A copy of prior correspondence on pallidotomy followed by my own
comments:
 
Subject:       Re: Pallidotomy
Return-Receipt-To: "Barb Colmery" <[log in to unmask]>
 
It is really heartwarming to learn about a treatment with what sounds
like a positive response (at least for a time) in most situations.
However, I am floored by the cost of the procedure, especially when
you consider the relatively brief duration of surgery &
hospitalization.
 
I received shockwave treatment (ESWL) for kidney
stones last year, with secondary complications resulting in
hospitalization for a week and was stunned by the $16,000 bill for
this "minor" outpatient procedure (though grateful most of it was
covered by insurance). However, that included 6 days of
hospitalization, 2 surgical procedures (1 relatively minor) under
anesthesia including the ESWL, and re-admission through the emergency
room.
 
I would be interested to hear any opinions on how Loma Linda
justifies such a seemingly astronomical fee.
 
At a glance, since this is the only treatment that really offers some
restoration of previous functioning, it would appear that they might
be taking advantage of people who are desperate for any relief possible.
I do understand that this must help cover the expense of developing the
treatment, but it still seems out of line. However, I wouldn't take away
from its apparent success in relieving major symptoms and disability.
I am also amazed that insurances cover the fee.
 
Again, it isn't that I don't appreciate the wonderful benefits
apparently experienced by those treated.
 
Thanks,
Barb
 
 
> Date:          Thu, 6 Oct 1994 11:29:31 EDT
> From:          Don Berns <[log in to unmask]>
> Subject:       Pallidotomy
 
> Dear Albert Ferris-Prabhu,
>
>      I am glad you found the info on the Pallidotomy helpful.  A
> Pallidotomy on one side takes about 2 hours at Loma Linda and on
> both sides about 3 hours.  Loma Linda and Dr Iacono is the only
> doctor in the world currently doing simultaneous bilateral (both
> sides) Pallidotomies.
>      Some of the counter indications are the possibility of
> bleeding and a possible stroke.  There is also a very slight risk
> of losing part of a field of vision.  Outside of this there are
> the normal surgical risks.
>      The average cost at Loma Linda is $20,000 for a unilateral
> and $30,000 for a biilateral.  Most insurance covers the cost and
> it is not considered experimental but therapeutic.
>      Th Pallidotomy is effective for all the symptoms of
> Parkinson's disease.  It takes anywhere from 2-3 months to
> schedule an appt. with Dr Iacono 909-796-4822.
>      The stay in the hospital barring any complications is
> limited to one day.  Check-in the morning of surgery and check
> out the next morning.
>      The first step I would recommend your taking is to make an
> appt. with Dr Iacono and come out for a consultation.
>
> Sincerely,
>
> Don Berns <[log in to unmask]>
> [log in to unmask]>
>
Barb Colmery ([log in to unmask])
 
 
 
---- End Forwarded Message
 
Yes, Barbara, I agree that the costs quoted are astronomical.  Yet,
they are not "out of line" when compared to what some hospitals
charge for care.  My 16-year-old daughter, last year, had surgery
for gallbladder disease (yes, pretty young for that!) and had a
laparoscopic operation (the "latest thing").  She was otherwise
quite healthy and was in the hospital for only 3 days, and the
hospital bill was $30,000!  Again, like you, I had "good insurance";
but this is why the insurance premiums have skyrocketed (one of the
reasons).  The surgeon who did the operation charged $1,500, which I
thought was quite reasonable; but, in most cases, it is the hospital
bill which is so high (like $5.00 aspirin tablets, etc.).
 
Most of this is related to "cost shifting", this being the hospital's
attempt to "make up" what it does not receive from people insured
under "managed care", HMOs, Medicaid, etc.  I do think, however,
that the costs of the pallidotomy described at Loma Linda are "out
of line", but I would like to see them broken down as to what are
the hospital charges, and what is the surgeon's fee.  For example,
in my practice, the charge for surgery for a brain tumor (which is a
more complex and risky operation than is a pallidotomy), is somewhere
between $5,000 and $6,000.  Medicare will pay about $1,800, Medicaid
will pay about $1,200; and some "good" private insurance policies
will pay as much as $2,500.
 
The present debates going on in health care do not really address
this situation.  While I am, in general, a Clinton supporter, I oppose
his Plan because it perpetuates the present system of "managed care",
which for the most part, results in large profits for the insurance
companies.  I support Proposition 186, the "Single-Payer Initiative"
which is on the November ballot in California, and which is
similar to the Canadian system; as it will "level the playing field".
There is no easy solution, but reform of health care financing is
urgent.
 
I have recently written an article concerning this and have submitted
it to several national magazines, but I have not yet heard as to
whether it will be accepted or not.  If not, I may consider posting
it here and elsewhere.  Sorry to get on my "soap box", but this is
a vital issue, not only for Parkinson people, but for all.
 
Best,
 
Bob
 
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Robert A. Fink, M. D., F.A.C.S.   Phone: 510-849-2555
Neurological Surgery              FAX:  510-849-2557
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USA
 
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