townsend7 New Reader
July 21, 2009 8:04 p.m.

We've got some medical professionals out there. Maybe someone can shine a little light on my situation.

A few months ago I lost my employer subsidized health insurance. Not cheap to replace for a 45yo guy making $20/hr with a mortgage to pay. Factor in summer being our slow season when I'm lucky to get more than 30 hours a week. I figured I'd put getting insurance off until fall when there's more money to be made (or until I found a new job). Seemed like a good idea at the time though I was certainly aware of the risk I was taking.

Sometimes ya win, other times ya lose. Last Tuesday I lost (fair enough). I broke my collarbone into "at least four pieces" they told me. Sure looked like four pieces to me on the x-ray. The ER took my Visa (cha-ching!), shot some x-rays, gave me a sling, a RX for Percocet and suggested I see a Ortho specialist. The x-rays looked pretty gruesome to me but what do I know. Immediate surgery was out of the option because I had a date that I was not going to miss Thursday. Up to this point I was perfectly content.

Went to my Ortho appointment last Thursday and met with the PA. He seems to feel that surgery will not be required which gives me a warm and fuzzy feeling. On the other hand there's quite a bit of deformity. My right should has moved quite noticeably and the bones are in some weird places IMO. My current employment requires a fair amount of heavy lifting so I'm obviously concerned how my newly deformed shoulder will handle the workload. And to be honest I'm a little concerned about the cosmetics of this. In the mirror (when the figure 8 splint is off) it looks really odd to me. So in sprite of medical pros saying surgery isn't necessary I'm still considering it. I've got savings that should easily cover it (cheaper, quicker and more fun than my divorce).

So I pressed for more info on the surgery option and asked for a ballpark estimate of the cost. Apparently nobody EVER asked this before because it triggered LOTS of running around and talks in the corners of the office. Seems like a pretty simple question to me. The answer I got was the surgeon's fee is $1440. Seems fair to me. So I ask if $5K - $10K would be a reasonable ballpark. I was told no probably $15K - $20K. Really? If the Surgeon is only $1500 who's making all the money? Isn't it reasonable that I get a better answer that what they gave me (which was basically: 1500 + "we have no idea" = 20,000). I was clear that I've got no problem paying out of pocket and can afford to do it. I expect these folks to give me reasonable answers. I feel like they're afraid to touch me because I'm uninsured and if, heaven forbid, something went wrong they wouldn't get paid. Am I just uneducated or do I have a point? How do I shop around for collarbone surgery?

Any ideas what reasonable cost for this might be? How much is it in Mites? (obligatory Mata content)

Thanks gang!

And for the record the date was perhaps the best first date ever. Remarkable girl that I simply adore, though I still have some minor hang-ups about a very substantial age difference.

Hal HalfDork
July 21, 2009 9:37 p.m.

Well, the work shown below was ~$22K. Outpatient surgery at hospital - was there for 4 hours total. Surgeon got a chunk, Anesthesiologist got just as big a chunk and there were some other folks who were on the bills also.

Hospital got some for the pre-op stuff, the operating room, recovery room, and all kinds of supplies. Some lab got paid for some tests but i don't even remember them.

I would say that their $15k - $20K is probably accurate.

oldtin New Reader
July 21, 2009 9:40 p.m.

20k sounds about right for "retail" - hospital fees, support staff, supplies, surgical suite rental, recovery room rental, meds, etc. Also add in anesthesiologist.

Hospitals and docs usually have contracts with insurance companies with discounted prices (50% discount is fairly common - medicare is more like 70%). Talk to a senior patient accounts person and see if you can work a deal. May have to leave a deposit - but worth a shot. Docs bill separately - so their fees have to be worked out independently. Sucks that people with the resources but no insurance get hit with the highest possible bill. In a previous life I designed health plans for an insurance company - now work in a hospital and getting pretty fed up. Good luck! Good on ya with the date.

oldtin New Reader
July 21, 2009 9:42 p.m.

Hey Hal - looks like you got a screw loose.

aussiesmg Dork
July 21, 2009 9:45 p.m.

Just a suggestion, but try flying to Australia or Canada then falling over and crying out in pain over the collarbone you just broke.....

pigeon Reader
July 21, 2009 10:16 p.m.
aussiesmg wrote: Just a suggestion, but try flying to Australia or Canada then falling over and crying out in pain over the collarbone you just broke.....

LOL!

Agree with the comments before. NOBODY pays for surgery themselves - if they have assets to pay for the surgery they're usually in a position to buy health insurance; if there's no health insurance 9.5 times out of 10 there's Medicare/Medicaid picking up the bill. I'd be willing to be that the office staff has never been asked how much for the surgery before.

For any surgery there's the "professional component" (surgeon, anestheologist) and the "technical component" (facility charges, supplies). Everything's billed separately. I'd negotiate a discount with the senior billing people for everyone including the surgeon, the sleepy doc and the outpatient surgery center you're likely to be operated on at. 50% from retail is not unreasonable, since nobody pays retail anyway. See if you can get the workers' compensation fee schedule from the state, if you can decode it that will give you a number to shoot for. Another good research point would be to ask your now-discontinued health insurance what they'd pay for this surgery - they may not give the answer but it's worth asking. Don't be afraid to shop around especially on the facility end, they're all the same really, and the surgeon's professional fee sounds very reasonable to me. Good luck.

Oh, and good for you on the date! Once you get to a certain point in life age is just a number; hopefully she's mature enough that you two can be at that point.

aircooled SuperDork
July 21, 2009 10:20 p.m.

One of the other places people go is Indonesia. Way cheaper than the US and the hospitals are setup like high end hotels / spas. They did a story about these places on 60 minutes or 20/20.

Wally SuperDork
July 22, 2009 1:56 a.m.

The Grassroots way would be with a decent pocket knife, a cut down Miata bumper reinforcement, and some screws we found in the garage, sterilized with some Brakekleen

ignorant SuperDork
July 22, 2009 4:34 a.m.

Insert witty comment here about how if we had some kind of basic universal coverage this guy wouldn't be making this horrible decision...

Wally SuperDork
July 22, 2009 6:03 a.m.
ignorant wrote: Insert witty comment here about how if we had some kind of basic universal coverage this guy wouldn't be making this horrible decision...

Angry reply that it would heal funny while he stood in line for x-rays and toilet paper comrade.

Edited: Forgot to add smiley faces, so people know it's a funny.

ZOOMiata Dork
July 22, 2009 6:45 a.m.
Wally wrote:
ignorant wrote: Insert witty comment here about how if we had some kind of basic universal coverage this guy wouldn't be making this horrible decision...

Angry reply that it would heal funny while he stood in line for x-rays and toilet paper comrade.

That explains all the mis-shapen Canadians . . .

Datsun1500 HalfDork
July 22, 2009 7:22 a.m.
ignorant wrote: Insert witty comment here about how if we had some kind of basic universal coverage this guy wouldn't be making this horrible decision...

I guess you did not read his post where he said:

I figured I'd put getting insurance off until fall when there's more money to be made (or until I found a new job). Seemed like a good idea at the time though I was certainly aware of the risk I was taking.

He made the choice, and was aware of the risk. I pay for mine, I don't need to pay for yours.....

aussiesmg Dork
July 22, 2009 7:48 a.m.
Wally wrote: Angry reply that it would heal funny while he stood in line for x-rays and toilet paper comrade.

Boy is that old line still out there, seems funny how it works out pretty well in countries that have socialized medicine. It's far from perfect because it is run by governments meaning "there has to be a harder way to do it than necessary"

When my (not yet) wife and I were traveling in Australia, she had a heart episode, we went to a local hospital and was seen immediately. She had the services of a doctor, a nurse, an EKG, stress test, meds, and more. She was in there care for 7 hours and the bill for that care in the US would have been thousands. At the completion of the treatment they came up with a bill for my wife (who is not an Aussie and was not my wife at the time). The total for that bill was $26.00.

Oh and she got toilet paper for free.

Australia's AMA also puts a ceiling on the price of any procedure making it illegal to charge over that amount, don't get me wrong doctors still drive a Mercedes and live in the best houses but they can only charge so much for a visit/procedure.

The only things not covered by this are dental, elective and similar which you can get private insurance for. You can also opt for insurance should you desire a private room, choice of doctor etc....otherwise just get patched up for free and go home.

townsend7 New Reader
July 22, 2009 8:35 a.m.
pigeon wrote: Oh, and good for you on the date! Once you get to a certain point in life age is just a number; hopefully she's mature enough that you two can be at that point.

Agreed on the point that age doesn't matter. I'll take it one day at a time and see where the journey takes us. But when I found out that I'm older than her parents.... She really shouldn't have told me that while I was driving. Lost my focus for a second. Guess I never did the math to even realize that was a possibility.

Think I'll audition to be the next Dos Equis "Most Interesting Man in the World". I think that comes with health benefits.

Duke SuperDork
July 22, 2009 8:54 a.m.
aussiesmg wrote: Boy is that old line still out there, seems funny how it works out pretty well in countries that have socialized medicine. It's far from perfect because it is run by governments meaning "there has to be a harder way to do it than necessary".

I've got some good friends in England and Scotland who would love to debate just how effective their "free" healthcare is. Most of them complain about having to pay for healthcare twice - both in taxes for the national system and in private insurance to assure prompt, consistent care from their own doctors.

At the OP - good on you for cheerfully accepting the consequences of your actions. Good luck to you in getting it solved for a reasonable cost!

DILYSI Dave SuperDork
July 22, 2009 10:17 a.m.

[Flounder]

... And this is why healthcare in this country is so damned expensive. We've isolated the price of the service from the consumer so much, that when the consumer WANTS to pay for it themselves, we can't even figure out how to.

[/Flounder]

RossD Reader
July 22, 2009 10:27 a.m.

The damnedest thing is that insurance insures that the hospitals get payed, not that we get health care.

iceracer HalfDork
July 22, 2009 11:08 a.m.

No comments on health insurance or lack of. On the relationship thing, I am in a very similar sitiuation. I'm older than her mother. There were a lot of people against it,but it now pretty much accepted. 10 years now.

Hal HalfDork
July 22, 2009 11:11 a.m.
oldtin wrote: Hey Hal - looks like you got a screw loose.

Looks that way. Doctor made a point of explaining that to me before he let me look at the X-ray!

Bone was snapped in half diagonally and that screw is to keep the two parts aligned properly. Then he added the armor plating on the outside.

maroon92 SuperDork
July 22, 2009 11:13 a.m.

just a suggestion, but I broke my collarbone, and they never cut me open...it healed on its own with a sling and a butterfly to hold my back straight.

ignorant SuperDork
July 22, 2009 11:18 a.m.
Duke wrote:
aussiesmg wrote: Boy is that old line still out there, seems funny how it works out pretty well in countries that have socialized medicine. It's far from perfect because it is run by governments meaning "there has to be a harder way to do it than necessary".

I've got some good friends in England and Scotland who would love to debate just how effective their "free" healthcare is. Most of them complain about having to pay for healthcare twice - both in taxes for the national system and in private insurance to assure prompt, consistent care from their own doctors.

for every bad there is good. and OMG its not governmnent run.. http://www.boston.com/bostonglobe/ideas/articles/2009/07/05/healthy_examples_plent...

If france can figure it out........

Clay Reader
July 22, 2009 11:31 a.m.

I figured this would take a political turn, especially since this has been in the news so much lately. Some folks just can't help themselves ;-)

To get back on topic. My buddy broke his collarbone on a mountain bike accident and was told to let it heal on it's own (I guess that's the usual way they handle it nowadays). It looked bad the day he broke it, but it healed up as a small bump. It's noticeable, but only if he points it out. Don't lose your shirt (literally and financially) and you'll be fine. I'm no doc, but I'd guess you are just as likely to have limitations with manual labor after the surgery as with no surgery.

CrackMonkey HalfDork
July 22, 2009 11:57 a.m.
Duke wrote: I've got some good friends in England and Scotland who would love to debate just how effective their "free" healthcare is. Most of them complain about having to pay for healthcare twice - both in taxes for the national system and in private insurance to assure prompt, consistent care from their own doctors.

And the NHS is arguably one of the worst in Western Europe.

motomoron Reader
July 22, 2009 12:19 p.m.

Bedrest for 6 weeks.

Check daily for bodily symmetry.

TJ HalfDork
July 22, 2009 12:23 p.m.
iceracer wrote: I'm older than her mother. .

You are older than your mother-in-law? That is a concept I've never considered....I am younger than my wife (not by much) and she is younger than her mom.

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