America’s Health Care Ripoff: An Example of Cancer Treatment in Australia

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Yves here. Reader Christopher J sent a contribution from Down Under, with a long note about his treatment for his first major medical treatment. I thought I would run it as a long-form example of how health care works in other advanced economies. Admittedly, my personal data points are stale, but when I was in Sydney (2002-2004), the caliber of health care was on a par with the US, and even with my paying out of pocket, the charges were about a third of what they would have been in the US. A couple I knew who had the option of the wife giving childbirth in New York City or Sydney chose Sydney because they deemed the care to be better.

One of the big things that allows for America’s health care looting to go well beyond what ought to have been its sell by date is our provincialism.

You can read about the Australian scheme here; the short version is citizens and permanent residents pay 2% of their annual income over a threshold for Medicare; they can then either buy private insurance or pay a surcharge for the balance of their coverage.

Christopher J lives in Cairns, which is a remote city of 150,000 near the Great Barrier Reef.

By Christopher J

I follow your blog most days and have been a part time commenter for well over 10 years now, since I worked for the Bureau of Transport Economics in Canberra.

Here is a story about my first medical emergency. I was born in the UK in 1961 and now live in Cairns after working in the public sector for 30 plus years in the finance and treasury sectors. I currently work for self as handyman and have a partner who also works.

Last September 2018, I gave up smoking cigarettes due to the expense. Heavily taxed to ‘discourage use’, a 20 pack of Marlboros now costs around A$30 – $20 US. And, I reckon my habit was costing around $750 a month, or the cost of an annual river cruise in Europe! I’d given up several times for months or even years, but this was the first time I’d given up arising from anger at how the Federal Government was tackling the problem with a huge tax on, mostly, working people.

After that first month, I withdrew the money I’d saved in cash and bought myself a flash wallet to put it in. Smug I was at the pub around my smoking friends. I found huge improvements in my health. For many years sleeping on my side led to my arms going to sleep as my circulation was constricted by all that smoke residue. After a month or so of not smoking, my blood circulation improved and I found I could sleep again on my side. I told partner we were going to extend all our run circuits by about 800 m and we started to hike up Mount Whitfield, and jog down, about an 8km round trip with an up and down of around 350m, with the trail along the ridge line. I was feeling very fit for my age and was feeling generally positive about my health and well being.

At the end of May, or so, and out of the blue, I found a lump as I was sitting on the bed one morning. This was a Monday about 4 months ago. At the top of my right thigh and groiu area was a lump, not painful, about the size of a small egg.’

How would I feel about this if I was living in Florida or Seattle? Australia has health insurance, but I don’t have any as the insurance is only useful, for example, if you think you might need elective surgery and have the money to pay for procedures through a private hospital. For higher income earners, extra tax is levied where the taxpayer does not have insurance. So, there are a number of for and not for profit companies that market cheap insurance that they know the consumer will never use, as everyone, insured or not, can fall back on the public system when they fall unwell.

Heather and I are more fortunate than most. She still has that rarity in modern Australia, a salary, and me a modest government pension already being paid each fortnight, plus work I do as a handyman. We have money in the bank as well, set aside to finish the balance of the work on our house. So, if I was a US citizen, I would either be insured and able to access care, and all the costs and complexities, or not insured and unlikely to have the funds to get cheaper treatment overseas, or even find out what is wrong.

My immediate questions were what is the lump in my thigh and, if it’s serious (my first thought was cancer), can it be treated? At its rawest, I was confronted with my own passing, years before I thought was my time. For US citizens, the first thought might have been how much money do I have? Is my insurance up to date and going to cover this? I am lucky as the thought of cost or access never crossed my mind.

Nonetheless, I hadn’t been to a doctor in years and didn’t know one who knew me, or my scant medical history. Heather works for an indigenous health care organization that provides primary health care to indigenous and non indigenous clients. I went there and the male doctor I saw sent me off for an ultrasound the same day. No cost, all ‘bulk billed’ to the Australian Government, at rates they set across the thousands of procedures that doctors and specialists perform.

Each time the results came back I was sent off to have more expensive diagnostic procedures. That same week, I had an xray and then a CAT scan. After the scan, my doctor rang the hematologist at Cairns Base Hospital and three days later I was in his consulting rooms as the evidence mounted that I had cancer. Dr Azz is an Australian, but his family is Asian. This neither concerned or surprised me, as our health sector is full of clinicians who have come from overseas or are first generation immigrants. But, for me, he looked and sounded the business.

He told me I had lymphoma, where cancer had infiltrated my body’s waste system. He didn’t know how far it had spread, so he scheduled an ecg to check my heart, a bone marrow biopsy, where marrow is taken from the hip area, to see if it had spread there, and a PET scan to see the extent to which the cancer had spread to other areas of my body. He also said that I needed to have a ‘biopsy’ on the tumor in my thigh and scheduled surgery for that the same week.

I haven’t determined what the cost of a CAT scan is in the USA, but count them, some seven different procedures involving radiologists, heart specialist, surgeons, anesthetists…. All happening with speed in the space of about three weeks, from the time I found the lump to me sitting down for my first cycle of chemotherapy. Even I was impressed at how quickly they’d commenced treatment.

Naturally, there were complications and, after my surgery was completed, I found out that ‘biopsy’ was actually the removal of the tumor, which was then tested in pathology. This surgery left me with a wound that was slightly open and constantly weeping plasma. I took the potential infection issue seriously and dressed the wound twice or more each day and regularly went into the men’s clinic to get the wound cleaned and re dressed. And, they also gave me valuable dressing supplies at no cost so that I could do it myself at home.

Yet, it probably took two months before the wound had closed and healed. It caused me a lot of trouble, particularly during the first couple of chemotherapy cycles as my immune system was very weak. Chemo was relatively okay for me. Not nice having four toxins dripped into your blood over 6 or 7 hours, but the staff were brilliant, I talked to people from all works of life and came out of it alright. I also lost all my hair and have other problems which should all go away over time.

I am scheduled for another PET scan at the end of November, allowing sufficient time for the drugs to fully work their way in and out of my system, leaving my lymphatic system free of tumor cells. That’s the goal.

I never thought about money, mine at least, throughout the whole ordeal No, but I did think of all the public resources involved in my diagnosis and treatment and assessed, as best I could that my treatment probably cost the taxpayer around $100k or so, probably more when you factor in all the capital and technology employed in my cure. I am sure there are some cancer survivors out there in the NC community who live in the US and elsewhere. What were their experiences in meeting the $ cost of cancer treatment?

It gets pointed out weekly in NC that the US has the most expensive health care system in the world with not the best outcomes. So many players, corporate and otherwise, profit from the system there. A just and fair society would have changed things long ago so that a free public health system existed In 2020, as in 2012, there are so many potential losers from a Medicare for all system, that they are all spending like crazy to ensure it never happens. And, outside of a revolution, I am not sure you will ever get it as advocates like Bernie will never be nominated as President, in my very humble opinion.

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  1. albrt

    Christopher – best wishes for treatment and the outcome of the tests.

    I was thinking about Obamacare today. For some reason the actual nature of Obamacare had never occurred to me until now. It is a protection racket, plain and simple, at least for those who can afford to pay.

    I am self-employed, so I pay about $13,000 per year for “health insurance” under Obamacare. It has “covered” literally nothing for the three years I have had it. This year I had minor surgery and paid about $4,000 out of pocket, with Obamacare once again paying nothing.

    But if I did not have “insurance” the surgery would have cost $47,000. That is the basic proposition of Obamacare. Pay $13,000 every year for nothing, or the “health care providers” will bankrupt you by charging 10 or 20 times the cost of your actual “health care” if you need it.

    That’s it, Obamacare in a nutshell. I will never vote for anyone, for any state or federal office, who had any role in creating or promoting Obamacare.

    Fortunately they are all war criminals so I wasn’t going to vote for them anyway.

    1. hoonose

      Obamacare works fine if you have very serious medical/surgical problems at a catastrophic level. Your annual total OOP spending may be about $20K, but your benefits can be enormous. My unfortunate wife is on the 5th $M since the 1st of 2017.

      So with Obamacare you do have the value of security. And the value of your bills being pre-negotiated. Although your $47K could easily be negotiated downward. Especially if you know hospitals only receive about 25% of total billings.

      But I do agree that if your are middle class and healthy, tow your medical line and don’t over use HC resources, total annual OOP expenses are just too high. If I were king I’d try and cut that by about 1/3. Most likely with tax rebates or credits.

      1. Kurtismayfield37

        Obamacare works fine if you have very serious medical/surgical problems at a catastrophic level. Your annual total OOP spending may be about $20K, but your benefits can be enormous. My unfortunate wife is on the 5th $M since the 1st of 2017.

        Yes, but would those 1M costs be the same worldwide?? There is no way that would happen! The reason they can say they are “charging” 1M is because of the obscene nature of the insurance market. “Look how much we saved you!” Is a lie.

        1. hoonose

          That is part of it, as are the ‘write offs’ or ‘losses’ illusions.

          Since her policy has already negotiated reimbursement rates, her Obamacare policy has and only pays about 25% of total billings. So payment wise she only on her 2nd $M.

  2. ChristopherJ

    Thank you, albrt. Wow, $13k, and US $s too.

    Sounds like an extortion racket.

    And I know, if we could vote the bums out, we would, but a new one seems to hoodwink us and we go further backwards. No wonder so many of us are apathetic when someone ‘needs’ our money, sorry, our vote.

  3. Barry Disch

    I live in Australia as well but am a transplant from the US. My wife is a GP (Family Medicine) in the US and I am an Acupuncturist. We live in a small town in Port Stevens 2 and a half hour drive north of Sydney. My wife and I have lived and worked in NZ and China as well for about 12 years. IMO the US has the worst care of the countries I have worked in. The privatisation of health care in all four of these countries have slowly worsened both outcomes and expense. China in 1985 when I did my internship was definitely backwards with medical technology but now in the major cities is on par or above many developed nations. They have adopted the US fee for service model although they do have a Medicare like public insurance. NZ I hear has privatised to some degree and Australia has in the four years I have lived and worked here have had increases in what private pays and more and more gap fees and out of pocket expenses for drugs and doctors fees.

    1. ChristopherJ

      Thank you, Barry. Our Liberal National Party government has been privatizing all sorts of services for years. Often with funding models that are provided direct to corporations, who are their donors, if not their mates. Labor’s done it too, particularly at the State level.

      I mean who really thinks it’s a good idea to replace visa processing by Australian public servants with private corporations? No distinction between the core business of government and everything else.

      And, we are not alone in our fears, with the UK looking at how the PPP model might do its NHS better. It’ll be something that gets me out on the streets if Medicare is weakened to the point that it doesn’t help you when you need it.

    2. Tom Bradford

      “NZ I hear has privatised to some degree”

      As a New Zealander I’m not aware of this. Yes there is health insurance available and yes there is a private sector providing hospital-level care for those who want it/can afford it. I have just experienced it. Although the initial diagnosis (enlarged prostate) and “holding treatment” (catheter to drain the bladder) was free under the public system, and although I don’t have insurance, I chose to go private because I could afford to.

      “Going private” saved me about two weeks before I would have been operated on in the public system – two weeks less of having to put up with a catheter 24/7, which is a nuisance but quite livable with – and the surgery, nearly 90 minutes on the operating table, plus two days recovery and observation in a private room, cost around $6,000. Yes, that’s US$6,000.

      Yes because I had the money I was able to jump the queue, but my surgeon also works in the public system and the surgery was performed in the theater of a public hospital – and in a real sense the fees I paid subsidised and underpinned the public service both by making it worthwhile for a top-quality surgeon to practice in a small town rather than a big city, and by easing the financial load on running a well-equipped and serviced hospital in said small town. That’s my excuse, anyway.

  4. campbeln

    We left Oz only 3 years ago. Medical care is on par or better than my previous and current experience with Kaiser (excluding yearly 40 hour workloads to rectify our coverage, which is another story).

    One more antidote… Our daughter had a full-thickness gash on her forehead in Australia about 5 years ago. The ER did a serviceable job patching her up and we went off to a plastic surgeon we’d seen before for something for my wife. We sat in the office without an appointment and were squeezed in. Within a week she was under the knife and now has a very minor scar in a very predominate place. We had private cover, which covered not much at all ($0 for the anesthesiologist?). All told for the day procedure, it was $1200 dollarydoos.

    I also had an injury about 6 months later (circa 4.5 years ago); penetrating skull fracture into the sinus (thankfully). Once again, got seen and under the knife within a week. Once again, just around $1200 dollarydoos out the door for a day procedure.

    If we EVER have the need for a plastic surgeon again, the plane ticket will be around the same price as the procedure it seems, and a far sight cheaper than even walking in the door here in the US.

    In both cases… anyone off the street (that is, non-Aussies with no national cover) would have been out of pocket about $2000 dollarydoos, or circa $1400 in freedom units. All for a very well respected plastic that I’d not hesitate to recommend.

    1. ChristopherJ

      Thanks campbeln. Dollaroos, I think you might mean. Some call it the poo here as, just when you think it’s going to sink out of sight, it bobs up again…

      Yes, I go to Asia when I need proper dental.

      Problem for your average US citizen though; is the cost of going to Mexico or wherever. Most are living pay check to pay check. Mobility? That’s for the people in RVs

      1. campbeln

        The poo… love it! We lived in Canberra, so being cut off from the rest of Oz was par for the course (though dollarydoos is a Simpsons reference).

        The irony is paycheck-to-paycheck players cannot afford to save money. One of life’s opposites, as my mom likes to say.

        Any recommendations for dental in Asia? I need a few fillings and I’ve seriously considered flying back to Canberra for the procedure as it’d be cheaper than down the road here in “competition makes things cheaper!” America.

        1. ChristopherJ

          there are horror stories, but I had good success in Manila. Just do the research and get some feedback from others.

  5. The Rev Kev

    Good to hear that you went through it all ok, mate. I was wondering what that cryptic reference was to an email to Yves in one of your comments. Discovering a lump like that sounds like one of those life-altering moments but it is good that you managed to clear it from your system. Something like that would frighten me. What would be more frightening would be to live under America’s health care system. I have read stories here on NC about peoples experiences with health problems and so many of them are appalling. The sheer callousness displayed by these heath care companies is something on another level.
    I have mentioned before how my wife is being treated for a smashed arm which, if we were living in America, would have bankrupted us. For American readers, I should mention another aspect of Australia’s health care system. This is not to boast of it but to say that something like this is what average Americans should be having. A family member needs several medications each day but here we have the Pharmaceutical Benefits Scheme (PBS) to deal with that. Here is a faq on this topic-

    So for us, this is how it goes. Instead of paying full freight on medications, the government subsidizes them to a large degree and there are about 600 drugs on a list of subsidized drugs. So each one will cost about US$4 at the chemist instead of the full amount. Christopher J would be no doubt familiar with this. The deal is, only effective drugs get on that list. American big pharma hates our scheme as they try to get more drugs on our list but unless there are facts to back up their claims, they don’t make it on the list. And that is how it should be in the US too. But as Christopher J points out, our neoliberal government (both political parties) would love to eventually get rid of these schemes – but not for themselves of course.

    1. ChristopherJ

      Thank you, Rev. And, yes, I do recall a cryptic reference as to why I’d been a bit quiet. So, perceptive of you…

      I was actually in the chemo seat when I overheard another patient converse with pharmacist about the new immunotherapy drugs he was getting – not sure of his cancer. She told him his drip feed (one) cost $9k aussie but was now on the PBS, so the hospital could afford to use it. The chemo I’ve been on called RCHOP has been going for almost 30 years I think. They work, but are a bit scatter gun in what they destroy. These new drugs are tailored for you and target your tumors a bit more selectively.

      Yes, mate, lucky to be here, but not as good as I remember. The past was better and that is a shame for those of us with children.

  6. Ignacio

    Christopher, thank you for sharing your experience. I admire your attitude and hope the best for you. Your post states clearly why HC4A in the US is necessary, and for what I have read here, preferred by a large majority. I am not from the US, don’t live there, but I wish, as you do, a better HC system for the US. Not long ago, when neolibs got power positions in Spain (think Aznar) and absolute power in the region of Madrid, there was a large push for health care privatization and the US HC system was tried to be sold as the example to be followed. The push was resisted. In Madrid the resistance to this was called the “white tide” for public HC and was accompanied by a “green tide” for public education and a “red tide” for public research.

    I think I can safely say that the worst of this push has already passed away. The unfortunate developments in the US HC system makes it useless as selling point for privatization. In the US, the resistance represents the contrary: vested interests against the general interest. Go and beat them!

    1. ChristopherJ

      Thank you, Ignacio. Yes, what the majority of citizens in the US wants, doesn’t seem to matter any more. Glad Spain saw some sense – now need to do a Spexit. Got a template now.

      Re costs – When you are unwell, the last thing you want to worry about is how you are going to afford a doctor.

      From what I see, the US clinicians, hospitals, insurers and so on have been all for the status quo, which means they don’t have the backs of ordinary Americans. Some can’t speak out, but many choose and chose not to say anything that would buck the gravy train. So some clinicians don’t like the new era, where your every move is tracked and monetized. Where were they when the whole sale sell off of the public system was underway?

      I like Spain…

  7. ambrit

    Greetings mate and I hope you are recovering strongly.
    Phyllis is enmeshed in the American Medicare system in dealing with her melanoma.
    I have commented before about how expensive her immunotherapy was, so, no ‘excess verbiage’ on that front.
    At present, she is in a hospice scheme, and scheme is the proper word to use in this regard. Here, taking hospice care under Medicare, which I would lump together with the VA system as the best ‘public’ health systems in America, precludes one from pursuing further treatment for the underlying malady. Some fiendish sort of ‘Catch 22’ in real life. As to scheme, the hospice provider is run as a for profit public/private chimera. Similar to an HMO, the ‘provider’ is paid a set amount per day, and expected to cover everything out of that pool of funds. This is the perfect incentive for parsimony. Phyl’s tumours on her leg require constant bandaging. She does it herself without complaint. However, the best material we have found for this purpose is something called ‘Calcium Alginate with Silver.’ The material is made from seaweed and swells up to adhere to the wound but not stick. The silver in it is anti-bacterial and thus sanitizes the wound. A win win on all counts. Here’s where the ‘grift’ comes in; this is more expensive than ordinary bandages. Citing ‘best practices’ as a reason, the hospice company won’t give us more than a two week supply. We are forced to troll e-bay and similar sites to find “deals” on this bandaging and pay for it out of our own pockets. The implied outcome here is; “When you run out of money, crawl off somewhere and die.”
    This state of affairs has gone on now for over half a year. Last week, one of the “head” nurses came out for the weekly ‘look see’ and bought up the subject of perhaps dropping Phyl off of the hospice program and steering her towards new treatments. Phyl was not dying fast enough! Indeed, the woman observed that she personally had dealt with melanoma patients who survived with forms of the disease similar to what Phyl was presenting with, for ten years or more.
    Hmmm…. “Let not the Left hand know what the Right hand doeth.”
    So, not only is the American ‘health’ system fragmented, but it also is actually counter-productive where medical outcomes are concerned. Were I a cynic, I would surmise that the fragmentary nature of that system was a part of the “secret agenda” of whomever one might wish to malign concerning this process. Fragmentation begets confusion and dysfunction, which beget fraud and waste.
    This was cathartic to type! Thanks Yves, Lambert et. al. for this digital therapy session! I’ll chip in a few bob when the next Social Security cheque comes in. (Lambert knows all about me and “tiny donations.”)
    Be well o Antipodeal correspondent! Love to everyone.

    1. katiebird

      I know that Medicare 4 All solves only some of those issues but it would sure help. My thoughts are often with you and Phyl. I admire your partnership. And wish I could help. Melanoma runs in my family. (I want to say more but am overwhelmed by Phyl’s situation xxoo)

      1. ambrit

        Your empathy brightens and illuminates the lustre of your inner nature. In today’s world, and, truth be told, in all former and perhaps future worlds, care and discernment must guide the extent and venue of our displays of “humanity.” Thank you.
        Too often people lose sight of the fact that the emotional panoply available to functional human beings is precisely what defines us as being human. Go too far towards materialism and we run the risk of losing sight of our “true” natures. Finding where the balance therin lies is the test of maturity.
        Do be very vigilant against the appearance of this literal cancer on the skin of your family. It is, I read, the most dangerous cancer.
        Medicare For All has now become, in my mind, a ‘gradualist’ smoke screen to hide the truly radical reforms needed in American health care. By lowering our sights here, we have implicitly accepted and validated the ‘status quo’s’ argument that supports a triage form of health care provision. (Just a ‘kinder gentler’ version of what we have now.) If something is ‘too expensive’ to provide to everyone, then where do we make the cut off points for literally life and death, and, more importantly, who makes those decisions? I do not impute malice on the part of those promoting M4A, merely an insufficiency of daring. As the last forty years in America has shown, “history” can indeed go backwards. It reminds me of the old joke saying; “One step forward and two steps back.”
        Be well and be wary.

    2. ChristopherJ

      Thank you, Ambrit, and my thoughts and prayers are sent to Phyllis.

      My wound was on leg. After much trial and error, I used a powdered iodine to pack into the wound and draw up infection. Sterile pad on top and, the best, a tubular bandage to hold it all tight. I’d tried all those self adhesive thingies – just irritated skin.

      I was going to the chemist regularly as the stuff I was given for free didn’t always last. But I got through it and I hope things improve for you both.

      Go well, mate.

      1. ambrit

        Ah, iodine, and as a dry pack! Thanks for this.
        We, really she, is using a sub-saturated solution of Potassium Iodide to bathe the tumours twice or thrice a day. That and Natrasan, hypochlorous, which is only available locally, in America in a watered down veterinary solution. I send off for the stronger version to an outfit in the Channel Islands! Talk about offshoring!
        Full recovery to you!

        1. ChristopherJ

          they come in little sachets, which last for a while as you only use a small amount.

          thanks again

  8. Jane

    Sincerely hope all goes well with your treatment Christopher. I’m a Canadian, and our counties health systems sound very similar. Personally, I’ve undergone eight surgeries since the ‘70s: broken ankle requiring a titanium plate and screws, knee surgery and 6 months rehab, two C-sections, two full knee replacements, angioplasty with two stents, cataract surgery. Cost, to me, roughly $200-300 for some extra physio before the first knee replacement, a few hundred on parking fees (which hospitals started charging in the ‘90s) and $6000 for upgraded lens after the cataract surgery (in retrospect I should have skipped these, the private clinic promised they would fix astigmatism and replace the need for glasses, they didn’t).

    Back in the early ‘70s a friend of my parents, who had moved to the US in the ‘50s, came home with his wife and leukaemia diagnosed daughter. They had spent all their savings and the money they made on the sale of their house on their’s daughter treatment. Quite frankly, if I lived in the US I might well be blind, crippled and probably dead as there is no way I could have paid for all my surgeries.

    As to cancer treatments specifically; I’ve lost a brother-in-law, three uncles, a mother, a sister and a husband to cancer. None were ever charged for any of their tests or treatments, which in some cases extended over 2 or more years. The enormous strain a family goes through in dealing with the disease is hard enough. I can imagine what it does to those who must also worry about costs; the stress must be almost unbearable for family who tend to feel helpless even when excellent care is being given, to be unable to provide even rudimentary care because you have no money must be its own special hell.

    Again, I wish you and your loved ones all the best for your future health.

    1. ChristopherJ

      thank you, Jane.

      By my estimation, you still have one life left. So go well.

      Disclaimer; I am an economist.

    1. ChristopherJ

      thank you, John.

      Yes, I was a bit surprised with Azz told me the RCHOP formulation was first used in the 90s.

      If the world had ‘properly’ funded research, I think we’d have all those magic bullets now.

      Too much money in keeping people alive would be my foily response.

  9. Kkkkate

    I have just finished chemotherapy and radiation for esophageal cancer here in northern Washington state. I have Medicare and Tricare for Life, which is retired military medical, and my experience at the Cancer Center was remarkably similar to the author’s. It was less than three weeks from CT scan to chemo and radiation, including surgical procedures to install a port (for chemo) and a feeding tube (I can’t swallow). I didn’t lose all my hair, quite, and the radiation burns healed nicely. So far my only expense besides the modest yearly premiums has been the copay for medicines, $4 to $8. Plus free hats, wigs, scarves, snacks and drinks for those who can swallow, always heated blankets and beautiful surroundings. The staff is incredibly kind and upbeat and I am so fortunate–counting my blessings!

  10. Synoia

    My sister in law here in the US was diagnosed with Cancer in 2015. Since then the medical costs are estimated at over $2 million, and her response to all the treatments were poor. Her prognosis is bad.

    Medicare paid for most, if not all, of the treatment., I’m told that if one is a two year survivor, Medicare will pick up 100% of the costs.

    Having witnessed this if I were diagnosed, I believe I’d jump off a cliff and leave the costs and cleanup to the fishes.

    1. ambrit

      From what I’m seeing of Phyllis’ travails with her melanoma, I suspect that I would be in a somewhat more ‘demonstrative’ frame of mind if so diagnosed. Don’t just jump off of that cliff. Tie yourself to a medical insurance corporation CEO or CFO and take a few of them with you. Consider it a form of toxic waste clean up.
      Sorry to hear about your sister-in-law. At this stage of the game her mental and emotional health is most important. Show her that you care about her. It will make a difference.

    2. ChristopherJ

      Sorry to hear that, Synoia.

      I always poo’d the treatments, as my impressions were the cures were worse than the disease, and without any guarantees you’d be okay.

      When your own life is before you though, you become more compliant and grasp at any help offered. Let’s hope you are never touched by the disease.

  11. Tim

    There is something to be said for first world single payer health care.

    My father in law was on a government health care plan in Mexico new Mazitlan, he was a smoker earlier in life, and by luck they found a small tumor in his lungs when he had a bout with Pneumonia. However, then it took 2 weeks to schedule and get the biopsy, one month to get the results back, another month to get a qualified doctor to look at the results (a one liner saying it was malignant) and prescribe treatment, and by then he was experiencing all the tell-tale signs of higher stage cancer. He died one month later.

    I did plead with my wife to attempt private care instead, which she obstructed me from doing so for way too long and maybe it didn’t matter because there isn’t a private care industry of consequence, because nobody can afford it.

    It’s really a sad state of affairs there all the way around.

    1. OpenThePodBayDoorsHAL

      Just another transplant chiming in, we pulled the ripcord in 2005 after Geo Bush was re-appointed the second time and moved to The Lucky Country.

      Single payer. Accept no substitutes.

      Through various procedures by various family members I can report that the level of care is on par with or better than the California Bay area.

      The other day I need to see an MD. I rocked up to the local clinic. Showed them my national health care card (public free care system). After a 10-minute wait I saw the MD, very methodical and thoughtful. He arranged a set of tests and gave me the forms for them.

      But what happened next was the astounding part. I stopped at the desk on the way out. Surely they needed to do something: bill me, have me pay a co-pay.

      No. They looked at me quizically and said “that’s it”.

      And in other cases there has been a fee that makes its way through the system. You pay with your credit card. Normally by the time I arrive back home the reimbursement has already hit my bank account.

      The US could do what The Netherlands did: keep the insurers in place but force them to offer a basic set of defined services at a fixed cost. Then above that they can upsell: private rooms, better service, add-ons etc.

      Oh, and elect a candidate other than Liz Warren, who wrote a whole paper in 2004 on why single payer would be politically impossible.

      1. ChristopherJ

        Welcome, HAL. Should’ve been here 40 years ago, mate. It was heaps better then. Even when Yves was here…

        The lucky country? It was and Medicare is one of the few bits left of a social contract that we all enjoyed back then.

    2. ChristopherJ

      thanks, Tim. Sorry to hear. Yes, speed is everything with C and when your only options are to leave your home and country, well a lot cannot afford to do so.

  12. petal

    Back in 1999 I had to have emergency surgery in Australia for a perforated bowel and abscess(due to undiagnosed Crohn’s disease). I was 21 and studying abroad. All I can say is thank dog it happened there and not in the US. Am convinced I’d likely have died if in the US. I know I received better care there than I would have had in the US. My hospital stay was 13 days. They made sure I was truly in good shape before they discharged me. I doubt that would’ve happened in the US. My surgeons were excellent, and it also did not bankrupt us. When I got back to the US and had a follow up with a local doctor, it was frightening as it seemed he didn’t know what he was doing-total opposite to the wonderful doctors I had in Wollongong.

    I honestly don’t know what would’ve happened to us if this had occurred in the US. Exactly 2 years before to the day, my father had gone in for surgery for a blood clot and didn’t make it out. 6 months before that, he was diagnosed with esophageal and stomach cancer. They operated on him, he developed a massive infection from that surgery, and was essentially sent home to die. Prior to that, they didn’t even bring up chemo or radiation. Hearing my parents talk, he was looked on as just a number and his doctors didn’t really care. The medical bills destroyed our finances. What happened to him scared me so much that I put off going to get checked out when the problems started in Australia. To this day I am grateful to the Australian health care system for saving my life and not ruining my family even more. One thing that keeps me taking care of myself is the fear of having to have a resection in the US. There’s no way I could afford it even with insurance, and I’m terrified about the care I’d receive and how fast I’d be kicked out after. For months afterward, the bills just keep coming.

    Christopher, you have my best wishes! RCHOP is like carpet bombing the cancer. Most of those drugs have a very long track record-they are harsh but they work.

    ambrit and Phyllis, you both are never far from my mind.

    1. ambrit

      Phyl says hi, (waves.)
      What this has done for me (ambrit) is to make me take a long hard look at myself. No, I don’t like all I see, but, that’s the breaks.
      As Phyl is wont to say; “Hey buster! Who’s the one with the problem? You? I thought not.”
      Stay well.

  13. Expat2uruguay

    It took me a couple of hours of going through billing statements but I now know how much it cost me to be treated for breast cancer in Uruguay. My cancer was grade 2B and required a lumpectomy and the removal of some lymph nodes in the adjacent armpit, six months of chemo, and two and a half months of radiation. Unfortunately, the chemotherapy and other medications to attack the cancer damaged my heart and cause left ventricular dysfunction. Therefore this accounting also includes treatment and testing for my newly acquired heart condition. The total period of this accounting includes 16 months of monthly premiums at approximately $60 per month, all costs for surgery and hospital visits (which equaled $0), all doctor co-pays (approximately $7 each), all Imaging and tests, and all medications. (My monthly premium was based on being a temporary resident aged 54 years old when I signed up.)

    Drumroll: $2,500, or $1,550 dollars after subtracting out the monthly premium.

    I am now doing well and walk 3 miles a day to bring my heart function back up to normal and lose weight. Funny story, after signing up for my health care plan I went to my first appointment because I needed a mammogram for my immigration process. That was when they found the cancer, the very first appointment I ever had with them!

    1. ChristopherJ

      that is some luck. As you would know, if the symptoms are absent, the cancer can spread without early treatment.

      I take it you would recommend living there?

      1. Expat2uruguay

        I would. But you have to be tolerant of a society that is not Heavily commercialized, where tranquilo is the zietgiest and there’s a lot of personal freedom due to the pragmatic Progressiveness. I see quite a few American expats that get bent out of shape about these things. Also, it’s the most expensive country in South America and it’s very difficult to find work locally. The city is also a bit trashy and not well maintained in appearance, but honestly my biggest complaint is that the food is boring! But the buses run on time, fracking is banned, weed is legal and so is gay marriage. I think all that’s awesome, so in my opinion this is the best place to live if you can generate a salary of $2,000 a month from a source outside the country. It’s also easy to immigrate too,
        and has the greatest economic and political stability in South America.

  14. ChristopherJ

    That’s a great story, Petal. My nephew (an identical twin) has battled Crohn’s for 20 plus years. He is okay, but I am well aware of how crippling that disease can be and how it has affected his quality of life. Other nephew is fine, go figure.

    After your experiences, I would be looking to live elsewhere, but I know how difficult putting that plan into place can be. Go well.

    At the end of day here in Australia, if you are in a life threatening situation and require hospital, you will be treated and, later, you will be billed if you’re not a citizen. But, we don’t dig into your wallet first and kick you out if it’s empty. That wouldn’t be Australian

  15. MichaelSF

    Christopher, if you had any lymph glands removed please read up and ask for advice on lymphedema.

    When it was discovered my wife’s stage IV uterine cancer surgery was very quickly scheduled and followed by chemo at Kaiser, but the surgeon basically blew off questions about the eventual swelling in her leg with mis- or mal-information (“just have Michael squeeze your ankle, or put an Ace bandage on it”), letting the lymphedema get a solid hold on her and it has been a continual downhill path with it since then (nearly 20 years ago). For years she’s been mobility challenged and often stuck in bed while being bandaged. The annoying thing is that lymphedema can often be controlled/minimized with proper treatment, and if we’d gotten good advice early on the last couple of decades would very likely have seen her with much greater quality of life.

    1. ChristopherJ

      Thank you, Michael.

      Now, if that isn’t a prime example of the benefits of the NC community, then I don’t know what is.

      Yes, have been worried about the wound area. Doesn’t feel quite like it did before, notwithstanding the scar. Will definitely ask Azz about it.

      1. MichaelSF

        Lymphedema seems to get spotty coverage with the medical people. Some are well aware of it, others seem to take a “everyone gets it after lymph gland removal (or other related issues)” and they don’t pay much attention to it in the post-surgical care. But if you can watch for it and keep it under control from the first time it surfaces the impact can be reduced. If not, you can end up with one limb being twice (or more) the size of the other.

  16. Dan

    That is an inspiring and informative story. Forwarding it to everyone in my daughter’s nursing class, one third of whom were not registered to vote!, until I got to them at least.

    “I’d given up several times for months or even years, but this was the first time I’d given up arising from anger at how the Federal Government was tackling the problem with a huge tax on, mostly, working people…”

    Maybe the government should have done the opposite, provided free cigarettes to anyone that wanted them? The tobacco tax was doing working people a favor, if it took a tax to dissuade them and you, from committing further suicide, it is a good thing. It’s disgusting how media and Hollywood continue to promote this habit in every new generation of videos and their theatrical equivalents that rope in new addicts who all think they are immune from disease with this karmic tax.

    If vaping can be outlawed, why not tobacco?

    Bernie or revolution.
    Another way to describe our current health care looting relative to what we pay in income taxes and the protections we get is “Taxation without representation.”

    What would happen if a certain number of taxpayers simply refused to file if we don’t get M4A? Got Pareto Principle?

    1. ChristopherJ

      Thank you, Dan. There is no doubt raising the price of cigarettes does discourage use, but tobacco is very inelastic re price. People tend to cut back, start rolling their own etc, spend less on other things.

      Was only about 12 years ago that a pack of Marlboros was $10 – that is how quick we have gone to $30. How this happens when the product is produced in Asia at a cost of less than a buck a packet is beyond me. Adding, that the statutes for tobacco provide for much, much higher criminal penalties for those who try to grow their own tobacco (and hence avoid paying the tax). Forget cannabis, tobacco is the higher value crop in this part of the world.

      I asked Robbie my tobacconist a few months later as to how many of his customers had quit. He said, only you.

      Higher prices mean less disposable income for other things. No one thinks about the children is another important point.

      Yes, going to be interesting to see what happens when Bernie is finally told to go and sit on the sidelines. Be a good catalyst to get out on the streets, until the police arrive, at least.

      1. ambrit

        Dress up like the police and act as anti-agent-provocateurs.
        “Hey Sarge. Who are those Peoples Militia cops over there?”
        “Oh man. Tell the guys to form a circle.”

  17. Sydney or the Bush

    When I scored the trifecta of bowel cancer, lung cancer and a mitral valve replacement I was treated at RPA, the teaching hospital attached to Sydney University.
    As I was being prepped for one of the operations the American doctor assisting was asked why he came to Oz. He gave two answers, firstly that the American health system was geared to making as much money as possible and secondly the constant fear of a malpractice suit wasn’t really conducive to his lifestyle.
    It’s good to be reminded that a generalisation about a group does not have to apply to every member of that group.

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