Canadian Choice - Wait or choose to pay?

[packman]

Newbie - first post and what a fabulous forum - kudos to Pat for starting this and all the contributors who share their inputs, stories and advice

My facts - 55 year old male 6ft 200lbs and large boned. First evaluated 2 years ago, when I had preliminary pain and an assistant to the ortho said "come back when the pain becomes a little more unbearable". Now it's serious discomfort, but the waiting list for my right BHR in the Toronto Ontario area is 1 year plus. I am quite disappointed - had I known then what I know now I would have said get me into the queue list.
Quality of surgeon is not the issue - there are some quite capable people here. I have been told by two specialists that I am a resurfacing candidate and that THR would be too aggressive. The medicare system I have paid into for over 35 years, is now not really there for me when I want it. I can handle waiting 6 months but 1 year plus without knowing when vs. living with not being able to really exercise with quality of life is disheartening. This is the first year I have not played ice hockey in 25 years (although I can give that up vs. risk of femoral head fractures on a fall). It's my golf and general exercise of light runs/walking. Yes putting the sock on the right foot, cutting toe nails on the right foot and sleeping and even driving pains occur radiating to the knee and forget walking a lot of stairs for load bearing. In August I had a cortisone shot and was on top of the world pain free for 5 weeks before my system voided it.

Questions that I need your input on:
1) Any cost ranges out there for those travelling into the US - FYI I am not into going to Belgium or India - just a personal decision/preference
2) If you had the money vs. saving 5-8 months of your discomfort and not knowing when - what would you do and pros/cons why?
3) I don't think as a Cdn. when I pay voluntatily thru the US, that the fees are tax deductible - anyone know?
I feel I am in a vicious cycle with my cardio/fitness suffering while I play the waiting game but the cost for a quality BHR surgeon and hospital stay in the US may be disturbing

[Marco Polo]

Sorry to hear about your challenges getting a surgery date.  I can't answer your tax question or the pro and cons of waiting but from what I've read I believe Dr. Gross would be your best option for a flat fee price without insurance.  A recent post on another board puts his flat rate at $25K, which I assume is "all in" including the hospital.  It would probably be cheaper with his new outpatient option.  You would want to call Nancy Smith at his office to get a more accurate estimate or someone on this Board may have recent personal experience.

I can relate to your frustrations dealing with physical limitations.  I am in a similar situation and have scheduled my surgery for the first week of April.  Best of luck as you sort through your options.

Marco

[Tim Bratten]

I would highly recommend you choose a surgeon who is a specialist in hip resurfacing. Last February De Smet was charging 12,500 Euros for the complete surgery and rehabilitation. You'll have to add transportation costs and about eight nights in a hotel. The plus side is visiting Ghent is like taking a vacation.

[Dan L]

You could have your surgery done in Cleveland at Cleveland Clinic Euclid, by Dr Peter Brooks, a Canadian native, an absolute magician when it comes to this surgery.  Not as far to go as SC.  He is now over 1500 procedures done.  Very good care all around.

The 2 days stay and operation was around $40k usd's, no idea what they do for self pay though, my reimbursement came through my employer's coverage and secondary, so they  have agreed- upon rates.

I ended up waiting longer than a year after things were miserable, (mostly due to my stuborness) which was tolerable for me, but only you can determine how long to wait and how much $$ makes sense.

Best regards going forward.

Dan


PS: I'm told by someone in the know that self pay here is higher because there are not agreed-upon rates like with insurers, so that number would be higher, potentially much higher.

[packman]

Thank you for your input - I am in the process of scheduling with Dr. Gross and his team in Columbia SC. A personal call on the phone with him was invaluable, and is somewhat unheard of within our busy Cdn. Medicare system.
By comparison after waiting for 90 minutes I might have gotten 5 minutes with the Toronto Specialist. I will save my chagrined comments for another time but suspect the govt.'s influence to make the system more efficient and control costs, has impacted many attitudes. Heck if my income was getting curtailed, I might get a little p'od too.
Generally Canadians are quite warm and friendly and it has been so reciprocated on my previous trips to the Carolinas (6). Discussion and exchanges with Dr. Gross's staff have been equally welcoming!
The  the accelerated time,return of lifestyle, ability to be pain free earlier, are outweighing the cost

[K2]

I am a Canadian and just went through all the same decisions you are facing. I will add that I had the ability to avoid the wait times in Canada if I wished to do so. 
But instead, I chose to go to Dr Gross because from what I could tell it was going to be best for me . Two weeks post op and I have never been so happy with a decision.  The Doctor, the team, the refinements to the procedure and care,  the hospital: all beyond outstanding.

I traveled from British Columbia but for what I got I would have gladly travelled to the moon. I am frankly surprised at how much weight some people seem to apply to going to a Surgeon that is a little closer.  For me,  I never wanted to say,  "I wish I had gone the extra mile"

Although I am not certain about the tax deductability, I would expect that you could deduct the actual medical expenses. Additionally, you might make some enquiries to see if OHIP will reimburse you for the cost of the surgery. I think they will, but only the amount they list it at in Ontario. By the way, I was extremely pleased with the price I paid. Both the doctor and the hospital offer discounts to self pay patients who pay in advance. You think dealing with the Canadian health system is frustrating?  Try being a health provider in the USA and dealing with insurance providers.

As for waiting for the operation in Canada or anywhere else, this forum is full of people who say they would have done it sooner knowing what they know after finally taking the step.  Add me to that list.  When it's time,  it's time and a year out of your life when you are 55?

Side point.  I flew into Columbia.  Next time I would probably fly into Charlotte and drive the hour and fifteen instead of a two hour connection, 40 minute flight and 15 minute drive into town.  Did I mention the missed connection on the way out? The funny thing is that in the Columbia airport some employees actually recognize Gross patients by the presence of the ice machine and maybe I imagined it but I think it got me special treatment.  Probably just good old southern hospitality.





 

[mslendzion]

Dr. Schmitt is in the Detroit area and has done over 1000 BMR's and, I feel, is a great surgeon just a long drive away.

[einreb]

the cost for a quality BHR surgeon and hospital stay in the US may be disturbing

I flew from Chicago to Charlotte and had the surgery with Dr Gross.  I think the previous mention of $25k is about right.

My insurance paid for most of it.  I'm not wealthy by any stretch of the imagination, but knowing what I know now... I'd now pay it out of pocket to go if I had to.  He's that good.  The system they have in place is that good.  The hospital is that good.  And I'm a cheap paranoid S.O.B.

I think DeSmet and others have comparable costs?  Other FINE choices available.  This is an actuarial gamble but the stakes are high.  For the cost of a mid-sized car (sounds corny I know) ... you can move the odds well into your favor for a good result.

Not an easy decision, good luck.

-Bernie