Author Topic: Do you ever gamble with your health to save money?  (Read 10097 times)

gbbi_977

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Do you ever gamble with your health to save money?
« on: November 18, 2015, 12:14:50 PM »
OK everyone, this is a tricky one. First off, I am not asking for medical advice, as a DIY forum is obviously not the place for that. This is a decision DH and I need to make ourselves, but I've changed my mind at least a dozen times this morning and maybe I'm not so much asking a question as just trying to sort some things out in my head.

A bit about me - young (early 30s), excellent health, no concerning/relevant family history.

A routine breast exam and my GP found some lumps. Had an ultrasound to follow up back in June - report said there were multiple lesions/lumps (according to my mom, "lumpy [benign] breasts" run in the family) and all appear benign but to have a doctor follow-up. Saw a breast cancer specialist, who looked at the ultrasound images/report, did a manual exam, and said he was "absolutely not at all concerned about any of these" but come back in 6 months (January 2016).

Decided (as I'm a hypochondriac) to go for an ultrasound last week. Radiologist (they are doctors, not just technicians FYI) told me that she was not at all concerned about any of the (innumerable) lumps - they all looked benign, no biopsies needed. Just as I was about to leave, she changed her mind and said "actually, I'm still not concerned, it definitely appears benign, but one of them may have grown slightly so let's have a biopsy just to be sure."

OK so here's my dilemma. I'm pregnant, which may explain the growth in the lump. And it also means that next year, I'm definitely going to hit my deductible and probably my max out of pocket. If I wait 45 days and have the biopsy January 1st, that cost kind of gets "absorbed"; if I have it now, online estimator says I can expect to pay between $1000 and $3000 out of pocket.

Can I afford that? Yes - although like a good mustachian, I like to save money! Every doctor who has looked at my ultrasounds and done a manual exam says very low chance of malignancy.

On the other hand, we're talking cancer! It's absolutely crazy to risk an extra 45 days of undiagnosed cancer just to save $3000, right?

I think I know that I need to get the biopsy now, because I'd never forgive myself if I put myself in danger to save money. But this has got me down about a user-pay healthcare system in general (the original ultrasound was done in my home country, where healthcare is free for all). How often do people in a high healthcare cost nation pause before seeking medical treatment/evaluation because they're weighing up the risk versus cost? Does it even make sense to be considering waiting until January?

Again, I'm not asking you to tell me what to do, and please be civil if you think I'm a complete idiot for even considering waiting until January. But I'm curious: have you personally had experience with making this sort of decision? What guided you?

lbmustache

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Re: Do you ever gamble with your health to save money?
« Reply #1 on: November 18, 2015, 12:21:24 PM »
My opinion and I am in no way a qualified medical expert.

It sounds like, worst case scenario, you may have a malignant lump. From what you are describing, it doesn't sound like the doctor's are too concerned that it's going to be serious, an aggressive form of cancer, or that it has spread to other parts of your body. With that said, a month or two would probably make very little difference, if any. You most likely do not have cancer based off the doctors' reactions.

FWIW, a friend of mine has breast cancer and it has taken her 6 MONTHS to get from the biopsy stage to the removal + radiation stage thanks to our bogus healthcare system. The cancer doesn't seem to have progressed although this chain of events might have been different if she had an aggressive/rapidly spreading cancer.

Good luck with everything, btw!
« Last Edit: November 18, 2015, 12:25:31 PM by lbmustache »

Freedom2016

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Re: Do you ever gamble with your health to save money?
« Reply #2 on: November 18, 2015, 12:29:55 PM »
You have time.

A lot of cancers are slow growing, and when I was diagnosed and faced a 6 week wait between biopsy and surgery, everyone I spoke to said that that gap would not make a difference.

Given that the doc is rather unconcerned but feels she must do due diligence, I would say you should be fine to wait til January. Schedule it for January 2. :)

use2betrix

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Re: Do you ever gamble with your health to save money?
« Reply #3 on: November 18, 2015, 12:32:32 PM »
I am in a somewhat similar situation but not overly concerned about the costs.

I am 27 and was diagnosed with skin cancer near my eye this week (BCC). I had the biopsy done last week, which was $300.

I am waiting until January to get it removed mostly because they aren't available for 3-4 weeks anyways and also cause I'm getting married in 6 weeks. The doctor said that's zero issue as this has likely been growing 5-10 years anyways.

Let me look at it this way. Even if it was cancer, would they still perform surgery while pregnant? Not sure how that works so just asking.

I don't know much about breast cancer, but I'd look into it more. If it seems like 6 weeks is a major difference, then go ahead and do it. If not, I wouldn't be too concerned.

Did you ask the doctor her opinion of waiting? That'd be the best step, and I'd honestly do whatever she says. Cancer is no joke, nor is risking your health, especially with a baby on the way you want to make sure you're able to stick around for.

AgentCooper

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Re: Do you ever gamble with your health to save money?
« Reply #4 on: November 18, 2015, 12:35:27 PM »
The question I ask myself (and the doctor) is:  What would they do if they did the test/lab/etc. and it came back positive?  Then what?

If the answer is, "Well then we'd need to immediately start aggressive treatment," then I am much more likely to act now.  (And how likely is it, that they would start you on some sort of cancer treatment while pregnant?  Would knowing now, rather than after baby delivery, even matter?)

An answer that is never good enough to cause me to consent to a test or procedure is, "Well, then you'd know what the problem is."  For me, "Let's do it just so we'll know" is not a reason to agree to a test.

Of course, your situation is your own and you have to do what you think is right.  I just advocate knowing the "why" of every procedure, and the next steps, before giving them the go-ahead for anything.

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #5 on: November 18, 2015, 12:41:42 PM »
Thanks all for your replies.

Re: asking the doctor if I can wait - maybe this is overly cynical, but I'm assuming that no health professional anywhere will ever say "I think you can wait, even though the radiologist said it needs a biopsy" because of liability potential.

Now I know that makes it sound like I think doctors care only about liability, and not patient health - obviously not true. But hear me out...in England, where all healthcare is on the public dime, would they be ordering this  biopsy, given that every single feature of the lump (other than small amount of growth, which could be due to pregnancy or could be due to difference in measuring techniques between here and England where I had the first u/s done) indicates benign [any medics reading along: minimally hypo echoic with posterior acoustical enhancement, wider than tall (ovoid), well defined, no blood flow]? Or would they adopt a wait and see approach?

I guess I'm wondering if there's a chance doctors are more test-happy here because they know we're the ones paying for it?

I would like to ask my doctor: if you had been unemployed for 18 months (which I have) and if you knew you could save $3000 by waiting 45 days, would you do the test now or wait 45 days? And I feel like that's not a question a doctor will be willing to answer...

rubybeth

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Re: Do you ever gamble with your health to save money?
« Reply #6 on: November 18, 2015, 12:48:36 PM »
Um, not to totally scare you, but I have a relative with breast cancer, and she found out she was pregnant about a week after the cancer diagnosis, and now that baby has been born, it's stage 4 (has spread to another organ, even though she did chemo while pregnant--yes, chemo while pregnant is possible). This relative was 29 when diagnosed. It's now palliative chemo for her, for the rest of her life, which we are hoping will be long so she can see her baby grow up, but who knows.

I would absolutely do the biopsy sooner rather than later, because if, on the remote chance that it is cancerous, swift treatment could make a huge difference. It could absolutely matter to know now vs. later, especially while pregnant. As with my relative's cancer, all the pregnancy hormones could be 'feeding' the cancer. I am sure that, if my relative could go back in time and be diagnosed sooner (even 45 days sooner), she would choose that, whatever the cost.  It could change all kinds of things in terms of your labor & delivery, too.

And, I am hopeful for you that it is not cancerous because of the family history of lumpy breasts. Will be thinking about you. Sincerely, the best of luck to you.

ThirdTimer

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Re: Do you ever gamble with your health to save money?
« Reply #7 on: November 18, 2015, 01:03:50 PM »
Annajane, I would ask the doctor exactly the question you propose. I'd ask her in even more detail. Ask her what the odds are of this being malignant, what the course of action would be if it turns out it is malignant, particularly given your pregnancy, and what the possible consequences could be of waiting until January 2nd for the biopsy.

She may not be willing to give you an answer directly about what you should do, but she can give you a lot of information that could inform your decision (like, for instance, that it would be possible to perform chemo now, but not in two months because the baby would be too developed, or vice versa, or that if it is cancer it's likely to be very aggressive, etc., etc.). I'd get as much information as you can from her before making a final decision.

Exflyboy

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Re: Do you ever gamble with your health to save money?
« Reply #8 on: November 18, 2015, 01:31:43 PM »
My guess is that the radiologist sensed your anxiety and God forbid she said she wasn't concerned when you were almost insisting it be looked it.. and then it eventually turned out to be cancer... LAWSUIT!

From what you have said I'd probably wait as it sounds like if the lump has grown its growing very slowly.

One piece of firm advice I can give you.. before going ahead with ANY chemo make sure you have the Dr get pre-approval from the insurance company. A friend of mine ended up shelling out over $100k because he assumed it would be covered.. "Oh sorry we don't cover that drug".. They are slippery bastards at the best of times and will do whatever they can to avoid paying.

use2betrix

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Re: Do you ever gamble with your health to save money?
« Reply #9 on: November 18, 2015, 01:34:27 PM »
Thanks all for your replies.

Re: asking the doctor if I can wait - maybe this is overly cynical, but I'm assuming that no health professional anywhere will ever say "I think you can wait, even though the radiologist said it needs a biopsy" because of liability potential.


Did you not read my response? I was diagnosed with skin cancer this week (albeit not breast) and my doctor said putting off treatment a couple months is zero issue at all. So don't go jumping to conclusions.

If the doctor says you need to do it, then I'd get it done. Your about to have a baby, think of the baby if you don't want to do it for yourself. Heck, even get a 2nd opinion, that'd be cheaper. But I wouldn't put that off if they say not to.

Sibley

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Re: Do you ever gamble with your health to save money?
« Reply #10 on: November 18, 2015, 01:51:09 PM »
OP, here's the facts.

1. Your family has a history of benign, lumpy breasts.
2. You're pregnant, which is known to cause breasts to change shape/size
3. There's a lump which may have grown slightly.
4. You've had 2 doctors tell you it's probably nothing.
5. The 3rd doctor tells you she's not worried, it looks benign, but lets do a biopsy to be sure.

Calm down. Take a deep breath. You have 2 proven reasons for this to be happening right now - family history, and the pregnancy. You've had plenty of doctor-y reassurance. Most likely it's nothing. You can wait until January. Learn to meditate or something if you need to, and get it checked out in January.

And congrats on the baby!

Villanelle

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Re: Do you ever gamble with your health to save money?
« Reply #11 on: November 18, 2015, 01:53:46 PM »
The doctor will still make her money, just a month and a half later, so there's little reason to lie.  I would ask.  At a minimum, she says it can't wait and you have to filter that through the cynicism, and you are no worse off than you are now.  At best, she says it can definitely wait, and your question is answered. 

Guava

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Re: Do you ever gamble with your health to save money?
« Reply #12 on: November 18, 2015, 04:10:31 PM »
I am not familiar with breast lumps or breast cancer but I will say that it took a full month to diagnose my blood cancer. After that diagnosis I was looking for a better equipped hospital to deal with my particular strain. One hospital said my case didn't warrant an immediate appointment and I had time to wait and scheduled my first appointmrnt for a month later. Another had a unplanned opening and squeezed me in but said I have a slow growing cancer. But not all cancers are slow growing. And I don't want to cause fear, but my first doctor wasn't overly concerned about my lump either, but subsequent testing was always bad news and radiologists kept recommending more tests.

What I would do: call to schedule the appointment.  With the holidays, it may take awhile to get you in. If its the difference between the last week of December and first week of January, wait. If not, get it done for the peace of mind.

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #13 on: November 18, 2015, 04:27:28 PM »
Thanks all for your replies.

Re: asking the doctor if I can wait - maybe this is overly cynical, but I'm assuming that no health professional anywhere will ever say "I think you can wait, even though the radiologist said it needs a biopsy" because of liability potential.


Did you not read my response? I was diagnosed with skin cancer this week (albeit not breast) and my doctor said putting off treatment a couple months is zero issue at all. So don't go jumping to conclusions.

If the doctor says you need to do it, then I'd get it done. Your about to have a baby, think of the baby if you don't want to do it for yourself. Heck, even get a 2nd opinion, that'd be cheaper. But I wouldn't put that off if they say not to.

Hi Trixr,

Sorry if it felt like I didn't read your response - I did, and I appreciated it, and I'm also sorry to hear about your diagnosis although it sounds like the prognosis is very good? Best of luck...I guess I feel like the situation is *slightly* different in that from what I understand, your doctor said it would not make any difference whereas my radiologist said to get the biopsy straight away. I'm not assuming no doctor will every say 'this can wait', obviously in some cases it can wait....I'm just a little unclear how to get a straight answer from a doctor in *this* situation (where a radiologist has expressly said 'don't wait') as I think liability issues may arise?

Thanks again for your reply.

Samala

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Re: Do you ever gamble with your health to save money?
« Reply #14 on: November 18, 2015, 07:40:21 PM »
I guess I feel like the situation is *slightly* different in that from what I understand, your doctor said it would not make any difference whereas my radiologist said to get the biopsy straight away.

If your radiologist truly said to get the biopsy done straight away, then I would call their office and get it scheduled.  As others have mentioned, in the US system, there can be long wait times even for things that seem incredibly urgent to the patient.  The question of waiting 45 days may be moot after you make that call. 

Cynicism aside, it's worthwhile to ask the radiologist what they would do in your situation and considering the financial impact.  We haven't had our current healthcare environment very long - nearly all physicians in practice today will remember pre-ACA when financial considerations often weighed heavily in healthcare decisions.  She may hedge, you're right, but its worth asking that question.

You asked: How often do people in a high cost of healthcare system pause before seeking treatment?

All the time.  There was even a recent NYT article about the impact of higher deductible plans. http://www.nytimes.com/2015/11/15/us/politics/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html

But when push comes to shove, the average American is willing to go into debt over medical bills (if they can access credit) rather than hold off on care.  (See the proliferation of credit cards aimed exclusively towards healthcare expenditures like CareCredit.)

okits

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Re: Do you ever gamble with your health to save money?
« Reply #15 on: November 19, 2015, 02:53:37 AM »
OP:
Quote
Again, I'm not asking you to tell me what to do, and please be civil if you think I'm a complete idiot for even considering waiting until January. But I'm curious: have you personally had experience with making this sort of decision? What guided you?

I understand the temptation to wait, but I'd do the biopsy now (as someone else said, if the earliest appointment is Dec 23, then okay, wait until Jan 2.)

$3k is a chunk of change, but we could easily pay it and would never miss it, and it sounds like you're in the same boat.  Having the money plus having responsibilities (spouse and child) would make me behave very cautiously.  (In your situation I would be concerned about how pregnancy hormones would change the growth of the lump vs. what the doctors expect.)

I have been in a situation where paying thousands and thousands of dollars out of pocket would give me a better medical experience (and quite likely a better outcome.)  After a brief examination of the numbers DH and I whipped out the chequebook.  No regrets.  This is why we have money saved: to look after the important things and to make our lives easier when misfortune strikes. 

Best wishes, I hope it is benign!

11ducks

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Re: Do you ever gamble with your health to save money?
« Reply #16 on: November 19, 2015, 03:04:24 AM »
Mustachianism is about choosing to use your money for what is important to you. If you are the type of person who is going to stress over it for the next few months, then get it done. It's a one-off occurrence, and a fairly unique situation. Sometimes peace of mind is worth it.

(Ps- I had to get a specialist root canal this month ($3000),  was trying to hold off till my health insurance kicked in (January) but it wasn't meant to be. I feel your pain. Que sera sera). It's only money.

Rachelocity

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Re: Do you ever gamble with your health to save money?
« Reply #17 on: November 19, 2015, 06:14:48 AM »
I would do it sooner rather than later, because $3000 is a small price to pay for peace of mind.  The money is replaceable.  Being able to enjoy the remainder of your pregnancy without a possible Sword of Damocles hanging over your head is priceless. 

ShoulderThingThatGoesUp

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Re: Do you ever gamble with your health to save money?
« Reply #18 on: November 19, 2015, 07:30:11 AM »
You can't take it with you. There's no point to being financially secure if you're not going to take care of yourself.

The_path_less_taken

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Re: Do you ever gamble with your health to save money?
« Reply #19 on: November 19, 2015, 07:42:51 AM »
I would do it sooner rather than later, because $3000 is a small price to pay for peace of mind.  The money is replaceable.  Being able to enjoy the remainder of your pregnancy without a possible Sword of Damocles hanging over your head is priceless.


1+

First, congrats on the pregnancy.

Question: if it were cancer, would that impact the baby if left untreated?

Also....some things are hereditary and easiest to pass on from one gender or another...diabetes supposedly is passed more often thru the mom (or so mine told me years ago). If it were cancer, would eliminating it early help to prevent that?

I guess I just don't understand how anything but a surgical solution could happen while pregnant...

Regardless: I'm thinking good thoughts for you AND your baby. Good luck and please keep us posted.

rubybeth

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Re: Do you ever gamble with your health to save money?
« Reply #20 on: November 19, 2015, 10:34:32 AM »
I would do it sooner rather than later, because $3000 is a small price to pay for peace of mind.  The money is replaceable.  Being able to enjoy the remainder of your pregnancy without a possible Sword of Damocles hanging over your head is priceless.


1+

First, congrats on the pregnancy.

Question: if it were cancer, would that impact the baby if left untreated?

Also....some things are hereditary and easiest to pass on from one gender or another...diabetes supposedly is passed more often thru the mom (or so mine told me years ago). If it were cancer, would eliminating it early help to prevent that?

I guess I just don't understand how anything but a surgical solution could happen while pregnant...

Regardless: I'm thinking good thoughts for you AND your baby. Good luck and please keep us posted.

Treatment wouldn't affect genetics. But yes, chemo can be done while pregnant to slow growth and prevent the spread of cancer. See my relative's story above.

And having cancer could affect labor & delivery; they may want to induce mom earlier in order to start treatment, for example, or do a c-section (or specifically try to avoid a c-section, depending on where the cancer is).

GuitarStv

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Re: Do you ever gamble with your health to save money?
« Reply #21 on: November 19, 2015, 12:35:13 PM »
You can't take it with you. There's no point to being financially secure if you're not going to take care of yourself.

+1

You can always make more money if you're healthy.  More money doesn't always allow you to stay healthy though.

Gone Fishing

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Re: Do you ever gamble with your health to save money?
« Reply #22 on: November 19, 2015, 02:11:05 PM »
OP, here's the facts.

1. Your family has a history of benign, lumpy breasts.
2. You're pregnant, which is known to cause breasts to change shape/size
3. There's a lump which may have grown slightly.
4. You've had 2 doctors tell you it's probably nothing.
5. The 3rd doctor tells you she's not worried, it looks benign, but lets do a biopsy to be sure.

Calm down. Take a deep breath. You have 2 proven reasons for this to be happening right now - family history, and the pregnancy. You've had plenty of doctor-y reassurance. Most likely it's nothing. You can wait until January. Learn to meditate or something if you need to, and get it checked out in January.

And congrats on the baby!

The voice of reason, thank you. 

As a self diagnosed hypochondriac, the OP doctor shopped until she found someone willing to recommend a biopsy and now is looking for justification to do it ASAP.  I would have stopped at the first doctor, certainly at the second.  I don't have any data on the subject, but I wouldn't be surprised if the miniscule risk of infection etc. from the biopsy isn't more dangerous in the short term than a slowly growing tumor.  Many doctors are perfectly willing to run just about any test you ask for unless there is a severe risk of complications.  Overtesting is well documented:

http://www.scientificamerican.com/article/medical-procedures-prove-unnecessary/

Having been thoroughly injected, inspected, detected, infected, neglected and selected in the past, I do my best to avoid doctors unless something obvious is wrong.

That said, best wishes for your baby and I hope everything goes well!

Astatine

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Re: Do you ever gamble with your health to save money?
« Reply #23 on: November 19, 2015, 02:58:19 PM »
Um, not to totally scare you, but I have a relative with breast cancer, and she found out she was pregnant about a week after the cancer diagnosis, and now that baby has been born, it's stage 4 (has spread to another organ, even though she did chemo while pregnant--yes, chemo while pregnant is possible). This relative was 29 when diagnosed. It's now palliative chemo for her, for the rest of her life, which we are hoping will be long so she can see her baby grow up, but who knows.

I would absolutely do the biopsy sooner rather than later, because if, on the remote chance that it is cancerous, swift treatment could make a huge difference. It could absolutely matter to know now vs. later, especially while pregnant. As with my relative's cancer, all the pregnancy hormones could be 'feeding' the cancer. I am sure that, if my relative could go back in time and be diagnosed sooner (even 45 days sooner), she would choose that, whatever the cost.  It could change all kinds of things in terms of your labor & delivery, too.

And, I am hopeful for you that it is not cancerous because of the family history of lumpy breasts. Will be thinking about you. Sincerely, the best of luck to you.

Yep. I'm going through breast cancer treatment right now (diagnosed in July). My cancer is aggressive and fast growing (I didn't even feel a lump - just my skin is hyper reactive and developed a rash in response to the cancer just beneath the skin). I was scheduled in to see a surgeon about 5 days after diagnosis and had surgery 2 weeks later. The lump was only 2cm (less than an inch) but had already just started to spread to a lymph node.

Nobody thought it was cancer til the biopsy results came back. Me and my GP could not feel a lump, the view on the ultrasound didn't look like cancer to the radiologist (it looked like an infection or the result of a car accident) and they did a biopsy because the docs wanted to know what antibiotic I should be put on. But, it was cancer. Again, not telling this to panic you but if I was in your shoes, I'd be getting the biopsy now. For peace of mind if nothing else. Unfortunately, breast cancer isn't a rare cancer, even for younger women (I'm in my early 40s, haven't gone through menopause).



Also, offtopic rant: $1000 to $3000 for a breast biopsy is crazy expensive. I went through the private system for my scans and biopsy so it was user pays with a small rebate from Medicare. Even without the rebate, my user-pays fee for ultrasound and fine needle biopsy was less than $500. (a core biopsy, which is a bit more invasive and takes a bigger sample, wouldn't have cost much more - have had one of those in the past to check one of the many benign large lumps in my other breast)

albireo13

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Re: Do you ever gamble with your health to save money?
« Reply #24 on: November 19, 2015, 04:32:39 PM »
wouldn't mind selling a kidney for big bucks!

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #25 on: November 19, 2015, 04:49:02 PM »
wouldn't mind selling a kidney for big bucks!

Thanks for the comic relief :)

Update: I spoke to my gynecologist again today. She shut down my question - she said something to the effect of "Do I think it's anything? No. But you're looking for the one in the thousand and you don't want to mess around with that."

So then I tried calling some hospitals to get a better estimate of prices, and I was told they would not do a biopsy without repeating the ultrasound. I already know that in-hospital ultrasounds cost $660/breast, and I think my insurance would pay maybe 30% of that? And that's before you get to the biopsy.

I then spoke to a nurse at the breast cancer centre at the hospital. She understood my dilemma, and said to fax through the radiologist report and she would speak to the doctor tomorrow to get his thoughts (she had my file, case notes etc in front of her and could see he'd told me to get the follow up ultrasound in January - I told her that I'd done it in Nov. as my gynecologist recommended this when I fell pregnant).

She is going to get back to me on Monday. Honestly, I hear what you're saying, those of you who are saying 'why wait, it could make all the difference' but I keep reading this report which says *every indication is its benign* and I just feel like I'm getting shafted if I have it now instead of in 40 days. Aaaghh!

I think I'm having this internal battle between two voices of reason, one that is maybe much more emotional than the other, but they're both reasonable!

Voice 1: both ultrasounds say it looks benign. Every feature of it is benign, other than possible growth, and there are two very good explanations for the perceived/possible growth [difference in technique + pregnancy]. 40 days won't make any difference.

Voice 2: why would you risk it? It's the big C-word. And you're pregnant.

Voice 1: would 40 days make any difference anyway?

Voice 2: YOU MIGHT DIE BECAUSE YOU WAITED 40 DAYS YOU BIG IDIOT.

Voice 1: Doubt it. Just wait.

Voice 2: YOU DON'T GET IT.

And so it goes, on loop. Husband says if it was him, he would wait - FWIW, he's generally a far more rational/less emotional person than me (clumsy way to describe it but he'd agree). But that if I don't want to wait, that's OK.

okits

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Re: Do you ever gamble with your health to save money?
« Reply #26 on: November 19, 2015, 06:39:46 PM »
I'm curious how far the embrace of rationality goes.  If you wait, the 1/1000 situation occurs and it is cancer, and knowing 40 days sooner would have improved your prognosis or availed you of less-invasive treatment options, would you kick yourself or would you say, "I made the best decision possible using reason and the information available.  Unlucky outcome, but I accept the result of taking the most rational course of action"?

For some things I would lament for a moment but acknowledge that I'd make the same choice again, it had the best expected outcome.  For other things, a big "NO WAY!"  Guilt, regret, and remorse until the cows came home.  In this specific case that would suck huge, because you're feeling those horrible emotions on top of having cancer and being pregnant.  But I fully expect some people 100% embrace the statistics and rationality and I have admiration for that; it must lead to a calmer emotional life.

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #27 on: January 11, 2016, 04:44:24 PM »
Update:

I decided to wait until January for the biopsy. I felt peaceful about it the whole time, despite a voicemail or two from my rather pushy gynecologist asking how it went...

(Some might take issue with my calling her pushy - I mean she's generally a fairly blunt + pushy person, I'm not just ascribing that trait to her based on this experience!)

So I went to the breast cancer specialist today. He did a manual exam, looked at the scans, and got out a portable ultrasound machine. He said he's "not at all excited about anything he's seeing/feeling." He also said he can't find the mass on his little machine, so I need to go back Thursday to see the mammogram department. So that's a bit annoying, as I walked/got public transport in 0 degree weather to get to this appointment and it took 90 minutes for all this to transpire.

[internally practicing gratitude that I have healthcare even if it's not always efficient. They knew I was coming in for a biopsy, why wasn't the proper ultrasound machine available?]

He said if they can't see it on Thursday on the 'state of the art' machine it will be because my breasts have changed too much b/c of pregnancy. In that case, he will recommend I come back in six months. He said he is close to certain there is nothing to be worried about.

No doubt today + Thursday will cost a lot. All things considered, I'm glad I waited. Will I feel differently if it's cancer? In response to the last poster...I don't think so? I mean, I think I made the "right" decision based on my personality and the information available and the context. [That doesn't mean I won't be a wreck if it turns out to be malignant. I just think rationally I made the right decision for me.]

Thanks all for your thoughtful advice, this is a great community.

rubybeth

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Re: Do you ever gamble with your health to save money?
« Reply #28 on: January 12, 2016, 10:04:22 AM »
I'll be hoping/praying that things go well. :)

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #29 on: January 18, 2016, 07:32:03 PM »
I'll be hoping/praying that things go well. :)

Thanks so much Rubybeth, and to all the other helpful and thoughtful commentators.

Update: I had the biopsy on Thursday. It was slightly uncomfortable, but not painful. The procedure took about 30 minutes. I got an email on Saturday night (thanks to whoever was working overtime/on a Saturday) that it came back benign - as five professionals had told me they expected it to.

I'm very grateful for the outcome, obviously. I would love to know whether I would even have been given a biopsy in a system like the NHS (UK) where government pays for healthcare. Given that all indicators were benign, other than slight growth (which on all the specialists' best guess was attributable to normal breast growth during pregnancy), I'm not entirely sure the NHS would have done a biopsy in the first place.

Just gets me thinking about the patient-as-consumer model and the impact it has on overall health costs for the government and for the individual...

Anyway, I have yet to receive the bill, but I've already received a $400 bill for my 12 week ultrasound, plus a $180 bill for a pregnancy blood test, and the doctor also gave me a BRACA (breast cancer gene test) that I'm yet to receive the bill for, plus I had a visit with the breast cancer specialist before the biopsy which I'm assuming will also be a hefty bill - all of which is to say, I think we're well on our way to meeting our deductible for the year ($3250 for me), I'm positive we will hit it when the delivery/labor bills arrive, and maybe even before then! I think our co-pay is 30% thereafter. We went with a bronze plan because that's what the math told us to do.

Husband is deducting $300/month from his paycheck that's going into our HSA, so we're sort of spreading the cost of all this out over the year, so hopefully it won't feel like a big hit when these bills start rolling in.

Over and out.

okits

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Re: Do you ever gamble with your health to save money?
« Reply #30 on: January 18, 2016, 09:36:33 PM »
That's great news!  So glad to hear it, hope you can enjoy the rest of your pregnancy without any health worries.

LeRainDrop

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Re: Do you ever gamble with your health to save money?
« Reply #31 on: January 18, 2016, 10:11:46 PM »
That's great news!  So glad to hear it, hope you can enjoy the rest of your pregnancy without any health worries.

+1!

rubybeth

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Re: Do you ever gamble with your health to save money?
« Reply #32 on: January 19, 2016, 07:43:33 AM »
Oh, what a relief. I'm so glad it's benign. My relative who has stage 4 breast cancer has a screening this week to find out if the cancer has spread/shrunk/whatever. It's pretty terrifying. Her baby is nearly 5 mos. old. I'm so glad your results were what your doctors expected.

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #33 on: January 19, 2016, 01:44:33 PM »
Oh, what a relief. I'm so glad it's benign. My relative who has stage 4 breast cancer has a screening this week to find out if the cancer has spread/shrunk/whatever. It's pretty terrifying. Her baby is nearly 5 mos. old. I'm so glad your results were what your doctors expected.

So sorry to hear that, Rubybeth. Terrifying indeed. Best wishes to your friend.

former player

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Re: Do you ever gamble with your health to save money?
« Reply #34 on: January 19, 2016, 02:25:32 PM »
I would love to know whether I would even have been given a biopsy in a system like the NHS (UK) where government pays for healthcare. Given that all indicators were benign, other than slight growth (which on all the specialists' best guess was attributable to normal breast growth during pregnancy), I'm not entirely sure the NHS would have done a biopsy in the first place.

Nice guidelines for breast cancer referrals are at http://www.nice.org.uk/guidance/NG12/chapter/1-recommendations

The World Health Organisation stats show death rates per 100,000 women, age standardised, at 19.36 in the USA and 22.10 in the UK- http://www.nice.org.uk/guidance/NG12/chapter/1-recommendations

Overall UK women have a life expectancy of 82.96 and USA women have a life expectancy of 78.80 - http://www.nice.org.uk/guidance/NG12/chapter/1-recommendations

gbbi_977

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Re: Do you ever gamble with your health to save money? Updated: Costs
« Reply #35 on: January 25, 2016, 02:17:47 PM »
UPDATE:

So I just logged into my health care website to check out what bills might be coming my way, and it looks like the cost of the breast biopsy will be:

Biopsy - $338
Surgical care - $1856.65 (that's the member discounted rate - provider charge was over $3000)
Pathology test - $60.58

I'm a bit shellshocked. My best guess, based on the healthcare bluebook, was that this might (conservatively) run to $1000. Over $2000 is kind of crazy to me.

And to repeat - every single professional I spoke to (5 total) told me they were sure it was benign. This was a 20 minute procedure with local anesthetic...how could it possibly cost $1800 after adjustments?

Anyway, I'm just glad I waited and glad this happened in a year when my health care costs are definitely going to hit the deductible ($3225). I think I go down to a 30% copay after that, so I suspect after delivering a baby, even assuming no complications, I will also hit the max out of pocket which is $6450.

I'm also thinking how awful the situation would have been for someone without the financial security to take a big medical bill hit like this, or who wasn't sure they would incur other expenses in the same year...crikey.

okits

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Re: Do you ever gamble with your health to save money?
« Reply #36 on: January 25, 2016, 02:46:04 PM »
Is there any value in politely questioning the bill ("I had this, blue book estimate was $X, why is the bill so much higher?")

Agree that when you are possibly sick, having money is a very, very good thing.

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #37 on: January 25, 2016, 02:51:51 PM »
Is there any value in politely questioning the bill ("I had this, blue book estimate was $X, why is the bill so much higher?")

Agree that when you are possibly sick, having money is a very, very good thing.

Oh sweet Canadian...sorry, I jest, but I used to think there was value in that too, coming to this system from the Australian system (I realize you might be very familiar with the US system)...

I don't think so? I mean, that's the whole issue with healthcare here right, there's no transparency and therefore there's no competition? So when you get a bill you just have to accept their prices (is my understanding).

I've been able to successfully dispute a bill in the past when my doctor coded something that I believed was medically preventative and routine as non-routine. Disputing the dollar amount on a bill, I'd love to know if anyone has ever successfully done that.

Maybe I could ask the hospital for a discount if I pay it all upfront?

Astatine

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Re: Do you ever gamble with your health to save money?
« Reply #38 on: January 25, 2016, 04:42:22 PM »
That is crazy expensive for a biopsy. I had a fine needle biopsy and breast ultrasound in the Australian private system last year and it was on the order of $500 or $600 (I forget exactly - I had a lot of medical expenses around that time) and that was before the Medicare rebate! I don't know if there any hidden subsidies for a breast biopsy and ultrasound but I don't get why the U.S. system is so much more expensive than the Australian private system.

(I had to have a core biopsy a few days after the fine needle biopsy. That was bulkbilled and hence I had no out of pocket costs for that one. The second biopsy was because the first biopsy showed it was cancer and the GP wanted more details for the surgeon).

gbbi_977

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Re: Do you ever gamble with your health to save money?
« Reply #39 on: January 26, 2016, 07:55:36 AM »
That is crazy expensive for a biopsy. I had a fine needle biopsy and breast ultrasound in the Australian private system last year and it was on the order of $500 or $600 (I forget exactly - I had a lot of medical expenses around that time) and that was before the Medicare rebate! I don't know if there any hidden subsidies for a breast biopsy and ultrasound but I don't get why the U.S. system is so much more expensive than the Australian private system.

(I had to have a core biopsy a few days after the fine needle biopsy. That was bulkbilled and hence I had no out of pocket costs for that one. The second biopsy was because the first biopsy showed it was cancer and the GP wanted more details for the surgeon).

I hope you're doing OK, well wishes to you.