Why is medical care so expensive

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engineer55
Regular Member


Date Joined May 2009
Total Posts : 121
   Posted 4/20/2010 9:49 AM (GMT -6)   
Did a 6 month follow up, I get my PSA test at Quest which is a shooting gallery, cost after insurance adjustment is $25.  But then you have to go in for your how are you doing visit, take the pee volume test, take the bladder sonogram (all tests that I have passed the last time) , and we get the visit price up to $370.  Is there a reason a doctor can not just review the PSA and email the results.
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 4/20/2010 10:01 AM (GMT -6)   

Ask your doctor. Course he's trying to earn a living and if you have insurance it is too much a big deal.

I've had good luck with all sorts of doctors when I told them money was an issue.

 


Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


engineer55
Regular Member


Date Joined May 2009
Total Posts : 121
   Posted 4/20/2010 10:58 AM (GMT -6)   
That is the whole issue, they think insurance will pay for it. Those of us who pay for their own insurace have very high deductibles
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 4/20/2010 11:24 AM (GMT -6)   
Talk to your doctor or his assistant before going in.

Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 4/20/2010 11:47 AM (GMT -6)   
Well also the tests WILL help in those cases where something is starting to go wrong ... flow-wise ... and your doc will then know.

But usually "You can see a lot just by observing" -- as Yogi Berra still says -- no need for fancy tests necessarily, "Just pay attention to your pee".
Age 59, 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
11/2008 Biopsy: 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery ,Nerve sparing, 1 day in hospital.
02/18/09 Cath out -- passed 1 cm oblong bladder stone (not kidney!).
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
04/09, 07/09, 10/09, 01/15/10 PSA <0.1
03/2009 Levitra@20mg / Viagra@100mg/Cialis@20mg -- (nocturnal stirrings started 02-03/2010).
08/09-09/09,02-03/10 MUSE@1000mcg 80-90% (with some ache )
10/09-11/09 TrimixGel@(500/300/100mcg): 60,70,80%,
02/10-03/10 TrimixGel@1000/300/100mcg - 80-90% - just @ usefulness.
Gel + MUSE 500mcg -- 100% for 30-60 mins and 80-90% for hours after that).


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/20/2010 12:45 PM (GMT -6)   
A good discussion with the doc to explain your insurance situation and to discuss the need for these tests will probably get things understood and result in fewer tests, or maybe reduced fees for those they insist on you getting. Talk to them when they mention schduling tests. It's your right to question and work out alternatives, so speak up... smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 4/20/2010 12:46 PM (GMT -6)   
engineer55 said...
Is there a reason a doctor can not just review the PSA and email the results.
 
This is what I do for my follow-up PSA test results.  Quest faxes the info to the doctor's office, and I get an email a few days later.

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 4/20/2010 1:43 PM (GMT -6)   
My husband saw his urologist every 6 months but was had PSA tests every 3 months. All he did was call the doctor's office and tell them to order a PSA test. John went into the local office (not where our urologist sits), rolled up his sleeve and gave the blood. Within 24 hours (give or take a few), the urologist would call with the results without billing our insurance company. When he would go in for his semi-annual with the doctor, it was just an office visit - no tests were done.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/20/2010 1:55 PM (GMT -6)   
my uro doesnt charge anything extra when its PSA test time, other than what the lab charges.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 4/21/2010 9:46 AM (GMT -6)   
I talked to my urologist about this very subject the last time I was in for a psa test. He mentioned a number of things but the one that he said most affects the cost is the government reimbursement for Medicare. He said that the dollars that he got back barely covered his clinics costs and they were scheduled to be reduced even more by the changes from the Healthcare legislation just passed. Since he deals with a high percentage of older patients, a lot of them are on Medicare. To offset that, he charges more for his other patients.

I haven’t seen any financial statements from him but I have read the same thing in other places.
63 yo
V10.46 Dx Feb-09

RRP 5-5-09

No adverse SE

PSA 6-19-09 -0-

PSA 9-21-09 -0-



Thriving, not just surviving!

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