Maybe this will flush Eki out- $143K Hospital Bill Shocks Snake Bite Victem

[Tazio]

SAN DIEGO -- A UC San Diego exchange student who is facing a $143,989 hospital bill for treatment after he was bitten by a rattlesnake spoke with 10News on Tuesday.
"My jaw was dropping down," said Dag-Are Trydal, as he described his reaction to the medical bill for treatment after he was bitten by a rattlesnake.

Trydal's bill made headlines in Norway, where his insurance provider was quoted as saying the charges from Scripps La Jolla Hospital were the highest they had ever seen.
Trydal, an exchange student studying cybernetics at UCSD, was walking to his car on April 26 when he felt a sharp pain in his foot.
"I stepped two steps back just immediately and I was seeing that a snake was sitting right between my flip flops," he told 10News reporter Allison Ash. "I was really scared, because I don't know much about the snakes here and how dangerous they are,"It is a good Idea to have snake awareness in San Diego. In Sping They just come out into the open and sun to raise their blood temperature. If you step right on one their is a fair chance youwill be bitten. :rolleyes:

When a passerby told him Scripps Hospital was right across the street, he decided to walk there.
"As I was walking over, my heart started thumping and I could feel a tingling in my body and a metallic taste in my mouth," he said.
Trydal was admitted to the hospital and given four doses of antivenom over a 24-hour period. He was thrilled that the treatment worked and he could get back to his studies, until he heard from his insurance companyThat was when Trydal learned what his visit to the hospital cost: $143,989. He was shocked.
"I thought maybe $10,000," he said, noting that if he'd had the same treatment back home in Norway "it would have been free."Y'awl boys have many venomous snakes in Norway?

Trydal agreed to let the hospital release a copy of the bill to 10News. In it there are two separate charges for antivenin croatalidfab. The first charge is for $102,440 and the second is for $25,610. That is a total of $128,050.
"This is way too much, at least for a person that doesn't have good insurance," he said.
Trydal admitted he was glad he bought an insurance policy to cover him during his six months in the United States. When asked what would happen if he had not, Trydal responded, "That would be very, very bad. I try not to think about that."
A spokesperson for Scripps told 10News the antivenom is expensive and issued this statement:

"First and most importantly, we are grateful for Mr. Trydal’s recovery. We have reviewed our billing practices in this case and find all charges to be accurate and appropriate.
The largest portion of the charges was for antivenom, a very costly life-saving drug manufactured from snake venom. The patient required 10 units of the antivenom and a night in the Intensive Care Unit, which provides around-the-clock direct nursing supervision...........
.


Although Trydal said he believes the healthcare system in the US is "wrong, he declined to be too critical, saying his treatment at Scripps La Jolla was "excellent."
Yes UCSD is cutting edge. At least he has that going for him. :p :

$143K Hospital Bill Shocks Snake Bite Victim - San Diego News Story - KGTV San Diego (http://www.10news.com/news/31128723/detail.html)
Health care is exspensive in California. :dozey:
Thoughts?

[Alexamateo]

First, I am glad to read he had insurance. Second, it is typical of hospitals to charge like this, but they never expect to collect it. It is just the way the insurance game is played.

My wife had a baby last year, and this was typical of one of the bills:

Charge $16,353.10..............Insurance payments $4629.25.................Insurance Adjustments $10,566.54.................Due from Patient $1157.31

So the actual charge was 35% of the bill, and my out-of-pocket was 7% of the bill (20% of actual charge).

It has been my experience that the top-line charge has nothing to do with the actual charge. It was similar to when I used to install underground irrigation systems. I asked for a catalog of the different pipe fittings. My jaw dropped at the prices when I started to look at it. The salesman laughed and said "Oh,you have an 83% discount, and truthfully, everybody gets at least 75%." It was done in that case to confuse the issue and , make it so no one knew what everybody else was paying.

Medicine and Health Care are unfortunately doing the same thing. I am sure no one ever expects to collect $144,000 from this incident, it's a shock thing to make you end up saying "Oh,it ended up being only $45,000."

The only thing I would say to the boy from Norway is that in Norway, he may not have had to pay anything out-of-pocket, but it was most assuredly not be free.

My opinion of all this? I think it stinks, and the health care industry better get it's act together and not continue to shake down its patients, or the government will do it for them. :p

[Tazio]

When I was in my early 40's I started training for a half marathon. I got to the point where I was running 9 miles at an accelerated pace. I'd always had an intermittent problem with chronic Bronchitis. After finishing on of these runs as I was cooling down I had a feeling in my esophagus sort of like post nasal drip in your throat. The next morning I was coughing up green "oysters". After a couple days I started feeling weak so I went to the urgent care at Grossmont Hospital. They informed me that I had Bi-lateral Pneumonia, and I'd be hanging out there for about a week so they could get me on the "big guns" (intravenous anti-biotics). I was in the hospital for 6 days. My tab was just under 30 large. My insurance took care of it, and I paid my $500.oo catastrophic hospitalization deductable. I know my insurance settled for less than 10 grand. That was about 15 years ago. Today that stay would be around 100 G I'm guessing. The system is skewed. You can get a name brand medication depending upon what it is for say $100.oo, the generic is probably $8.oo pharmaceutical companies play a big role in the bottom line. If they were the ones that did the research and devlopement I can almost understand it before it went generic. But their continues to be a big desparity after. WTF is up with that? :p : :andrea: :erm:

[Big Ben]

What would have happened if he had no insurance?

[Malbec]

Yes UCSD is cutting edge. At least he has that going for him. :p :

$143K Hospital Bill Shocks Snake Bite Victim - San Diego News Story - KGTV San Diego (http://www.10news.com/news/31128723/detail.html)
Health care is exspensive in California. :dozey:
Thoughts?

If you're going to have a licenced drug that sees very little use then the per unit cost will be very very high. That drug wouldn't have been much cheaper than any other drug to develop and the R/D costs would have to be recouped somehow.

If you're also going to have a healthcare system that bills patients for the cost of their individual treatment then bills like this, while shocking, should be expected.

In Britain there are plans to send patients virtual invoices after their treatment to give them an idea how much it cost to treat them (these wouldn't have to be paid). I think thats a pretty good idea as most people don't know how much such things cost.

[Tazio]

What would have happened if he had no insurance?
Charities would kick in. When you are giving them information like the name of your insurance carrier they also ask what religion you be representin’, it is best to say you are Catholic. Catholic Family Charities kick in big dough. They would also send it to a collection agency for whatever balance is left. In the vast majority of those cases they realize they can’t squeeze blood out of a turnip, so you take a big hit on your credit rating. That is part of the reason health care insurance is so high here. But when you go to the emergency room in California they can't, and won't refuse to treat you. That is why most of the rest of the country say we are socialist's.
Tough sh!t.
If you don't have net assets in excess of $1,999.oo and you can prove it CMS County Medical Services will negociate the rest in San Diego.
If you are military or a veteran of it they have their own facilities, and you don't pay squat. That is another reason health care in the country in general is high

[Tazio]

If you're going to have a licenced drug that sees very little use then the per unit cost will be very very high. That drug wouldn't have been much cheaper than any other drug to develop and the R/D costs would have to be recouped somehow.

If you're also going to have a healthcare system that bills patients for the cost of their individual treatment then bills like this, while shocking, should be expected.

In Britain there are plans to send patients virtual invoices after their treatment to give them an idea how much it cost to treat them (these wouldn't have to be paid). I think thats a pretty good idea as most people don't know how much such things cost.
That's your problem ;)

[Dave B]

First, I am glad to read he had insurance. Second, it is typical of hospitals to charge like this, but they never expect to collect it. It is just the way the insurance game is played.
My wife had a baby last year, and this was typical of one of the bills:

Charge $16,353.10..............Insurance payments $4629.25.................Insurance Adjustments $10,566.54.................Due from Patient $1157.31

So the actual charge was 35% of the bill, and my out-of-pocket was 7% of the bill (20% of actual charge).
Wow. We had our baby in February and the hospital bill was a big fat zero at the point of delivery (no pun intended). I thought that's what tax was for.

[Malbec]

That was about 15 years ago. Today that stay would be around 100 G I'm guessing. The system is skewed. You can get a name brand medication depending upon what it is for say $100.oo, the generic is probably $8.oo pharmaceutical companies play a big role in the bottom line. If they were the ones that did the research and devlopement I can almost understand it before it went generic. But their continues to be a big desparity after. WTF is up with that? :p : :andrea: :erm:

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.

[odykas]

SAN DIEGO -- A UC San Diego exchange student who is facing a $143,989 hospital bill for treatment after he was bitten by a rattlesnake spoke with 10News on Tuesday.


That it just outrageous.
What would the expected bill be like, in case a serious operation was necessary?
$1M for appendix removal operation? :down: :crazy:

[Tazio]

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.Oh yes I also had a Bronchoscopy

[Tazio]

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.

Oh yes I also had a Bronchoscopy
Oh yes I also had a Bronchoscopy and no they were not giving me generics. I also was awaken by a Filipino nurse slapping the sh!t out of me in the middle of the night. She ejaculated: "why you blood pressure 85/45" to which I retorted "maybe because I'm sleeping"? The most obtuse charge on my bill was one tablet of Elavil "Amatryptaline" a multi use tricyclic that my osteopath had put me on to relax a lower back issue. It cost more than the liquid cocaine (a 7% solution) they used as a local they poured down one nostril when they snaked the camera down my nose with a tiny alligator snipper on it to see, and remove crystallized cucus :p : to loosen and extract from my lungs. That was about 15 minutes of gagging and dropping as low as 90% oxygen saturation which in a controlled environment is not too dangerous but typically you absorb over 99+% with normal lung function. I'm not exactly sure how that is calculated.

[Malbec]

Oh yes I also had a Bronchoscopy and no they were not giving me generics. I also was awaken by a Filipino nurse slapping the sh!t out of me in the middle of the night. She ejaculated: "why you blood pressure 85/45" to which I retorted "maybe because I'm sleeping"? The most obtuse charge on my bill was one tablet of Elavil "Amatryptaline" a multi use tricyclic that my osteopath had put me on to relax a lower back issue. It cost more than the liquid cocaine (a 7% solution) they used as a local they poured down one nostril when they snaked the camera down my nose with a tiny alligator snipper on it to see, and remove crystallized cucus :p : to loosen and extract from my lungs. That was about 15 minutes of gagging and dropping as low as 90% oxygen saturation which in a controlled environment is not too dangerous but typically you absorb over 99+% with normal lung function. I'm not exactly sure how that is calculated.

How do you know they weren't giving you generics? The drug name (not the marketing name but the pharmaceutical name) on the side of the bottle or bag would be the same for a generic and patented drug.

I'm not surprised the nurse woke you up. A diastolic blood pressure that low (whilst maybe being utterly normal for you) would require further investigation to make sure you weren't going into shock and since you describe yourself as having a significant infection at that time septic shock would have been a concern. She would have been negligent had she not woken you up and investigated further.

I don't understand why the charge for amitryptiline is obtuse. If it was an ongoing prescription that you were on prior to admission they'd carry on giving it to you unless it interfered with your treatment. Was there a reason for them not to have?

I'm surprised they used cocaine because for procedures such as a bronchoscopy it has been superceded by bupivacaine and other local anaesthetics, even 15 years ago. Pharmaceutical cocaine and morphine are much MUCH less costly than their street equivalents and are actually pretty cheap. Both are 'historical' drugs with no R/D costs to recoup and the actual cost of growing and refining the drugs is not expensive if given legal cover, the pharm companies don't have to worry about confiscated shipments, buying off officials and all the other paraphenalia that comes with illegal drug supply.

[Rudy Tamasz]

My opinion of all this? I think it stinks, and the health care industry better get it's act together and not continue to shake down its patients, or the government will do it for them. :p

Just tell 'em so and make sure they listen.

[Tazio]

@maybec. My bill said Elavil on it that is how I know. My referance to generics was about just going to the pharmacy for medicine in general, it had nothing to do with that trip. A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you? I got 5 Elavil while at the hospital and it came to 25 dollars and something. It was a long time ago. The Cocaine was $20 and something. I don't go to the pharmacy and pay that kind of money for that med. It was only 10 milligrams and I think my script was for 20 and that was less than 5 bucks generic at the pharmacy. So you can quit with your obsessive conspiracy theory :laugh:

[schmenke]

Wow. We had our baby in February and the hospital bill was a big fat zero at the point of delivery (no pun intended). ....

The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that :p : :dozey:

[Malbec]

@maybec. My bill said Elavil on it that is how I know. My referance to generics was about just going to the pharmacy for medicine in general, it had nothing to do with that trip. A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you? I got 5 Elavil while at the hospital and it came to 25 dollars and something. It was a long time ago. The Cocaine was $20 and something. I don't go to the pharmacy and pay that kind of money for that med. It was only 10 milligrams and I think my script was for 20 and that was less than 5 bucks generic at the pharmacy. So you can quit with your obsessive conspiracy theory :laugh:

Sorry but I don't buy into conspiracies. I'm trying to clarify what you're talking about because it sounds as if you didn't understand how/why certain things were done to you. From your post it seemed as if you were claiming that your IV antibiotics were/weren't generic.

Elavil is merely a brand name for amitryptiline. Amitryptiline is the pharmaceutical name, you can buy this from several different manufacturers who will all stamp a different name on the tablet of which elavil is one. This isn't obtuse but I agree that the difference between the pharmaceutical name and the marketing name is confusing.

Just to clarify elavil IS a generic medication as the patent on amitryptiline ran out some time in pre-history.

[Malbec]

The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that :p : :dozey:

Ditto. I've always wondered if people in the US and elsewhere where they pay for delivery are put off having kids because of it.

[Tazio]

Sorry but I don't buy into conspiracies. I'm trying to clarify what you're talking about because it sounds as if you didn't understand how/why certain things were done to you. From your post it seemed as if you were claiming that your IV antibiotics were/weren't generic.

Elavil is merely a brand name for amitryptiline. Amitryptiline is the pharmaceutical name, you can buy this from several different manufacturers who will all stamp a different name on the tablet of which elavil is one. This isn't obtuse but I agree that the difference between the pharmaceutical name and the marketing name is confusing.

Just to clarify elavil IS a generic medication as the patent on amitryptiline ran out some time in pre-history.No Sh!t, I'm only 58 years old I know my way around pharmaceuticals You just can't tell when I'm being facetious, with the fake cowboy/ redneck expressions. I will say this though, at the time I told a friend that they gave me cocaine for a local and he told me no way. I showed him my itemized bill and he ate crow. I played sports at a highly competitive level until the second time I tore the same hamstring after 6 months of rehab. I could have gone to a top shelf sports medicine facility, as I had a tear so big you could almost put a tennis ball inside it. However that is elective surgery and unless you are professional making big buck you live with it, and try not to exacerbate it, and all the peripheral effect it has like making my lower back more susceptible to acute episodes That was when I was 44 over the course of time it has regenerated to a small divit, with no doubt a healthy portion of scar tissue.
BTW I have a bottle of amatriptyline sitting in front of me right now. You know what it says here in the "home of the brave" :eek: Amitrptyline sub for Elavil
ssssssssssssssaaaaaanap for the win :rotflmao:

[Malbec]

No Sh!t, I'm only 58 years old I know my way around pharmaceuticals You just can't tell when I'm being facetious, with the fake cowboy/ redneck expressions. I will say this though, at the time I told a friend that they gave me cocaine for a local and he told me no way. I showed him my itemized bill and he ate crow. I played sports at a highly competitive level until the second time I tore the same hamstring after 6 months of rehab. I could have gone to a top shelf sports medicine facility, as I had a tear so big you could almost put a tennis ball inside it. However that is elective surgery and unless you are professional making big buck you live with it, and try not to exacerbate it, and all the peripheral effect it has like making my lower back more susceptible to acute episodes

I'm not posting here to insult you but what you're saying doesn't make sense.

You said yourself you were prescribed Elavil and that you weren't palmed off with a generic drug:


A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you?

Elavil IS a generic drug. The patent on amitryptiline ran out in the mid-70s.

I suspect the root problem here is that there are crossed wires. For me, a generic drug is any drug that is not still under patent. Most bread and butter drugs ARE generic.

Elavil may be marketed by Merck, the company that developed the drug back in the '50s but the medication would be produced VERY cheaply by ACME corp somewhere in India/China with the same supplier producing the drug for several different companies, ie once you get beyond the title on the packet it is a generic.

[Tazio]

BTW I have a bottle of amatriptyline sitting in front of me right now. You know what it says here in the "home of the brave" Amitrptyline sub for Elavil
ssssssssssssssaaaaaanap for the win. Yes at the hospital they gave me E-L-A-V-I-L Yes I have always known the difference so please stop being so anal ;)

[Malbec]

BTW I have a bottle of amatriptyline sitting in front of me right now. You know what it says here in the "home of the brave" Amitrptyline sub for Elavil
ssssssssssssssaaaaaanap for the win. Yes at the hospital they gave me E-L-A-V-I-L Yes I have always known the difference so please stop being so anal ;)

Crossed wires again I suspect. I never said that you didn't get Elavil from your hospital. I said Elavil is now a generic drug. Sorry if you didn't understand my point that I repeated several times.... Third time lucky (or is it fourth?) ;)

[D-Type]

That charge cannot in any way reflect the hospital's costs. Does that make it fraud? Surely the insurance company could afford to take legal action.

The moral of the tale is to take out unlimited medical insurance if visiting the USA.

[Tazio]

Crossed wires again I suspect. I never said that you didn't get Elavil from your hospital. I said Elavil is now a generic drug. Sorry if you didn't understand my point that I repeated several times.... Third time lucky (or is it fourth?) ;)

WTF are you trying to say. I have always known that Amatriptyline is generic for Elavil It was when my osteopath prescribed it to me for the first time. What I said was in the hospital they gave me the branded name so my bill would be higher. Then you started crossing wires in a very anally retentive kind of way :dork: You are really impressive with your tight a$$ matter of fact empiricism. Please take it away junior, because I'm done beating a dead horse!

[Tazio]

That charge cannot in any way reflect the hospital's costs. Does that make it fraud? Surely the insurance company could afford to take legal action.

The moral of the tale is to take out unlimited medical insurance if visiting the USA.
Rollo when you say does it reflect the hospitals cost are you saying that they marked it up too much, because I know you don't mean to imply that they are not in business to make money! That is the way the song goes here. My sister was the CFO of a company that secured blood from people with rare blood disease, and you know what? One guy who had an extremely rare blood disease would put them through so much grief, because he knew that he could almost get whatever price he wanted. Plus he was such a dick that he would not show up for appointments. So you have a large company having to barter with private citizens and you know what? Everybody that worked there drew a salary representative of corporate equivalents. So you can see how the price for getting the finished product to the hospitals where the Hematologist’s that use it (Who also) make some damn good money as well, get the price up very rapidly. A law suit would be a joke. Who do you sue first?

[Tazio]

@ maybec check post #15 I made it clear what i was saying, you just wanted to be an authority, about all my freakin meds. You kept on trying to get me to maker a distinction that I made inpost #15 yes that is 1-5 But feel free to be so full of yourself to the point of humiliation.
It's cool with me :)

[Malbec]

WTF are you trying to say. I have always known that Amatriptyline is generic for Elavil It was when my osteopath prescribed it to me for the first time. What I said was in the hospital they gave me the branded name so my bill would be higher. Then you started crossing wires in a very anally retentive kind of way :dork: You are really impressive with your tight a$$ matter of fact empiricism. Please take it away junior, because I'm done beating a dead horse!

Perhaps it would help if you write your posts in a more lucid consistent way.

Now you're claiming that the hospital gave you a branded version of amitryptiline when previously you claimed that they gave you Elavil, or at least that is how your post comes across.

I suspect what you are trying to say is that you were given Elavil but the hospital charged for amitryptiline because that attracts a higher fee despite the drugs being one and the same.

It might come across to you that I'm anally retentive. I'm a doctor so I do have some history in prescribing drugs and just a little understanding of the difference between drugs as well as the ins and outs of the pharm industry. Your posts as originally written make little sense, are highly confusing and often contradict each other so please think about how you come across before you criticise me.

Have a nice day!

[Malbec]

@ maybec check post #15 I made it clear what i was saying, you just wanted to be an authority, about all my freakin meds. You kept on trying to get me to maker a distinction that I made inpost #15 yes that is 1-5 But feel free to be so full of yourself to the point of humiliation.
It's cool with me :)

I did read post 15, in fact I quoted it.

Its difficult to understand as its barely coherent English.

In post 15 you said that Elavil was not a generic then in post 24 you directly contradict that statement. You did that several times in this thread.

Also I don't know where you were going with the cocaine stuff, I merely explained that I find it odd that your doctors were using cocaine when standard practice even at that time was to use bupivacaine, and that cocaine for medical use is surprisingly cheap given what it costs on the street.

I apologise to you. From the tone of post 12 I thought that you were pissed off about certain aspects of your treatment and I explained to you the medical rationale behind some of what you described, and why some drugs were cheaper than others when you wouldn't expect them to be. I guess you didn't really want to know.

[Tazio]

Perhaps it would help if you write your posts in a more lucid consistent way.

Now you're claiming that the hospital gave you a branded version of amitryptiline when previously you claimed that they gave you Elavil, or at least that is how your post comes across.
I suspect what you are trying to say is that you were given Elavil but the hospital charged for amitryptiline because that attracts a higher fee despite the drugs being one and the same.

It might come across to you that I'm anally retentive. I'm a doctor so I do have some history in prescribing drugs and just a little understanding of the difference between drugs as well as the ins and outs of the pharm industry. Your posts as originally written make little sense, are highly confusing and often contradict each other so please think about how you come across before you criticise me.

Have a nice day!

Tell you what Doc No. They gave me the branded Elavil and charged me for it.
Amatriptyline is the generic as you know they use the name of the chemical compound on generics. God-all-freakin-mighty you are a hard case. You can't be that dense.

[Malbec]

Tell you what Doc No. They gave me the branded Elavil and charged me for it.
Amatriptyline is the generic as you know they use the name of the chemical compound on generics. God-all-freakin-mighty you are a hard case. You can't be that dense.

I think you misunderstand the meaning of the word generic in this case.

Amitryptiline is the pharmaceutical name, Elavil the marketing name.

Generic doesn't refer to this at all. A generic drug is one made out of patent, ie once the patent expires, and can be made by companies other than the one holding the patent. Generic does not refer to the name of the drug.

And you call me dense?

[Firstgear]

Dr. Malbec and dr Giacomo - I think the confusion here is over the definition of the word 'generic'. Over here, as i understand it, generic would be a bottle of, for example cough syrup, that might say Walmart. The brand name might be a similar bottle that says Bayer or Tylenol.

I don't know enough to know who had the original patent. So names like Tylenol are considered brand names, and names like Walmart are considered generic names.

Hope this helps. Now shake hands and move along. :p :

oops - just saw Malbec's post above - looks like I'm a little late.

[Tazio]

Perhaps it would help if you write your posts in a more lucid consistent way.

Now you're claiming that the hospital gave you a branded version of amitryptiline when previously you claimed that they gave you Elavil, or at least that is how your post comes across.

I suspect what you are trying to say is that you were given Elavil but the hospital charged for amitryptiline because that attracts a higher fee despite the drugs being one and the same.

It might come across to you that I'm anally retentive. I'm a doctor so I do have some history in prescribing drugs and just a little understanding of the difference between drugs as well as the ins and outs of the pharm industry. Your posts as originally written make little sense, are highly confusing and often contradict each other so please think about how you come across before you criticise me.

Have a nice day!OK it is time for a truce. The comment I made about the Nurse was a form of comic relief. For all I know she could have been trying to wake me up in a more gentle manner and resorted to smacking me around. Yes my answer was what I said,
and no that is nowhere near my typical BP. So let us let it go if that is all right with you.
I come on here for fun, not cross examination.
BTW how is your bedside manner?

[Alexamateo]

Wow. We had our baby in February and the hospital bill was a big fat zero at the point of delivery (no pun intended). I thought that's what tax was for.

Oh that's just the hospitalization for the wife. That's not the Obstetrician, the labs, the babies bill, the first examination by the pediatrician,etc,etc. We paid $7500 out of pocket which is the maximum calendar year for the individual. I have a fairly high deductible for lower overall premiums. Our family's medical bill was $11,500 out of pocket for the year including insurance premiums. Of course we pay less taxes than you do so it would be interesting to see how it all ended up overall.

PS Parking was free though :p :)

[Malbec]

OK it is time for a truce. The comment I made about the Nurse was a form of comic relief. For all I know she could have been trying to wake me up in a more gentle manner and resorted to smacking me around. Yes my answer was what I said,
and no that is nowhere near my typical BP. So let us let it go if that is all right with you.

No problem.

I merely thought that you were pissed off with being woken up and didn't understand why she did what she did. Hence my explanation.


I come on here for fun, not cross examination.

So do I. Unfortunately with topics that directly involve my job its difficult to not be precise and anal. I'm if we were to talk about something in your field of expertise you would be the same.

I suspect if a real racing driver or engineer found his way onto the racing forums here he'd tear his hair out in frustration at our poor understanding of their day job.


BTW how is your bedside manner?

Good enough that patients comment on how good it is :)

The crossed wires and aggravation we had on this thread wouldn't have happened in a face to face meeting, we'd have been able to read each other a lot better!

Peace.

[Tazio]

I think you misunderstand the meaning of the word generic in this case.

Amitryptiline is the pharmaceutical name, Elavil the marketing name.

Generic doesn't refer to this at all. A generic drug is one made out of patent, ie once the patent expires, and can be made by companies other than the one holding the patent. Generic does not refer to the name of the drug.

And you call me dense?OK here we go splitting hairs for your inflated ego. Over in the good old USA it is common vernacular to "get the generic equivalent". I was using it loosely and you were dogging me. What an ego. Thanks for the info. If anyone else is interested, do a search with the words "Generic equivalent" and the distinction from a practical point of view, is abundantly clear. That is all I was saying and you have really impressed me with your store house of useless information G'day

[ioan]

I think thats a pretty good idea as most people don't know how much such things cost.

Way too much is the right answer. And I work very closely with the pharma industry so I know quite a few things people don't even dream about.

[Malbec]

Chill out guys, I'm only a youngster but I can see this is a pointless disagreement over a term for cheap drugs. Not worth a whole thread in itself IMO.. :)

You're right. I have to admit I'm surprised by how personally this chap takes things, should have spotted that earlier and bowed out!

[Malbec]

Way too much is the right answer. And I work very closely with the pharma industry so I know quite a few things people don't even dream about.

In the old days yes I agree, the pharm companies charged way too much. These days though, I'm not so sure. I hope you only work WITH the pharm companies and not actually IN one, otherwise its time to bail out old chap.

[ioan]

She ejaculated: "why you blood pressure 85/45" to which I retorted "maybe because I'm sleeping"?

Back in the highschool when I was training regularly 6 times a week the school's nurse measure my blood pressure 3 times (and she measured it for others in between and those were all in 'normal' range) because it was only 90/40, and I was feeling perfectly, so having 85/45 while sleeping might be OK for some people.

[ioan]

In the old days yes I agree, the pharm companies charged way too much. These days though, I'm not so sure. I hope you only work WITH the pharm companies and not actually IN one, otherwise its time to bail out old chap.

I do not work for one of them, and I agree I am pretty lucky with that.

[Tazio]

What is wrong with this picture smart a$$ ?

Amitriptyline (generic for Elavil) (http://medicine.uab.edu/neurology/faculty/65787/Halsey/NotesForPatients/63375/)


Amitriptyline (generic for Elavil)








Amitriptyline

This drug is very useful is several areas of general neurologic and general medical practice.

•It is sometimes helpul for various other kinds of pain, including neurological pains characterized by burning and tingling, but rarely for quick stabbing pains. Sometimes it is as effective as morphine. Amitriptyline has no addictive risk

[Rollo]

Rollo when you say...

When I say what? I've not posted in this thread until now.

If this had happened in Australia, then it would have been administered via the A&E unit and the charge to the end user would have been NIL. The fact that a $143,000 bill exists at all just shows you how pathetic the US health care system is.

I had an Anterior Cruciate Ligament operated on in 2010 and I paid nothing. Admittedly I had to wait 8 weeks because it wasn't life threatening but that's fine, it is elective surgery after all.


The moral of the tale is to take out unlimited medical insurance if visiting the USA.

Actually even then it won't help you. In 2007 despite taking out medical insurance for my trip to America, when I had a case of appendicitis, I was turned away by two hospitals because they couldn't work out how to process the paperwork for the insurance; flew back across the Pacific and had the operation done at Sydney Hospital (again I paid nothing).

[Tazio]

Back in the highschool when I was training regularly 6 times a week the school's nurse measure my blood pressure 3 times (and she measure it for others in between and those were all in 'normal' range) because it was only 90/40, and I was feeling perfectly, so having 85/45 while sleeping might be OK for some people. Yes High school is one thing. But I was like I say in my forties. Even when in great shape my resting BP was in normal range. However I don't think I was in peril of expiring ;)
Even if I was how on earth could I answer such a rhetorical question like that? :p :
Let me try: “Well I'm glad you asked me that my good lady! I had purposely slowed down my metabolism through transcendental meditation.
I was just testing it out here because I'm bored having lain in this bed for three days with needles in my arms, and I thought I would see if you are on the ball." :laugh:
http://aaronandandy.com/wp-content/uploads/2010/07/bitchslap4.gif

[Tazio]

When I say what? I've not posted in this thread until now.

If this had happened in Australia, then it would have been administered via the A&E unit and the charge to the end user would have been NIL. The fact that a $143,000 bill exists at all just shows you how pathetic the US health care system is.

I had an Anterior Cruciate Ligament operated on in 2010 and I paid nothing. Admittedly I had to wait 8 weeks because it wasn't life threatening but that's fine, it is elective surgery after all.



Actually even then it won't help you. In 2007 despite taking out medical insurance for my trip to America, when I had a case of appendicitis, I was turned away by two hospitals because they couldn't work out how to process the paperwork for the insurance; flew back across the Pacific and had the operation done at Sydney Hospital (again I paid nothing).
That was in reply to what Duncan Rollo asked. Sorry for the confusion, but maybe you should pay closer attention. Which Hospitals in California refused to treat a life threatening injury or illness you had? They cannot turn you away from the emergency room So if it was in California you had a billing problem. It is not uncommon as their are so many carriers. Here is reality. You have the proceedure if their is a dispute it is taken care of in due course, They don't hold a gun to your head and say you cant leave untill you fork over the the frog skins.

[janvanvurpa]

.
The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that :p : :dozey:
Yeah but we know about which way youse canajians lean, if ya know what I mean...

You think the color of that leaf was accidental???

can't fool us with that horrible "Oh canada, eh", this is what you guys want to have for an anthem:

http://www.youtube.com/watch?v=U06jlgpMtQs&feature=related

[Tazio]

Here is something that may be of interest. I guess we use different terminology than nit picking
blow-hards.
https://docs.google.com/viewer?a=v&q=cache:jpsfL9DmBBoJ:www.bcbst.com/learn/pharmacy/brand_generic.pdf+generic+equivalent&hl=en&gl=us&pid=bl&srcid=ADGEESjYt8kajZ7vY858fsQO5Ym6q3TH0mo_6uB6TKA6 2qoioM2OCXBk3tmzDLBfIsWntM6W396N1_UgzVeYtpSTEODpDC kXGvB0To6aDZwRn6TpCQDv5DBpbsUWJfxsizv8jcNsKmzM&sig=AHIEtbTD59oXe1_s77k_liG24bPlO3g5eg

[Malbec]

Here is something that may be of interest. I guess we use different terminology than nit picking
blow-hards.
https://docs.google.com/viewer?a=v&q=cache:jpsfL9DmBBoJ:www.bcbst.com/learn/pharmacy/brand_generic.pdf+generic+equivalent&hl=en&gl=us&pid=bl&srcid=ADGEESjYt8kajZ7vY858fsQO5Ym6q3TH0mo_6uB6TKA6 2qoioM2OCXBk3tmzDLBfIsWntM6W396N1_UgzVeYtpSTEODpDC kXGvB0To6aDZwRn6TpCQDv5DBpbsUWJfxsizv8jcNsKmzM&sig=AHIEtbTD59oXe1_s77k_liG24bPlO3g5eg

What a bizarre post.

I've made my point clear. I'm very happy with my interpretation, I hope you are happy with yours. Mine certainly functions very well where I work. I've made it clear to you that there is a difference in our interpretations and I'm not bothered that yours is different. Its a shame that the difference in interpretations lead to a misunderstanding between us, but I believe I have tried explaining why I said what I said.

I'm terribly sorry that you find that such a massive blow to your ego that you have to carry on about it 24 hours later. Its time to back off or take it off the forum, feel free to PM me if you have anything you want to sort out.

[Tazio]

What a bizarre post.

I've made my point clear. I'm very happy with my interpretation, I hope you are happy with yours. Mine certainly functions very well where I work. I've made it clear to you that there is a difference in our interpretations and I'm not bothered that yours is different. Its a shame that the difference in interpretations lead to a misunderstanding between us, but I believe I have tried explaining why I said what I said.

I'm terribly sorry that you find that such a massive blow to your ego that you have to carry on about it 24 hours later. Its time to back off or take it off the forum, feel free to PM me if you have anything you want to sort out.I am also very pleased. Now, go explain what you explained to me to the other 250 million Americans :wave: Ba bye

[Mark]

The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that :p : :dozey:

Yeah it was like £3.00 per day :hmh:

[ioan]

Yeah it was like £3.00 per day :hmh:

Maybe per hour?!

[schmenke]

Maybe per hour?!

Why would you think that?

It's been a while but from what I remember the daily parking rate at our hospital was about $10.00 (or £4.00)

[donKey jote]

because it sounds extremely cheap for rip-off Britain's normal parking fees :)

[ioan]

Why would you think that?

It's been a while but from what I remember the daily parking rate at our hospital was about $10.00 (or £4.00)

It approx 3€/hour around here, so 3£/day is a steal.

[schmenke]

Well, same here, but the hospital parking lot is not a public lot.

Around here the daily parking fee in a downtown public lot can be as much as $40.00 :s

[Tazio]

Well, same here, but the hospital parking lot is not a public lot.

Around here the daily parking fee in a downtown public lot can be as much as $40.00 :s
How much of that goes into the fund for your medical coverage? ;)

[SGWilko]

That charge cannot in any way reflect the hospital's costs. Does that make it fraud? Surely the insurance company could afford to take legal action.

The moral of the tale is to take out unlimited medical insurance if visiting the USA.

Or just don't bother crossing the pond, Period!

[SGWilko]

Wow, an arguement I can't follow and have no idea what is going on lol.. Interesting OP though, I'd better not have a nose bleed when I visit the US :eek:

$20k for a cleenex (3 ply is extra). But they do throw in a super duper mega max king whopper burger and a coke that comes in a cup the size of a bucket.......

[SGWilko]

What is wrong with this picture smart a$$ ?

Amitriptyline (generic for Elavil) (http://medicine.uab.edu/neurology/faculty/65787/Halsey/NotesForPatients/63375/)


Amitriptyline (generic for Elavil)








Amitriptyline

This drug is very useful is several areas of general neurologic and general medical practice.

•It is sometimes helpul for various other kinds of pain, including neurological pains characterized by burning and tingling, but rarely for quick stabbing pains. Sometimes it is as effective as morphine. Amitriptyline has no addictive risk

Jeez, let it go, or you'll have an anurism [sic] - and I really cannot stomach another round of this name that name re the drugs they'd use for that!

[SGWilko]

go explain what you explained to me to the other 250 million Americans :wave: Ba bye

Don't they go all vacant after a simple 'hello'?

[Mark]

No, it was £3 per day

[airshifter]

$20k for a cleenex (3 ply is extra). But they do throw in a super duper mega max king whopper burger and a coke that comes in a cup the size of a bucket.......

The drinks the size of the bucket are now old news. Mini kegs is the current trend. :D

[Rollo]

This was an advert inside the bus in Sydney today:

http://i45.twitgoo.com/214qh38.jpg

[Tazio]

Sounds like a clever marketing slogan to me. I would be a little suspicious of that particular insurance company. :bulb :( although it is true) :p :
The exspression "When in Rome" comes to mind right about now. It is probably a good idea that you stay as far away from the U.S. as possible. ;) We are going to miss you so terribly though. :mad: :laugh:

[Tazio]

Don't they go all vacant after a simple 'hello'?
No, but many would if they heard in a cockney accented… 'ello

[Tazio]

But they do throw in a super duper mega max king whopper burger and a coke that comes in a cup the size of a bucket....... That is as undeniably true as all Brits having "bangers and mash" for breakfast every day with a huge helping of fried bread and a bowl of lard the size of Stonehenge to dip it in. ;)

http://t2.gstatic.com/images?q=tbn:ANd9GcS-majEdmLlt5Ky0-9-JoiYcjW7QUip6pxzfrbX_yCuAGWFTOIq

Oh yes and what teeth you do have are in a state of terrible disrepair. :p :

[Rollo]

Sounds like a clever marketing slogan to me. I would be a little suspicious of that particular insurance company. :bulb:


From the TID website:
This insurance is arranged and managed by Cerberus and underwritten by certain underwriters at Lloyd's.

Cerberus Capital Management LP has roughly $20bn in assets under management. I would be a little suspicious of one of the top 100 Contractors of the U.S. Federal Government too. :D

[Tazio]

Ok fair enough. Now how many fraudulent companies do you suspect that hospitals have to deal with? I would say quite a few. Never the less If your policy was from such a legit operation as Lloyds and you were in California, why did you not have the procedure? I had Blue Cross and had an emergency procedure at a hospital that is practically in bed with Blue Cross. But since I didn’t have my Blue Cross ID with me they billed me. I spoke with them and they said just send us a photo copy of it and everything will be taken care of. Well it was, it took almost a year of correspondences between us (which by the way I found quite absurd and still do). But you being a tourist you really didn't know the ins and outs of the system. As I stated before if this happened in California all you had to do is go in through the emergency room, and have your visit. They do not discriminate against people with or without insurance. After your stay you walk away or you leave in a wheel chair. You go home and I guarantee you Lloyds would take care of it.
You still haven’t told me which hospitals in
California refused to treat you. I would really like to know because they would be in deep sh!t.
Maybe as a tourist you asked for a guarantee that this surgery was going to cover you completely and the people on staff could not tell you what you wanted to hear. I suspect that is more like something I would believe you could make happen, and pitch a fit about it.
So this guy From Norway who admitted he had cut rate insurance did not have to pay a dime, and went on with his studies in cybernetics at UCSD. You went crying home to Australia even though you could have had the procedure done here. (if it was in California) I love the fear mongering, it is hysterical. If you don't like our policy's stay away, because the majority of San Diegans don't want you anyway.
When I was hitting the beaches as a much younger man there was a popular saying among the locals:
"Tourist's Go Home But Leave Your Daughters".
Ciao........saaanap!!

[Tazio]

That may be true, however this is a very large country California Alone is about the same size as France. I probably have about as much in common with someone From Auburn Alabama as I do with someone from the Canari Islands. Visit [/I]if you dare[I] Del Mar, Solana Beach Santa Monica/Venice, San Francisco, Carmel, Napa, Mendocino, and the only fat people you will see are tourist's form Illinois, (they also love their sausage) Virginia,( they specialize in Ham although Newport News VA. is very progressive) and depending upon who can afford it many other States. The statistics are skewed and you can't draw conclusions from it other than as a whole we are fat. Let me give you another example. I don't think that San Diego would rate very high in the lean index because it is/was a Navy Town. With all the conflict's that the previous administration was drooling to throw us into and did. The only people in my line of thinking that would enlist are misguided patriots, or others that have no other real options. They generally come from the South or just about any poor rural area including California. When in training, these men and women are probably in pretty good shape. But that doesn't last long, plus their dependants who don't have to train are generally good candidates for type two Diabetes by the time they are 14. The hard core capitalist’s in the "Home of the Gullible" tell us that we need lower taxes to generate more growth in the economy. That is something I believe is a bad solution. Not because I don't think it's true, because it will bring on more of the same people running around with GPS’s, and hand held internet, and always at least a cell phone, so they can be much more effective working machines. Don't get me wrong I think these are all great devices, but over here they are great tools to get employees in the field to run around like mad men, and women who make psychologists and psychiatrists wealthy, making the idea of fast, cheap comfort food very appealing. Personally when I go out I only bring my cell phone (turned on) with me if I am expecting a call, you know why? I come from a different time. A time when your only phone was hard wired to a line in your house. So I have carried over some of its so called limitations. My cell phone is off because (metaphorically speaking) I'm not at home. I'm sure plenty of people will say what if someone in your family has an emergency? If they can reach a phone they can dial 911 and you know what else the paramedics that arrive cannot refuse to treat you in your own house or anywhere else in California.
Now if you are savvy, and you don't have insurance in San Diego, you can go to the San Diego Mid City Clinic. Here is there phone number; (619) 280-2058 The vast amount of people that go there are on CMS (Not having a net worth of $1,999.99 excluding one auto for transportation) Everything that is done for these people is covered by County Medical Services. They don't pay a penny and that would include antivenin from a rattlesnake bite, plus it can be applied retroactively. If you don't have insurance, you can and (I have) go there. Your office visit is all the way up to $36 dollars (that is to see an MD) They will give you lists of facilities for whatever tests you may need. Some of them are so low that it would impress a Canadian or a Romanian :erm: ;) Who pays for all this you say; The Tax payers? As I said before most of the rest of the country and many in California call us communists, although I think what their dumb asses mean is socialist’s. What I'm saying is that statistics can paint us with a broad brush. And please remember this: No other Country has blindly followed us into military conflict in the last 20 years than the UK. That is why I respected the stance that the French took especially in the UN when the case was made for us to go into Iraq because of the overwhelming body of evidence of weapons of mass destruction :crazy:

[Tazio]

.......and I almost forgot, the Native Americans which probably outnumber Brits have a genetic predisposition to becoming obese and getting type 2 diabetes. Why you say? I so glad you asked. They spent many thousands of years as mostly gathers. As much as you would like to believe they gorged themselves on Buffalo that is a creation of Hollywood (not that some didn't hunt Buffalo). However there were none in the vast majority of what is now the USA. These peoples ate as many berries nuts and fruit as they could find, however it was for the most part just enough to survive. It is no secret that these people have a conditioned response to over-eat. I think if you check these peoples have an enormously high percentage of obesity, and type 2 diabetes even compared to all other Americans. Black descendants of Slaves have a less rate than Natives although if you check I think you will see that they are higher than European/descended Americans. saanap