Monthly Archives: October, 2011

Getting An Estimate of Surgery Costs

In cosmetic surgery, pricing may not be as important as the reputation of the provider

If you’re a patient about to enter hospital for a procedure or treatment, one of the hardest things to obtain is an estimate of how much all of that is going to cost. Talk about healthcare being an industry, it is well within a consumer’s rights to know what he is paying for and how much it will set him back.

In today’s world of egalitarianism and transparency, one would expect that  hospitals would give a reasonable estimate of the expected expenditure, in much the same way that a consumer expects a price quote for services to be rendered in practically every other industry. But yet, as a government study in the US published last month confirmed, consumers are usually unable to get accurate information about how much medical treatment will cost them before they receive it.

There were several reasons disclosed for this: difficulty of itemizing health care services in advance, billing coming from multiple providers, and the variety of insurance benefit structures. Add to this legal and competitive concerns about sharing price information, causing price comparisons to be extremely difficult.

I have always maintained that unlike other industries and businesses, healthcare services do not provide any ‘money-back’ guarantees should good outcomes are not achieved. Even if the surgery was a failure and death results, the costs of services provided still have to be paid by the consumer. Worse, if the surgery undergoes complications despite competent surgeons and fail-proof equipment, the unexpected expenditure incurred will prove to be an extra burden for the consumer. Herein lies another problem – the nature of medical treatment and surgery is such that, despite the best of intentions, unexpected complications can occur and upset the most carefully-thought budgets.

In an emergency, pricing and choice goes out of the window

What do I recommend? Several hospitals now put up a price-list on their websites and it may be prudent to search around if you are price-conscious and paying out-of-pocket. But the final decision still depends on other factors like  the quality of healthcare delivery and the reputation of the attending doctor as these do determine a good outcome. Legislation is pending in many countries where it is mandatory to exhibit a price-list so that price variations are transparent.

Even then, these price-lists will come to naught in the case of a medical emergency, where its really a case of Hobson’s choice and the consumer is pressured to pay for the services, like it or not. Yet again another example of why healthcare is not like any other industry..

The Ideal Plate of Food

For more info, go to Healthy Eating Plate.

Curing Credit Card-itis

With unsolicited offers of credit cards coming ‘free-for-life’, its not surprising that many consumers will find that, with easy credit in hand amounting to a few extra thousand dollars, there’s a tendency to  treat it as extra spending money and over-indulge with bliss..till the end of the month, that is.

credit-card-addiction-cartoon

The real danger is when credit card usage passes the barrier of overspending and enters the realm of addiction. Yes, there are increasing numbers who will treat cards as extra spending money and go on a splurge , thereby  forgetting about the liabilities of spending beyond their means and ending up with huge balances at the end of the month, leading to, in extreme cases,  financial ruin.

Credit card addiction (I call it credit carditis) strikes when you least expect it. As with most addictions, the person with the problem is often the last one to realize that they have a problem.

How do you spot the warning signs of credit card addiction?

According to financial planner Julie Casserly, you’re there if you have 3 or more of the following features:

  • You never have cash in your wallet
  • When you do have cash, it burns a hole in your pocket.
  • You buy things just because they’re on sale, or because they make you feel better if you’re upset.
  • You have more than two “branded” or store credit cards.
  • You and your spouse or partner argue over money.
  • Credit cards balances are growing — and not being paid down — each month.
  • Your cards are all maxed out. But instead of paying them off, you open new ones in order to have additional credit.
  • You don’t know how much you owe on the cards you have.
  • You own several things you’ve never worn, used, etc.
  • You hide your credit card statements from your spouse.

How do you cure this addiction?CreditCard

  • Spend cash – this reduces the risk of impulse purchases.
  • Hide the card – out of sight, out of mind.
  • Set your short-term and long-term financial goals.
  • If all else fails, seek counselling. There’s some websites worth looking  –Debtors Anonymous,
    Credit Cards.com

Some governments feel that by imposing an annual surcharge/fee for using each credit card, this  will help reduce the number of cards and help solve the addiction. As one can see from the experience of taxing cigarettes, this method is highly ineffective!


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Steve Jobs – What the Death Certificate Showed

Tributes lie on the pavement outside Steve Jobs home in Palo Alto, California

 

According to the Santa Clara County Public Health Department in San Jose, California which issued the death certificate, the immediate cause of death of the Apple CEO was listed as respiratory arrest with the underlying cause “metastatic pancreas neuroendocrine tumor”.

This puts to rest the speculations that arose when Apple Inc announced his demise without specifying any details. Other facts which emerged, according to Bloomberg:

-he passed away at home, 3pm on October 5.

-no autopsy was performed.

– he was buried at a non-denominational cemetery in Santa Clara County on Oct. 7.

The conclusions that can be drawn from the death certificate implies that the neuroendocrine cancer of the pancreas (the rarer form of cancer of the pancreas) presumably spread to the rest of the body (stage 4) despite the liver transplant in 2009 to remove cancer cells in the liver. This is much in keeping with the seriousness and malignant nature of this type of cancer, where the survival rates are less than 4% after 5 years (less than 4% of sufferers live beyond 5 years).

The Reason Steve Jobs Died

For such a visionary man who had a profound influence on the IT landscape, Apple’s announcement of his demise was strangely devoid of the cause of death. Maybe because Steve Jobs was an intensely private person, but it is a known fact that he had been suffering from a type of pancreatic cancer since 2004.

 

There are two types of cancer of the pancreas : the commoner (95%) exocrine type aka adenocarcinoma and the rarer (5%) neuro-endocrine type aka Islet cell carcinoma. The latter  form was what afflicted Steve Jobs, according to several sources. Although rarer, this form of tumor is slow-growing and can produce various hormones (“functional tumors”), af act which was acknowledged by Steve Jobs in explaining his profound loss of weight.

A gaunt Steve Jobs, as the illness took hold

Patrick Swayze- another victim of pancreatic cancer

 

Nevertheless, cancer of the pancreas, apart from being difficult to diagnose in the early stages, is notorious for carrying a bad prognosis.. only 4% of people suffering from it can expect to live beyond 5 years. So how did Steve Jobs  manage to go on for 7 years?

Standard treatments for pancreatic cancer include the 3 common tumor-fighting strategies — surgery, chemotherapy, radiation and, most recently, targeted anticancer drugs.

Firstly, it was reported that he underwent pancreatectomy (an operation to remove the tumor) when it was first diagnosed in 2004. It is not known whether he underwent chemotherapy or radiation but, subsequently, in 2009, he had a liver transplant which probably meant that the cancer had spread to the liver. Although liver transplants are not the usual way of treating such spread of cancer, it is believed that it can be a form of cure for neuro-endocrine tumors such as the one Jobs had.

In any case, with a transplant, the use of immuno-suppressive drugs became mandatory. These drugs work by preventing the body from rejecting the transplant (which came from a human donor) but carry severe side-effects, like suppressing the body’s own immunity. Sometimes, these drugs can themselves cause fatal effects.

Because of the poor outlook, many sufferers tend to try alternative treatment startegies. Some include the Gonzalez regimen (using enzymes and vitamin supplement), radiation-based hormone therapy and herbal therapy but it is unclear whether he had resorted to alternative therapy.

Despite the best available medical care, the fact that he finally succumbed to the illness goes to show that cancer of the pancreas remains notoriously difficult to treat and still carries with it a rather grim prognosis.

 

Fatty Foods? Pay For It!

In what may be a trend of the future,  Denmark has decided to impose a tax based on the amount of fats in a particular food. The basis behind this is apparently to make the population eat less fatty foods, in an attempt to increase the life expectancy of Danes.

How it works is that a surcharge(“Fat Tax“) is placed on foods high in saturated fat. Butter, milk, cheese, pizza, meat, oil and processed food will all be subject to the levy. The tax amounts to 16 kroner (about USD 3 ) per kilogram of saturated fat in a product.

“Higher fees on sugar, fat and tobacco is an important step on the way toward a higher average life expectancy in Denmark,” health minister Jakob Axel Nielsen said when he introduced the idea in 2009, because “saturated fats can cause cardiovascular disease and cancer.”

The hazard of being obese!

The idea isn’t that original really – last month, Hungary introduced a new tax popularly known as the “Hamburger Law,” but that only involves higher taxes on soft drinks, pastries, salty snacks and food flavorings.In the UK last year, news reports raised the possibility of inposing VAT (currently 17.5%) on foods high in fat(currently there is no VAT on foods).

My view on this is that, as far as foods are concerned, it is equally important to cut down on salt and sugar as well, so does that mean taxes need to be imposed on food in general? The other point is whether the sole objective of prolonging life alone is adequate when many agree quality of life is just as important.

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