AF Association
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Just Got My Hospital Bill for My Ablation!

Holy Moly!!!!  You guys in the UK and Canada in spite of all the down sides really cant complain. Just for the pharmacy ,recovery room,labs,anesthesia and cardiology the hospital billed almost $80,000 or 55,200 English Pounds. Of course the hospital does their adjustments ;-) and the insurance company pays their adjusted portion. Doesn't anybody think this is totally outrageous? Too bad we couldn't negotiate with them and say "hey, we want to pay cash  where is  our discount ?" I feel I'm fortunate that when all said and done I'll pay under $500 (345 Pounds) for mine. Was it worth it ? YES!! But what about those over here who need it but are looking at huge medical copay's so they just put it off. Ok, I'm officially off my soap box.

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What down sides?

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Waiting time for out-patient appointments and time it takes for procedures (operations/investigations etc)months sometimes!

Appointments with GPS ! 

Our A&E services are excellent,but other services need improving!

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Wow, terrifying costs.  Be well and good luck for a af free future.

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Too right, we must do all we can to protect our NHS and the right for everyone to receive treatment on the basis of need and not private medicare. 

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Yes, but I always think there is something unfair about being the only one in a queue of 20 people who pays for his prescription.  The system at times seems to work against the tax paying classes. I wouldn't get rid of the NHS, but it does need to be dragged organisationally into a modern customer oriented culture.

Bomb dropped, I'm off...

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Even though some of us are over 60 and get it free we are still tax paying classes!!!!  In fact the amount of tax and NI that I have paid over the years is very much more.  Also some of the people in the queue may have bought a prescription pass!!!

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Unfortunately I am in that minority that have to pay when 90% of prescriptions are given for free. But really I can't complain as a beneficiary of a costly operation.

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Don't forget also that those of us over 60 have been paying our national insurance for in excess of 40 years, so have paid up front! Some of us have also been paying for private health care while at work, thereby saving the national health service the cost of treatment while still paying for the NHS?

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Interesting Andyu80

I did a little research and to my surprise you are right.

90% of all prescriptions are free, so only 10% pay.

However

60% of them are for the over 60s who of course do still pay tax and have paid NI for the whole lifes.

6% are for the young (up to 18 in full time education of up to 16 otherwise), and I am sure that you don't want them to pay for their prescriptions.

7% are for those in maternity or other temporary medical need.

That leaves 17% who are getting free prescriptions mainly on the basis of low income and being in receipt of benefits.

But I was surprised at the overall number of 90% but it does need to be broken down further to actually see who is claiming.

Be well

Ian

 

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Paulh, you must be in the US. I'm going for an ablation soon and I can't believe the cost! I'm on Medicare with a supplemental and hope all will be good. Not sure Obamacare has helped anyone. Best of health to you! 

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Private hospitals are part of the problem...I had a simple procedure recently not AF related and when I went to settle the account was told "if you pay now the cost is £420 and you can claim it back through your private health care"....if we being the hospital have to deal with your PHC then the cost will be £675...the NHS is something we should be very proud of and often taken for granted..but we are taxed to death on everything which supports it....

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Hi gosh that's horrendous.  Personally I don't see any downsides to having one of the best medical systems in the world, available equally to everyone regardless of financial health (even visiting Americans 😊).  I suspect the dear old NHS got a lot of bad press in the US during the Obama Care debates but don't believe everything you hear.

For comparison however it is worth mentioning that the local private hospital here (Aberdeen so very high per capita wealth and correspondingly high cost of living) the ablation all inclusive price is under £2,000.  

I hope.you make a full recovery and don't have to shoulder any of that punitive cost yourself.  Be well. 

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£2K? I was quoted £1,500 for a cardioversion plus the cost of two consultants appointments and that was the cheapest after asking hospitals from Kent along the coast to Devon .

Others here have been told 'You don't want to know' when inquiring about having an ablation privately. I have heard of charges of £15K.

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I think that £15k was the number many years ago.  Even some of the high cost London ones do not charge that now!!!

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Presumably ablations are costed by time taken as much as anything and they can take up to six hours. My local private hospital charge £1870 just for a colonoscopy, and £1595 for a cardioversion plus the consultants fee. Angioplasty and Ablations don't have a fixed fee and are obviously dependent on factors involved.

I'm about to pay £995 for a three part spine MRI scan plus around £250 for the radiologists report.

Cost for fitting a Watchman device at London Bridge hospital is about £16K plus two consultations and CT scans before and after.

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Mine was £30,000 and that was in 2006 and that was in the uk. Fortunately we had insurance that covered it. All the rest have been NHS and have not had to wait that long either

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That is a lot of money for a procedure that presumably did not last as you then had NHS ones. Was it based on the time taken to do it?

It is about £2K more than I was quoted for having my aortic valve replaced four years ago. One hospital said that it would be an unknown amount more if it turned out that I also needed a pacemaker.

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As with all operations and procedures that require new equipment thay are initially very expensive. This is because the manufacturers have to recover all the development costs, launch costs, training costs, etc, as well as their normal manufacturing and overhead costs. Roll on a few years when all those costs have been recovered they can reduce their price. That often had a double effect because then more hospitals can afford them and the unit manufacturing cost drops further.

The the hospitals have to recover all their costs which not only include the equipment but also new or refurbished cath labs, training, etc.

Then the consultant and their team costs need to be considered. Initially they will be higher because they are not as familiar or as slick initially as say 10 years later. My hunch is that an ablation that took 4 hours in 2006 would probably be done in 3.0 to 3.5 hours now.

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Hence prices drop.

And competition reduces prices!!!

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2K for  an ablation, are you sure ??  I was quoted  15K seven years ago

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As a fellow Scot, hearing that Aberdeen can do an Ablation for £2K is very upsetting as I have just paid over £13K (including initial and follow up consultations) for this op in London. I wonder how there can be such a huge difference in the charge?

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Hi there sorry to cause you any upset I got the figure wrong! Don't have a clue what the ablation figure is here I was looking at entirely the wrong procedure on the hospital list.

Hope you're feeling better now anyway.

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My cardioversion cost under £1k so it can't be that!!!!

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I agree that free prescriptions are a problem. Although I paid my NICs for 44 years, I am well aware those payments did not build up any sort of credit but were used up in the year in which they were paid. So the benefits that I get in old age are coming out of today's taxpayers' pockets, many of whom have the additional burden of paying for their prescriptions. If our NIC payments had been actuarially calculated so as to build up a fund to pay for pensions and senior benefits, they would have had to be many times higher, and even then there would be likely to be a deficit because no one could have accurately calculated what the future cost would be.

It is clear that whatever party is in power in the UK, the cost of the health service will rise massively every year. Apart from huge improvements in treatments and drugs, which must be welcomed but have to be paid for, the founding fathers of the NHS could never have envisaged that it would be paying for cosmetic surgery, abortions, IVF and the myriad other things for which there is an insatiable demand (I make no judgement here other than a financial one).  

What can be done about this? Very little, I suggest, but tinkering at the edges might help to make people realise that nothing is free. So far as prescriptions are concerned, one suggestion might be for all of us to pay for our prescriptions, but those on low incomes to be able to reclaim.

Another possibility would be for the pharmacy to require evidence of eligibility for free prescriptions. I am never asked for this, but as I am 73 I regret to say it is probably obvious. But I observe that  many younger people are never asked for evidence.

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I agree that It is almost impossible to fund the NHS to the extent that is demanded.

We pay for far too many procedures which are to my mind not absolutely necessary. If people want IVF why should I pay for it out of my taxes? Abortions save the taxpayer tons in the long run. The cost of a child to the state is masses - education etc.

It costs a fortune for end of life care, which is sometimes forced on the poor victim who would rather be allowed to die peacefully when they wish to do so. Why do we do that? What right has anyone to tell me that I should be kept alive at vast expense when I don’t want it and therefore others are being deprived of proper prompt medical care?

There is far too much form filling in the system.

I have seen a complete lack of common sense and kindness in some hospital wards with a total tick box mentality. In others it was the opposite.

I believe there is a lot of waste in the system when it can cost far too much for everyday items rather than them being cheaper because of scale of purchase.

Why do we need so many expensive administrative staff pushing paper?

If you miss an appointment for no really good reason you should be made to pay something.

Foreigners should be made to pay for their treatment, unless we have a reciprocal arrangement, or they should pay a ‘health insurance tax’ per day when they enter the country which would pay for emergency care while they are here.

I know the above will not be popular but we have to do something about our spiralling costs. As our PM says money does not grow on trees.

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The cost of administering a claim back system would be high and would also eat up a very large part of the savings. Also it would psychologically put off a load of older people to take medicines because they would think that they would save some money by not having the medicines and some would calculate it as £8.40 per time even though they probably had the annual pass which costs circa £100.

With the computerised system the pharmacy automatically knows you are entitled to the over 60 no pay rate.  Some other categories are entitled to free medicines (eg some benefits or someone who has an annual pass).  The passes are certainly checked by chemists.  However if someone falsely claims that they are entitled to free prescriptions in those categories and actually gets away with it at the point of sale then the logging and payments system will pick that up and they will be issued with a £100 penalty notice and in addition have to pay the cost.

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Thanks Peter Wh, that is reassuring. My comment about what can we do about the NHS cost increase juggernaut still stands however, and no, I don't recommend an insurance system. Changing the rules around prescription charges would only be tinkering round the edges in any event, but perhaps the age at which prescriptions are free could be linked to the retirement age, which is now above 60 for both men and women.

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I think that originally (well years back) it was 65 for men and 60 for women.  Then it was felt that that was discriminatory (which it was) so it was made 60 for both. However the nett cost for dropping the charges for men between 60 and 65 was actually very small because actually thee take up of prescriptions was small and many of those who did actually purchased an annual passport, thereby limiting their costs.

I also forgot to mention before that there needs to be a factor (ie extra money) included for additional costs of hospital stays, GP visits, A&E visits, etc that people would end up making because they had saved money by not having the medicines.

As you rightly say these charges would only be tinkering around the edge of the system.  I did read that one really big wasted cost item is people not attending appointments. Hence why many CCGs / GPs send text reminders two or three times in the run up.  Even then there are still a large number. 

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That's a scary amount of money!

Yes we are very lucky to have a National Health Service (despite its current problems and lack of funding) but we're British so we moan about it (and the weather of course).

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$80,000 sure seems like a lot of money.  My first ablation under light sedation cost about $50,000 and the second one, under full anesthesia, was about $80,000.  So, Paul, your cost figure seems about right to me (I'm in Wisconsin).

Now consider what you get for that:

- Very high-tech equipment, including 3D heart scan and remote control surgical tools;

- An EP team that works together to make sure everything goes right;

- A hospital with all that technology, the people, and the supporting resources in case something goes wrong;

- Various drugs that of course support pharmaceutical CEOs 7- and 8-figure salaries;

- Lots of padding, thanks to the "chartmaster" system of billing;

- Your life back.

That seems worth it to me, especially considering I, like you, paid only a tiny fraction of the cost.

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The last line"your life back" hit the nail right on the head. What I was saying  is that they balloon the price up because who can verify the pricing structure. You know they are still making a profit even with the deep discounts and adjustments. The average person who doesn't have a great health plan has to look twice at these costs and whether they can afford to have the procedure. We can not negotiate price other than to shop around for elective  procedures but then we have to make sure our insurance will cover this hospital and at what cost.

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Paul, if you want to know the inside story of hospital charges, read this article:

uta.edu/faculty/story/2311/...

Wikipedia has a reasonable summary of the practice:

en.wikipedia.org/wiki/Charg...

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