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The Cost of an ACL Injury

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Re: The Cost of an ACL Injury

#71

Post by matwood »

dkl wrote: post #68

Achilles tendon harvested from a cadaver Yeah, I wouldn't recommend this route, either. I read an article in The New Yorker about body parts harvested from cadavers that were used in transplants. The parts were way past their harvest-by date. This was discovered, at least partially, by someone having an ACL transplant from one of this bad parts, and the recipient of the bad part died from bad infection due to a mold…

The lack of controls on that business forever made me wary of using cadaver parts for transplants.

I didn't know that, but cadaver parts freak me out so when I had my ACL done I did the standard patellagraph. If I tear the same knee again I'll have to go cadaver or hamstring, but hopefully that never happens (knock on wood). The problem with the hamstring is it never quite heals as strong.

As an aside, pro-athletes typically go cadaver because the time to heal can be quicker. They probably aren't getting bad ones though.

Re: The Cost of an ACL Injury

#74

Post by matwood »

showerst wrote: post #15

One thing to be aware of in how all of this stuff works; oftentimes medical billing codes don't map 1:1 to exactly how things work in the hospital, so the medical staff puts together a statement of everything they did, and then the billing staff (approximately) maps it to billing codes. This means that they'll overshoot on some codes to make up for other acts and overhead that doesn't have an exact billing code, and…

I had mallet finger once and they coded it as a broken bone with the associated costs. They wanted to charge me for a full broken bone and typical time spent with hundreds of dollars of costs when all the doc did was spend 5 minutes, give me a plastic splint and tell me to not bend the finger for 8 weeks.

After many phone calls I finally got someone on the phone who realized how idiotic the code was and changed it to something more reasonable to the service rendered.

Re: The Cost of an ACL Injury

#75

Post by matwood »

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…

Depends. An ACL tear can feel better on it's own after a few weeks assuming you don't go running into any hard direction changes. Many docs would prefer pre-hab prior to surgery in order to get maximum flexibility and strength for every patient, but most insurance will not pay for it.

Re: The Cost of an ACL Injury

#76

Post by ry0ohki »

old-gregg wrote: post #27
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…

Similar to my experiences as well. I once compared the price of a knee MRI scan across several countries by calling folks I knew. This is why I was dumbfounded by the call for "innovation" in medical industry at the end of the post. There's plenty of innovation is going on, it's the corruption and extortion we're looking at here: $60K were simply extorted from a person in pain. It's a legislation+law enforcement issu…

>$60K were simply extorted from a person in pain.

Or more specifically from all of us. The author only paid $2400. The whole system is designed to be opaque and non-competitive so they can just bill insurance companies for whatever. I wonder what it would have cost if he said he was paying in cash (hint: a lot less).

Re: The Cost of an ACL Injury

#77

Post by larrys »

angersock wrote: post #47
ISL wrote: post #8

Excellent read. One point on disposing of fancy, potentially reusable, tools: We do more than a little precision machining in our lab. When a job matters, the shop buys new tooling. It's lower in cost, especially time, than verifying that a tool is sharp and correct. At first, it seems wasteful to throw away a once-used tool, but if all you do is critical work, you must be certain that your tools are reliable and cor…

To be fair, you're doing exceedingly delicate machine and test equipment manufacture. The machine shops I know will buy new tools as needed, but reuse them on large job runs--and throw them out once they lose tolerance. Something like the $900 knife in the article is/could be a mass-produced stamped piece of metal, perhaps sharpened on-site or at the factory; unit cost for that should be easily less than $10.

"Something like the $900 knife in the article is/could be a mass-produced stamped piece of metal"

Very well could be some liability potential wrapped into reuse of a device. After all part of the cost does go toward covering things that go wrong for whatever reason.

If you take the device fresh and something isn't right you can claim it was defective. If it was used for another operation who is to say when something happened to it?

An inverse analogy might be the difference in potential problems from using a hard drive that has been previously used where something is later found vs. using a brand new hard drive.

Re: The Cost of an ACL Injury

#78

Post by larrys »

apendleton wrote: post #12
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…

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?

"I wonder why there aren't more Americans who go to the UK for surgery?"

Potential issues with follow up care as one drawback.

Re: The Cost of an ACL Injury

#79

Post by jostmey »

Here is an idea for an awesome law that might fix some of the problems with the medical industry! Remove the ability of the billing departments to determine who has insurance and who doesn't. That way, everyone is charged the same amount for similar procedures. The whole practice of over-billing insurance companies has simply become ridiculous.

Why do the insurance companies tolerate this practice?

Re: The Cost of an ACL Injury

#80

Post by chinpokomon »

I had my ACL repaired in 2007. I don't remember the costs any more, but I had essentially the same procedure using my patella and a meniscus tear repair. While I was able to put weight on my injured leg and was out of physical therapy after only a few months, it has taken several years to "fully" recover; even then I have the occasional gentle reminder that my knee is not the same as before my soccer mishap.
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