Posts by Casey Cook10

Angela Wright said:Dr. Biočina is an amazing vascular surgeon over at Mayo Clinic. My uncle had this massive aortic tear running from his stomach up past his heart about two years ago, and honestly, we all thought he wasn't going to make it—they gave him maybe a 20% chance. But Dr. Biočina was just incredible with him. Now, the guy is totally fine, healthy, and active.

Congrats!
I mean, just to be totally fair though, I think Dr. Biočina is actually a CARDIAC surgeon, so he probably doesn't handle carotid stuff. At a place like Mayo, the cardiac and vascular departments are usually kept separate.
The vascular surgeons there are more like Dr. Šarlija, Dr. Pavić, and Dr. Ajduk.

So, I guess there’s also a vascular surgery department that handles carotid procedures on a regular basis...
And then you've got interventional radiology, where they can just pop stents into the carotid if the situation calls for it, I suppose.

Lawrence Wells said:That’s just nonsense, honestly. I mean, those on-call shifts pay pretty damn well, I guess.😛

I mean, I guess you should probably just swing by one of the coffee shops and hang out there for a bit. You don't even have to actually do anything, really.
I mean, honestly, people in certain professions really should be getting paid based on what they actually bring to the table. But I guess we're still stuck with that old-school, one-size-fits-all approach where everyone just gets paid the exact same thing regardless. 🙄

If they only estimated the stenosis using a Doppler ultrasound, you really have to keep in mind that the results can vary a lot depending on who’s running the scan. I guess you get a much more accurate picture if you go with an angiography or a CT scan instead.
At that point, it might be a good idea to check in with a vascular surgeon. I should probably mention that with a blockage at that level, endovascular options—like getting a stent placed in the carotid artery—are definitely on the table, so you wouldn't necessarily need traditional surgery. Also, how can they even call it "asymptomatic" if you're dealing with dizziness?

Eric Robinson81 said:What are you even getting at? There are laws in America where journalists have been successfully sued for defamation, so doctors could definitely try that.

I mean, with our court system, anyone can basically try anything. And BTW, doctors aren't CONVICTED, they're just SUSPECTED. You don't even make that distinction, so for someone acting all smart when you clearly don't know what you're talking about...

Eric Robinson81 said:Low-income people only get basic services, but I guess it’s more honest to say that than to lie and claim everything is available to everyone, because when you actually need something, you realize you have to pay for it directly to the surgeon, like under the table in a blue envelope.

It feels like we've been waiting for years for someone to tell those low-income folks—who are basically the whole country—what they actually have access to and what they don't. But I guess the government, through its own departments, has just failed to do that for fifteen years now. They just dump all the risk onto the shoulders of doctors who are working themselves to death trying to maintain service levels that just don't match how little the healthcare system is funded. On top of that, the non-medical staff that clogs up the system isn't being laid off, retired, or moved over to private firms that could help out the public system.
And for people who actually want to pay for better, more advanced procedures that our doctors are totally capable of performing in hospitals, they're shut out in the name of this fake equality. It's almost like they don't want certain doctors, like cardiac surgeons for instance, to gain too much influence or financial standing. Instead, they just throw everyone into the same bucket to enforce equality, and occasionally slap people with extra mandatory shifts or whatever...
Meanwhile, I guess the people designing these policies are the ones getting rich off the healthcare system...

Anthony Kim18 said:I mean, let's just skip all those heavy spirits, since I guess the average price tag on them isn't exactly cheap either, maybe around... $50So, I guess if you multiply that by 50, you end up with 7... maybe? $167.

So, here we go... just one of those folks who thinks they can enlighten us all by using basic math to supposedly expose corruption, though I guess they’re basically just trying to lecture anyone with a "lower education" level, if you catch my drift.
I guess the most common gift is just some of that "famous" Jack Daniel's, though if you're considered a "better" doctor, maybe you'll get a couple of glasses to go along with it... aside from the cigarettes, I suppose. $17....
Look, just so we’re all on the same page here, I’m not out here looking for bribes or anything like that, and honestly, I’m not even hunting for much gratitude, though I guess a simple "thanks" for doing a solid job wouldn't hurt... but even that’s pretty rare since most people just head out of the department without even giving you a nod, but whatever. I suppose some folks, for reasons they probably shouldn't have to explain themselves for, feel this sudden urge to show their appreciation, so they end up doing it this way instead. It’s funny because it's usually the exact same people who were making the most noise when we were talking about... $10 I mean, they're shelling out like 50 bucks a month just on administrative fees... it's kind of wild how much they end up blowing on stuff like that, I guess.$33 I mean, strictly speaking, if we’re talking about some kind of "token of gratitude," I guess I'd much rather have the government just pay me that amount per patient directly instead of having to spend my time bagging up supplies, even though I really do value my job and the pay is alright as it is.

Anthony Kim18 said:I guess it depends on how many doctors you're actually looking to see, maybe?
I guess there were maybe like ten of them out today, if that's even right. $250 I guess it’s just a matter of how you look at things, personally.
I mean, if you ask me, that's just a massive stain, I guess.
I mean, if they weren't pulling in salaries or taking bribes, they could probably live pretty comfortably just off their side hustles, I guess... which is wild when you think about how much more most regular people actually put in, even those with way higher degrees and way more responsibility than them.

I guess those big bucks floating around the healthcare system like that mostly just end up in the pockets of liquor distributors or maybe some doctors who happen to be heavy drinkers, though I suppose it also goes toward the bottles I bring along whenever I head over to a friend's place for a visit.
Since I don't actually drink the stuff myself, and I definitely don't have some fancy liquor store stand where I could flip it for a quick buck to live like a king without ever worrying about a paycheck again, I guess I'm just left hoping that someone finally invents those alcohol-powered cars soon, so I can at least find some way to make use of it...

😕

Ashley Moore8 said:okay doc....
I mean, correct me if I'm wrong, but I think Madeline actually has a set price list for certain checkups or surgeries, so if I just show up there and drop 7k bucks—and I'm definitely NOT asking Medicare for any kind of reimbursement, even though I know they work with them as a contracted provider—I don't really see what the big deal is. 😕

I guess you might be mistaken, since you maybe didn't catch everything I was saying in my last post.
The thing is, it wouldn't actually cost you just 7k, it would probably end up being way more depending on the surgery or how long you stay, or if there are complications and stuff...
That 7k is basically just the surgeon's fee (specifically for Professor Turner, which seems fine to me. There used to be prices for other surgeons too, but I think they phased that out recently. It was called a "one-time insurance fee" and it was listed online in the price guide. I know because I actually paid it myself). Supplies aren't even included in that price.
And honestly, as long as Medicare contributes even a single cent toward covering someone's medical costs, I feel like that person shouldn't get any special treatment over any other insured person just because they're paying the rest out of pocket.

Ashley Moore8 said:that doesn't happen at Cleveland Clinic...

It doesn't happen anywhere in public hospitals. I suppose Madeline is allowed to do it just because they've branded themselves as a private facility or something.😕
Like I said... if Medicare is helping pay the bills, then that patient should be treated just like anyone else, and we shouldn't allow people to be discriminated against based on their bank account. Or, if things are going that way, then it should be allowed in public hospitals too—during a doctor's scheduled hours, of course, while paying the hospital, the staff, and all that... which is the most important part for the IRS!!!

Ashley Moore8 said:so I was just looking at Madeline's website

"Madeline is a specialized hospital for cardiovascular surgery and cardiology.
It’s the first private hospital in America."

I mean, that's really just a tiny distinction compared to the Cleveland Clinic...

I guess you don't quite get how the whole system actually works, maybe? Like, there's the whole dynamic of how private facilities deal with Medicare when they're negotiating coverage for massive things like heart surgery.

So, I feel like there isn't much point in us keeping this conversation going since I haven't been able to make it any clearer than this.

Ashley Moore8 said:I guess things just kind of have a way of smoothing themselves out eventually, you know? Maybe everything just starts to feel a little less complicated over time. 😬
It’s not really just about one surgeon (and those massive hospital bills they rack up), I guess... it's more about who’s actually footing the bill for the entire medical team involved in a surgery. You've got more than just one doctor; there's always at least two surgeons, plus the anesthesiologist, the nurses, the surgical techs, and all that, not to mention the operating rooms and all the expensive equipment itself.
I mean, I guess we just need to build a handful of hospitals, get them fully equipped, teach everyone what they need to know, and then handle a few other little things like that. 😬
I guess it’s probably just a matter of figuring out how we're supposed to cover that cost, maybe?

That’s true, I guess... but there was a time when you actually had to think about things. Back in the 90s, medical specialties were handed out based on who you knew or political connections rather than merit, so we basically lost an entire generation of doctors across every single field.

Ashley Moore8 said:I don't really get why people would bother paying bribes for heart surgery, especially when you're talking about figures like $5,000... I mean, if the news isn't totally blowing things out of proportion, there's always an alternative at Magdalena where the procedures probably only run between $2,000 and $7,000.
I mean, I guess if someone actually wanted to go through the trouble of paying off a bribe, they could probably just spend that same amount of cash to do things by the book instead, maybe. 😕

Hey Ashley Moore8 and everyone else, I’m just gonna say it again because I feel like I've lost count of how many times I've mentioned this—just because something is allowed doesn't necessarily mean it's actually legal, you know? It honestly feels like they're just playing by a totally different set of rules when it comes to Magdalena compared to everywhere else.
So, you could actually skip the whole Medicare waiting list at that facility if you paid an extra $7,000 to go with Professor Turin—though I think they recently shut that option down for their other surgeons, leaving it only for him. Since Magdalena operates as both a private clinic and a Medicare provider, they had this unique setup that nobody else really offers. That $7,000 is basically just the surgeon's personal fee, because the actual cost of the surgery is way higher; I was looking at some government data, and it’s closer to $15,000 when you factor everything in. I guess if someone walks in and drops $15,000 upfront, then sure, they’ve covered the whole bill, so they definitely earned their spot at the front of the line. But for most people, it's different. For things like heart catheterizations, it’s either strictly out-of-pocket or fully covered by Medicare under their annual quota. Most of their surgical patients are actually on Medicare, and since Medicare covers all the supplies, the hospital stay, the implants—like a valve that costs over $2,000—and the meds, those patients are essentially treated exactly like everyone else. They just paid a premium to have a specific surgeon handle the job, which is how they effectively jump the queue, since anyone covered by Medicare is technically in the same boat.
I guess that woman should've just paid Simic to cut the line too, though I suppose it wouldn't exactly be legal if she was paying Simic, whereas choosing Turin is totally fine, I guess.😕 Look, I'm not exactly out here defending Simic, far from it, but I guess it feels kind of paradoxical when both sides seem to be cutting the line, right? Maybe if we just let people pay their fair share properly, everyone would actually come out ahead... like, if the public hospitals handled the scheduled cases in the morning and then switched over to private procedures in the afternoon—sort of how they do things overseas—everyone would stay on top of their taxes and everything would just work out fine.
I honestly don't get why people are acting so surprised about that advertisement for Magdalena in the Wall Street Journal today... you should probably ask the author why they’re conveniently leaving out certain obvious facts, I guess. Anyway, a heart surgery can actually be covered for around $7,000 through Medicare, and even the diagnostic stuff like catheterizations and stents usually ends up being way cheaper than that, maybe.

Angela Bailey30 said:2) Fine, let's all just go get medical degrees so we can diagnose ourselves and decide who actually deserves an ER visit and who can just wait their turn.

Hell no!!! Please, by all means, come on in. But maybe don't start threatening the Department of Health or calling the local news when a doctor tells you that your issue isn't an emergency... and suggests you just hang tight until tomorrow...

Jacob Wood9 said:That’s actually why those waiting lists don't even exist...

Well, I mean, they definitely exist. It happens in pretty much any country that's struggling with limited resources. Even in places like Sweden or over in England with the National Health Service.... but there, you can just opt to pay out of pocket for private surgery if you want to skip the line. So if you don't have the cash, you're stuck waiting... which honestly feels pretty similar to how things work here, just without the legal way to pay your way out of it.

jadetinker85 said:Look, lady, when you're dealing with someone willing to let a man die just because he can't cough up the cash for surgery, you really can't be sure what you're getting into...

So, I guess it's like this: guys like this surgeon probably have plenty of people on waiting lists for cardiac surgery everywhere... and honestly, his offer to see him in 2-3 months—which is about how long you'd wait in a place like San Diego—seemed pretty fair. In other parts of the country, you might be waiting two years, so that's not really an issue with him, or John, or Mark; it’s more about the government not having the resources or even trying to build them to shorten those wait times.
From what it looks like in the text, the patient's daughter actually went ahead and dropped 5K on her own after being nudged by "someone from the hospital" who "knew" the cost... even though he didn't even ask for it!!! Up until that point, there might have been a chance to walk away....If she had just asked what it was for, or refused, or returned it... he would've stayed out of trouble... But now, I guess he's right where he belongs.

Maybe we should remember that situation at the Mayo Clinic, where they kept pushing back heart surgeries for kids who needed them urgently, and kids were dying left and right, yet there was hardly any coverage on it.

And now, that same Mayo Clinic crew is showing up acting like the big saviors, claiming they'll operate on the guy without "disrupting the current system" or "hurting anyone else." But, I mean, by definition, someone is going to get screwed over because if they aren't taking a surgical slot, they're taking up space in the ICU that someone else needs.

bluerider2 said:Basically, it just means the funds are a total mess, specifically when it comes to how the money gets redistributed.

I mean, the seniors we have today spent their entire careers contributing to both funds—social security and Medicare—so if those funds were mismanaged, that's definitely not on the retirees.

The whole system just leaks everywhere, and honestly, I guess most of the cash gets wasted because everything is so poorly organized.

The system leaks because the money doesn't actually end up where it's supposed to go. No matter how you look at Medicare, it's being flooded with billions in guaranteed taxpayer dollars, so since it’s government-run, it’s way too easy for them to dip into it for other stuff.
Plus, there's this huge burden of non-medical staff—you know, all the administrative and tech folks—who get paid out of that same pool, so a massive chunk of the budget just disappears into salaries. But I suppose that's just how they buy social peace, since they won't lay anyone off or privatize departments that could be private, mostly because all those workers would just end up unemployed immediately if they did...

@Scott Allen10/">@@Scott Allen10: I feel like primary care doctors really can't do much, especially since the system is basically designed to discourage them from even trying. And why would they? Because any cost for supplies or whatever they use on a patient comes straight OUT OF THEIR OWN POCKET!!! I mean, who in their right mind would pay out of their own pocket like that? It leads to these totally absurd situations where they'll send a patient in 31 miles stone-cold dead just to get a single stitch ($17), plus a bandage $2.25 and instrument sterilization ($50)—those prices are just rough estimates, I guess.

Bradley Barnes90 said:I get you... so I guess that makes the Secretary of Health responsible for most of it?

Yeah, but you've got one former 😈

All jokes aside, I guess every administration up until now is to blame because they just don't want to actually commit to healthcare reform. They know perfectly well that it would mean more costs for everyone, which is basically political suicide for anyone brave enough to even mention it, let alone try to make it happen.
It’s the same people too, honestly—it's kind of weird how Americans have embraced capitalism in every other part of life, yet when it comes to health, they expect the government to foot the whole bill while cutting corners everywhere else. People are struggling, sure, but much wealthier nations handle the social side of healthcare because, well, it's incredibly expensive and only getting pricier. HEALTH COSTS MONEY!!! Just like gas, designer clothes, or a new iPhone... people have money for all those luxuries, but they hate spending it on health. Then there's this whole misunderstanding of insurance, where people see it as just throwing money away for something they might never even need. Like, if car insurance wasn't mandatory, who would actually pay for it???
The folks working within the system realize the standard of care needs to be world-class, but nobody seems to know what that price tag actually looks like.
So, it’s probably easier for the public to just vent their frustration at doctors every day rather than actually asking why the entire system is fundamentally broken (and look, I know not every doctor is a saint, let's be real). And believe it or not, actual corruption isn't about some random $5,000 bribe; there are much larger sums moving through the higher levels of the system, though I guess the FBI doesn't bother looking there....

And that's how you end up in this endless loop where the same old problems just get passed around from election to election without ever being mentioned in a campaign, while the system just keeps sinking... so it’s no wonder corruption exists.

Bradley Barnes90 said:Why on earth are people waiting so long for surgeries that are literally life-saving?
I mean, what are the doctors even doing in the meantime?

Well, they’re out there performing surgery, I guess. Every single day. In some places, they’re pulling two major operations a day—the kind of long procedures that rarely wrap up during normal business hours—and guess what?? They aren't even getting overtime pay (plus, not everyone in the OR actually gets a slice of the pie if there's any extra money to go around).
And honestly, the system just accepts it and looks the other way, year after year.

Scott Allen10 said:I have no clue which referral you're talking about or what the point of it even is.

Well, I guess that referral basically did what it was supposed to do at any other hospital, which was just making sure Medicare covered the treatment costs. And the cash part? That was mostly just so people could "pick their surgeon" and skip the line, I suppose.

Scott Allen10 said:As for the stench... sniff, sniff... hmm... maybe Professor Dr. "Big" T.

Nah, it’s more like that ever-present Prof. Dr. H. I mean, I guess that's why they're allowed to operate like that—it's basically "whatever the gods allow."

Scott Allen10 said:Magdalena isn't just part of the Medicare system. They basically just have a contract with Medicare for a specific number of surgeries per year. I guess you could say Medicare is just one of many parties involved.

Yeah, they probably have contracts covering like 99% of their surgeries through Medicare. So if that's the case, why on earth would you still need to bring a referral when you're paying extra to pick your surgeon?? It’s probably just to cover the costs for intensive care, meds, and stuff like that... I mean, a surgery doesn't cost $50,000. Even with those ridiculous Medicare rates, it shouldn't be that much.

So, I guess Magdalena—which started out as a totally private facility with some pretty shady ownership—couldn't really make it as a purely private business, so they just became this weird hybrid of private and systemic where they can play by whatever rules they want whenever they feel like it... and honestly, I wonder which of their supposed shareholders might be benefiting from that setup...😎

Jacob Wood9 said:I feel like you could probably get pretty much anything out of Magdalena if you had, say, 5k euros to spare.

Yeah, I guess you can technically skip the waiting list legally; it’s just a matter of how you frame it, like choosing your own provider. For example, if you're just using Medicare, you basically get stuck with whoever happens to be available, but if you drop 5k, you actually get to pick your surgeon. And if you're willing to shell out 17k, you could even get Prof. Turin.
Since Magdalena is part of the Medicare system too, I suppose it was pretty convenient that this "anomaly" was totally fine there while other hospitals wouldn't allow it at all...
Paying upfront meant you could just show up for surgery without dealing with any waitlists. And honestly, we just paid it.

I guess I’m seeing that the admins aren't really stepping up when names get called out publicly like this...

And where is her dad even supposed to go for surgery now? Like, will he actually get seen in a timely manner, or is he just stuck on a two-year waiting list and left to whatever happens?

Honestly, anyone else stuck waiting should probably just reach out to the Department of Health—since they've been letting this slide for years—and maybe ask their preferred providers why things are so slow, though I suppose you could just head over to Xavier 200a and find out for yourself.

I guess it’s through the National Institute of Standards and Technology or some agency like that... they're the ones who put those little yellow stickers on things, you know, at gas stations and on scales...
I'm not entirely sure if that's the exact name of the organization, but it's something along those lines, I suppose...