Thanks! The surgery began at 12:45 pm and I was home by 3:45pm. A bit sore at the surgery site (I had an inguinal hernia), but strangely enough no pain at all around each incision.
As far as cost, yes, from my research these machines now start at 2 million, and for whatever reason, the maintenance costs on these are out of sight. I guess they don't want the 'da Vinci' rebooting during your surgery.
" Maintenance of the da Vinci Xi was $621,245 for a three-year contract. During the study period, the median maintenance cost was $2290 per case. If the robotic theatre was completely utilized, the maintenance cost would be reduced to $845 per case."
From what I have read surgeries billed using this machine have higher numbers, for obvious reasons. Leads me to an interesting question that when I have some time I'll try and research. I wonder if there are unique CPT codes for a surgery using 'standard' laparoscopic techniques vs the da Vinci, and if so, does Medicare reimburse differently based on those.
As for costs in general, it leads back to the article you posted, and I would assume rural areas do not have as much access to all these high end machines. I was surprised at how smaller practices are reimbursed at lower rates than larger ones as pointed out in the article. Doesn't seem right.
The most expensive medical device I am aware of is the proton therapy machine, there is a center about 20 minutes from my home.
"Another issue is cost. The equipment used for proton therapy initially carried a price tag of between $120 million and $200 million, which gave many facilities pause, Lagasse writes."
Similar problems on the drug side, there was a lot of press last year over the 17% increase in the Medicare Part B monthly cost, that was mostly due to the projected introduction of one drug, Aduhelm, for treating Alzheimer's. At the time of approval, Biogen set the price at $56,000 yearly, and was going to require that patients also be monitored via MRI's on a regular interval due to the possibility of bleeding in the brain. There was a huge amount of controversy over that drug's approval, and since then a second decision was made to allow it's use on a trial basis only, which will restrict the potential user base substantially. Of course when that was announced Biogen cut the price of the drug in half. Medicare has stated that it is too late to adjust the premium this year, so they will do something for 2023...
Bottom line, all this stuff is wonderful, but if we do get something like an Alzheimer's drug in the future that works well, does Medicare pay whatever is charged, or does the government have to step in and say 'you can have a generous profit margin, but you cannot bankrupt us'?? |
