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Dear Ivan, This is off course a big problem. When we started here in Belgium, only those who could afford it had the surgery done. Friends of one of my patients organized a charity night for the patient to be operated and collected the money for the surgery. Since this year we have a reimbursement for 80 patients (Belgium has around 10-15,000 PD patients), which is not enough, but at least it is a start. In the USA I believe at this moment it is only possible to have a surgery done without costs, if it is part of a research project. You may want to ask the NY university administrator Anne O'Sullivan, what she knows about reimbursement in the USA or at her hospital (apart from her recent postings, that some insurance companies carry the cost of surgery). It would, by the way, be interesting to compare the cost of surgery in the differerent countries wordlwide. I have suggested this before, but nobody seems to pay attention to the fact, that there are such a large differences in the cost of surgery in different countries. It is a shame that in some Western countries, including Belgium, two kinds of health care exist, one for the well-to-do and one for the less fortunate people, even though they all have the same disease. You could argue that funding for PD research may be reduced for the benefit of the care of those who cannot afford the right medicine or surgery and continue to be invalidated. Greetings, Chris