and the payout to the last guy who sued and won). As with every service ind…

Is the cost of staff included in the cost of the meds, or elsewhere? Are they double-billing for staff costs?

Re: The Cost of an ACL Injury

#35

Post by ChaseB »

bluedino wrote: post #11

It was $1,600 have ACL surgery on our dog. Think about that one for a while.

$1,600? My Saint has had two TPLO's, which is the most common surgery for an ACL(CCL in canines) tear. Each Surgery was $5,000+. You got out on the cheap!

Having said that, still 1/12th of the OP's bill.

Re: The Cost of an ACL Injury

#36

Post by dionidium »

goronbjorn wrote: post #19

When I was in college, I couldn't afford health insurance (no parents + financial aid does not cover it). I played rugby (generally not the safest sport) for two years, in addition to playing pickup basketball all four years. I very fortunately did not sustain any major injuries. Six months after graduating (and getting a job with health insurance), I tore my ACL while playing pickup basketball. The costs were as ins…

You wouldn't have paid anything like $68k. As mentioned in the article, those prices are inflated for charging the insurance company, who in turn negotiates a much better actual price. Similarly, the hospital would have likely worked out a better deal with you. Or, if you qualified (and it sounds like you would have), then Medicaid would have initially picked up the tab and they would have negotiated a better deal for themselves.

In none of these scenarios does anybody actually pay the made-up $68k number.

Re: The Cost of an ACL Injury

#37

Post by dr_ »

Interesting read, and a valid criticism of the costs associated with ACL repair in the US. It would be nice to know, however, how much your insurance company actually paid for the procedure. There's probably a large discrepancy there.

My own thoughts are that if there were a true free market for healthcare, with insurance only for real medical emergencies, the costs of a lot of these services would drop, including physician fees, equipment etc. Most of the population would not, and likely could not, pay 68,000 for an ACL repair, which would leave medical providers the option of 1) lowering prices substantially or 2) being out of work. Having put ourselves on high deductible health plans, we are super vigilant now about how we spend our healthcare dollars. And having realized the impact of this, since we are medical providers ourselves, we are now transitioning to a model where we are not participating with many insurance plans, but our fees will be completely transparent - published online - and fairly reasonable (I think).

Re: The Cost of an ACL Injury

#38

Post by taude »

gojomo wrote: post #24

I also had my ACL replaced (hamstring autograft), in SF, about 2.5 years ago after a basketball injury. I'm pretty sure these prices are starting 'list' prices, whereas the negotiated/'allowed' cost that you and your insurance company actually wind up paying tends to be 1/2 to 1/3 these numbers. My surgery was also about 3 months after the injury, which isn't optimal. It took me a few weeks to see a doctor, I didn't…

I saw a doctor right away, but they still wanted to wait a month until ACL reconstruction surgery (cadaver achilles heal) so that all the mobility could be returned before the operation to help speed up the post op rehab.

Re: The Cost of an ACL Injury

#39

Post by chudi »

dbuxton wrote: post #9

This is absolutely shocking to me. Had my ACL replaced in the UK privately about 8 years ago (no health insurance, paid out of pocket). Total cost was £3000 (+ £600 for initial scan). I could have got it done for free on the NHS but it would have messed up my term time at university. Like the OP I had meniscal tearing too so more or less directly comparable. (Although obviously 8 years is probably a long time in medi…

I got my ACL replaced in Argentina and the cost including rehab was about U$S 3000 having one of the best insurance companies (about 120 U$S a month). If I wanted to use the public care, it could probably cost almost nothing.

It always amazed me that in the US the health of a person is not a right and if you get hurt doing anything you have to pay huge fees.

Re: The Cost of an ACL Injury

#40

Post by stonemetal »

DanBC wrote: post #34
stonemetal wrote: post #33

Earlier quoted context omitted.

Did you include the cost of having a trained medical professional administer them? The cost of hospital aspirin isn't the pill it is the doc deciding to give them to you and the nurse who dispenses the pills( don't forget the billing person who charged you for the pills, the staff lawyer who was retained just in case you sue over the aspirin, and the payout to the last guy who sued and won). As with every service ind…

Is the cost of staff included in the cost of the meds, or elsewhere? Are they double-billing for staff costs?

Hard to tell from the post, there was zero mention of staff costs besides the surgeon and anesthesiologist. So they fit in to the bill in one of two places equipment\drug cost or facilities. My guess is some of both. Time spent changing iv fluids is probably covered by the iv fluid line item vs time spent changing sheets being part of the facilities line item.
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