My personal opinion is that we should give tax breaks to HMOs like Kaiser Permanante, and allow entry of foreign health care providers and doctors who can pass the same standards of US doctors. Just giving patients the hospital bill up front will improve transparency, but might ultimately be counterproductive, as patients might choose to skip certain procedures or examinations with upfront costs, leading to more serious health issues later. Instead, we should try to align the cost reducing incentive of insurers with healthcare providers, and we should favor private providers over a usually less efficient public system.
One of the main reasons I like state provided healthcare, perferably a free system in Canada is that I think it would boost entrepreneurship. I know a lot of mid 20’s professionals that are hesitant to make the leap because of the need to maintain health insurance for them and their families. We should make it easier for risk takers.
The flaw with the British and Canadian systems is not single payer, its the heavily unionised and bureaucratic provision. I see no reason why private hospitals should be banned, as long as all individuals have access to care through public insurance.
I agree though interestingly entrepreneurship is lower in Canada and Europe with public systems. Again, don’t confuse insurance with health care. Public insurance can be great, public provision is a monster Americans do not want.
No shit? My son has epilepsy too. What kind does he have? My son started having partial complex seizures when he was one, and was later confirmed to have cortical dysplasia type 2. Your story sounds similar in many ways to ours. Sounds like your son has faced more severe side-effects than mine has. Thankfully he’s basically completely healthy outside of having seizures every day (which I don’t mean to downplay. He can’t really lead a normal life when he’s getting knocked on his ass several times a day, not to mention scaring the crap out of anyone around him that’s never seen a seizure before). At first it was only every few months, then it got much, much worse. He recently went through his second craniotomy, but right before that he was having over 100 seizures a day. Still too early to tell how effective the surgery was, but we’re probably looking at a VNS in his near future.
That said, I have some thoughts on my experience with our insurance and health care system. For context, I have an HSA coupled with a high-deductible plan. I’m a big supporter of HSAs (as I’ve mentioned in the past), espeically for younger, healthy people. For people in my situation it’s not ideal since we’re pretty much guaranteed to hit our out-of-pocket max every year. But, our insurance company has been great to work with and never balks at anything the doctors send for approval. To date, they’ve received claims well into the seven figures for everything my son has been through. Not sure how much they actually have paid, but we’re definitely getting our money’s worth.
On the healthcare side of things, this is when I’m really happy to be in America. I really can’t say enough about his doctors and their willingness to work in our best interest. For example, right around the beginning of Dec. my son’s seizures skyrocketed from about one a day to over 100 a day almost over night. That’s obviously terrifying and amazingly concerning. We were able to get in to see both our neurologist and our neurosurgeon within three days, and he was scheduled for surgery before the year-end (both because we wanted it done ASAP and so it would hit our already maxed out 2014 insurance). You know how hard it is to schedule something around Christmas with several doctors? Well, they did it and although we had to stay over into 2015 (nothing like ringing in the New Year in the PICU) it’s a testiment to how quickly we can get shit done when we need to. I’m active on several other epilepsy boards, and based on what others tell me, being in Canada (or the UK) is a nightmare in similar situations. Takes forever to see a specialist and then if you do need surgery it takes several months to get on the schedule.
I can’t really say I have much of a problem with either our insurance or our health care system. Sure, that’d be great if everything was free, but $6,000 a year plus $34/month in premiums isn’t that bad for what we’re getting.
Yeah, it’s just something that I think could be examined. Not sure what the real solution is there for the US, but a little more focus on taking some of the risk away for entrepreneurs on the healthcare side would be worth looking into.
STL, are you in Boston? If so, Boston Children’s is awesome and probably what you’re referring to. It’s probably been the best part about our move up here.
^Nope. But, yes, they have a very good program. Cleveland is considered to have the top pediatric epilepsy program, but not even that could get me to go to Cleveland.
It’s not the tax/fines per se, but the dramatic increase in premiums that hit small businesses. Yes, it ate up enough margin that it was effectively better to close up shop.
For STL and TTM, have you ever considered trying CBD’s to treat your child’s epilepsy/seizures? I don’t know how you feel about cannabis derived products but I saw this video recently and thought it was pretty dramatic. You may have seen the clip. The story is from 2012 but I saw it again the other day.
Also, not sure if CBD’s are legal in your state.
http://www.cnn.com/2012/12/10/health/medical-marijuana-child/
Good luck to your children and you as parents.
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I’m really sorry to hear you son has to go through that. It’s so hard sometimes going to the children’s hospital and seeing the crap hand so many kids get dealt.
I’d need to look through some of my records at home to tell you the specific diagnosis, but he has tonic-clonic seizures when he has episodes. The first episode happened when he was napping on my wife. He just started mild spasming and she couldn’t wake him up. I didn’t bother calling 911, we just broke every known traffic law and made it to St. Paul Children’s Hospital in about 5 minutes. He was put on medication right away, and had another 4 or 5 serious episodes in the 2 years after that. These were much more severe and usually resulted in a multiple day hospital stay. The most serious one they couldn’t break the seizure for 30 or so minutes in the ER and resulted in the heavy sedation and intubation and the week long stay. Thankfully, his seizures were infrequent, because the severity of them wipes him out for days at a time.
We did some genetic testing and they found a gene deletion that was present in a dozen or so other patients with similar issues, but nobody had done any further research as to what was going on. It was actually scary because most(or all, I don’t remember) of the cases with that genetic abnormality had heart malformation issues. So we opted to do a bunch of additional testing and everything looked good.
We’re on our third medicine with him. He started on keppra which controlled the seizures but turned him into a monster due to the behavioral side effects. Then he switched to a liquid suspension of trileptal plus some other drug, that worked, was running a couple thousand a month, then just stopped working one day. So now he’s on Vimpat and has been there for almost 3 years without issue. There are occasional episodes that we worry are absence seizures, and the neurologist shares this concern, but we’re all reluctant to change medications unless there is a breakthrough seizure.
We’ve done some work with the epliepsy foundation in MN and participated in some panel discussions through the county(these were great, but were painfully slow because there were typically 6 or 7 languages being spoken, so each interpreter would need to restate the question and answer every 30 seconds). We feel extremely fortunate that the frequency of our son’s seizures was minimal, but we are also very grateful that the neurologist on call the first time we went in has been such an amazing specialist to work with. I’ve never worked with a more caring, thorough and awesome doctor. There’s never any rushing you out the door, extremely relatable, willing to discuss options and lay out multiple levels of various plans and strategies. Because we’re “seiure free” right now, we see him on an annual basis. I ran into him in the grocery store and he stopped me and asked how we were doing. Then he asked by name how our oldest son was doing. They’ve met maybe twice and have no doctor-patient relationship. Perhaps all that means is he’s good with names, but as a parent, it really puts me at ease.
But anecdotal evidence is anecdotal evidence. My fathers small business just had its 3 biggest years. Obamacare really didn’t have a big impact on him, but he already provided health benefits to his workers (often immigrants) of his own choice.
@Cold Dark Matter - Oh yes, I’ve considered everything. If CBD’s would help my son I’d move to Colorado tomorrow. Unfortunately, it’s extremely unlikely they would do anything for him. Our neurologist is an advocate for CBDs and believes there’s huge potential there, but they’re not the golden ticket. Doctors know what receptors CBDs inhibit and there are already medications that do that (my son is on one and tried others). What CBD offers is lower cost, little to no side effects, and it may work more effectively.
Problem with our case in particular is that we’re on our fifth medication and statistically speaking, there’s less than a 1% chance another medicine would do anything for my son. And, at the end of the day, that’s all CBD is, just another medicine. That’s not to say there isn’t tremendous promise. As Twice the Man stated, Keppra (a popular anti-epileptic) can have horrible side effects. Being able to start with something much more mild but perhaps just as effective? That would be awesome.
Now, in our particular situation, we’re also almost out of options. We’ve got a couple more things we can try (and we still don’t know how successful the last surgery was), but if nothing does the trick, I would imagine a family vacation to Colorado will be in order.
@TtM - My son’s seizures are very different than what your son experienced. Tonic-clonic seizures are much worse (in most cases) than what my son goes through, though he has many more of his. Ain’t epilepsy something?
Keppra is the one drug that seems to have helped in the past, but I think the benefits have diminished to pratically nothing. We’re also on Vimpat and a benzo. The good news for my son is he doesn’t seem to get any of the negative side effects. The bad news is he doesn’t seem to get any of the positive, intended results either.
As you’re probably aware, Vimpat is basically just stronger Trileptal which explains why they’re both so ungodly expensive. My son’s Vimpat is $1,400 for a 20 day supply. Yep, no problem hitting our out-of-pocket max. Being able to get drugs from Canada would be nice…
We also work with our local epilepsy foundation. They’re great and have tons of resources. Depending on how things shape up over the next couple-few months, we may be utilizing them.
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I’ll take an American doctor over an Indian doctor absolutely any day of the week!
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This is because you are mildly xenophobic and borderline ignorant. The quality of doctors originating from countries like India / China / Former USSR tend to be of high quality and standard and coupled with high healthcare costs are the primary reasons a whole new industry ‘medical tourism’ has sprung up.
IMO though sourcing doctors / physicians / surgeons from other parts of the world to meet shortfall is akin to opening a can of worms with respect to ethics. There was a shocking statistic a while back related to this where in the entire country of Liberia had ~5 neurosurgeons whereas the USA had 12 in the same field that had been trained in Liberia. The source was WHO if I remember correctly so it was more or less reliable.
I think by “American” doctor he means doctor practicing in America. So an Indian doctor in America would be considered American in this scenario. In which case I also agree I’ll take a doctor practicing in America over one in India 10 days out of 10.
dr nick or indian doctor?
^Hi Everybody!