Posts Tagged ‘Thailand’

From the Editor’s Perch

June 10, 2013

The High Cost of Medical Care

The High Cost of Medicine

To increase the availability of medical care, we must drive down costs.   And I can’t see costs going down until medical consumers begin to shop.  Let me illustrate this with two recent examples.

Recently I had a long standing sebaceous cyst on my lower back removed.  It had slowly enlarged and gotten infected.  The surgeon said it was right on the line between doing it in the office and doing it in a surgical suite.  He would feel more comfortable doing it in the surgical suite, he said.  I have insurance, so it didn’t occur to me to inquire about the cost.

The procedure took 45 minutes of surgical time.  Billing for the hospital surgical suite use was around $8,000.  A bill for $2,000 from the surgeon arrived sometime later.  Sometime later a bill for $1,000 arrived from the anesthesiologist.  This is $11,000.  I had no idea!  After the insurance negotiated and paid their portion, I was still left with around $1600.  out of pocket expense.  This is still quite a bit to have a bump on my lower back removed.

I told my neighbor who said he was in his doctor’s office and showed him a like bump.  The doctor asked him if he’d like it removed?  My neighbor said, “Yes.”  My neighbor said the doctor recruited two nurses and they removed it right there in the office.  He paid $100.  (Whether or not this was the ‘after insurance’ payment or not, I didn’t think to ask.)

In retrospect, if I had stopped to consider the expense of the procedure, I might have done three things.  First, I might have had it removed earlier, prior to its growth and prior to its infection.  Second, I might have opted to have it removed in the surgeon’s clinic offices.  And third, I might have shopped around for a better price.  I told my son, for $11,000 we might both have flown back to Thailand for a week’s vacation, had the lump removed and returned, none the worse.  He’s currently watching me closely for another ‘bump’ to manifest.

My other example is my friend’s experience which I will give you in his own words:

I’ve had a blockage in my left ear since Feb. It was just normal wax
buildup; I tried hydrogen peroxide and carbamide peroxide drops for weeks,
but that only softened it.

I made an appointment for the ear blockage at the clinic where my primary
physician works. They told me they’d clear out the ear canal with an
elephant wash. I asked the nurse how much that would cost, because I’m
uninsured. She said she had no idea and she would check. A day later I
searched for “elephant ear wash” on the web and found the Elephant Ear
Washer Bottle System by Doctor Easy
> . I ordered one with two-day shipping and canceled my

The appointment would have cost $300 for the office visit + treatment.

The Elephant Ear Wash kit cost $30.

It’s nothing more than a spray bottle connected to a very narrow nozzle. I
cleared the blockage in 5 minutes.

The fact that the nurse had no idea that their treatment cost 10 times as
much as a perfectly safe home treatment–and the fact that I never asked or
had to ask about the actual cost before–says a lot about the health care

And folks, there you have it.

Photo by Carl Nelson of a scene from the play, Dark Farce, by Freddie Brinster

Update: 8.22.13  –  This article in the Wall Street Journal provides more focus and information:

From the Editor’s Perch

May 28, 2011


Taking Out Insurance on Modernism in Bangkok

Modernism Chews Up the Third World

“Arguably the most paradigmatic motive of modernism is the rejection of tradition and its reprise, incorporation, rewriting, recapitulation, revision and parody in new forms.”[ 

                                                                                                                                                                                                                                                                                                                                                                                              – Wikipedia

 Imagine Modernism and you might be hard pressed to think of a cultural movement that might more seduce the young ego.  Place Modernism in the mix with “scrumptious” Capitalism (as it was described in a Thai film I saw while visiting) and you have a cultural buzz saw.  I am not a widely travelled person, but just from the information I see and from a recent visit to Thailand, this couldn’t seem to be more apparent.  The young people may still live in Thailand, but on their cell phones and computers they travel about, and live in the virtual world with as much familiarity as the mega-rich… even in the orphanage.  T shirt slogans capture attention world-wide.  And religion, national boundaries, national identities, language, customs… are all looking to be outflanked like the Maginot Line.  It’s really a bubbling caldron out here in the world.  Not necessarily violent, but certainly volatile.

Pray with me.

Photo by Carl Nelson

From the Editor’s Perch

April 21, 2011

Everyone Here at the Office is Headed for Thailand

We’re All Going South

One of the things your Editor is currently “gaga” about is visiting Thailand.  Where he will be for the next month or so…  (Unless he wanders away on top an elephant, never to be seen again.)  It’s supposed to be hot! (I’ll let you know) and beautiful, with superb food and very pleasant people.  I’ve usually thought of travel as for people who haven’t anything better to do… and now I find, I can’t think of anything better to do!

See you all on the flip-flop, and the rebop – and on the B-side, when I’m back from the beachside.  – Ur Editor

Photo by Carl Nelson

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