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Originally posted by ******** I'm currious of how they came up with a bill of 193K USD for an operation? Even at 1000$/hour that is hopefully less than $10,000 If the operation took 5 hours that would something like $40,000/hour? Where exactly do they come up with figures like that?

I had an itemized invoice for it and it was absolutely crazy; however, it's a good eight years ago so I'm afraid I can't recall the details. It was 5 surgeries though, not one... a debridement, bone-graft, nerve-graft, muscle-graft, skin-graft. I seem to recall that the nerve-graft was by far the most expensive item but I cannot recall what the cost for it alone was. I do recall that it was $1,100/night for the ICU bed. As Narcism mentioned the invoice from the hospital is actually a collection of the invoices for all the surgeons involved... the hospital bills the surgeon for the use of the theater and the equipment, the surgeon then bills for their time and the time of their staff adding to that bill the fees they had to pay the hospital, then the hospital amalgamates all the fees from all the surgeons and adds them onto their invoice for the hospital stay.... kind of like how if you have a car repaired for collision damage the body-shop will often outsource the mechanical work or glass replacement and then add those subcontractor's bills onto their own... same thing with surgeries. As a quick note... the same holds true in Canada; invoicing is accounted for the same way, the only difference is that the province gets the bill.

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Originally posted by RickyM you're just a shit version of Moral Hazard. At least he knows what he's talking about.

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Originally posted by pkcRAISTLIN lol, i love it when moral feels the need to lay the smack down

it's not really surprising how much an operation costs when you dig into it.
start with doctors who begin by being in the top fraction of a percent of school leavers, study for longer than any other group, get paid very poorly for years until they study some more and specialise. then add in the insurance, a lot of support staff, some incredibly specialised equipment and a very high ration of staff to patients in before and after surgery care.

How could a doctor cut off a guys arm, which he knew it would be possible to save. That's just horrible.

In the UK everything aside from dental is free, aside from you need to pay £6 for drugs if you aren't exempt (though this is being abolished in Scotland).

Had experience of both Scottish and English systems. Scottish system is needs based, while the English is a weird monster of targets and admin (there is an element of this in the Scottish system).

I got surgery for simple thing (non-urgent) in just over a month in Scotland. A reasonably serious thing to do with my eye (is a check really) in England I can't get an appointment through the massive mess of a system down here at all even though I've been refereed by my GP because they basically stop you getting an appointment if it means you balls up their targets (by getting an appointment outside their target date). So instead they give you no appointment... and every appointment they give is magically within their target date... great! Cunts. Same check in my home town was done within the month too.

Just a huge bloated mess of admin and targets down here. Though I'd never even consider taking the american system. Also disagree with the two tier system. As inevitably the restricted resource would drift towards the top tier.

In fact if I had my way (call me Stalin) would possibly tax to hell the private medical system to try to divert staff back to the public system or to support the development of new staff to replace those who had left to the private sector. (as here doctors etc. get subsidised to train) Hey ho you might get a brain drain to other countries without that tax but it would be fairer.

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If you can read this, I'm seriously fucking bored.