Modern Vespa

We mostly watch TV w/o those ads for drugs most of us have never heard of, probably don't need nor care about or could afford if we did need them. DVR is our saviour when it comes to USA TV!
As for costs, my wife and I live on KY Teacher retirement checks, plus SS plus we are self sufficient to the extreme, limited only by technology and aging. My meds come in the mail via my retirement plans Rx contract. I pay $10 for 90 days or less for several that are cheaper at a few bucks. There is no mail charge unless I ask for a rush. A few items I do through a local Rx as they are cheap and need to be timely, such as an antibiotic for an infection @ only a few dollars. Many of our extremely high priced drugs are a reality of course but more than a few have been miss-characterized by a (so-called) news media for sensationalism. The $600 allergic reaction epi-pens are my prime e.g.. While you can pay that much for a pair of them, mine have never been even 10% of that price-last ones were like $32 for a box of two. I self inject seasonal allergy serum thus keep them around in spite of never a reaction.
My shoulder surgery doc gave me a sample of an NSAID ointment to try on my shoulder. He said it was said to be for knees and I got like 4 samples. i then got a call from a sales rep asking if I'd filled the Rx. I said no, but lets ask how much the stuff costs? She says i can get a coupon to which I say those are for those who are not insured so how much? She then says, "this is the worst part of my job", it is $2,000 USD for one Rx. NSAID creams are common in Europe me thinks but not here. At $2k per pop I can see why. It's a zoo out there!
Our Medicare comes via our retirement plan at no extra cost for a Medicare Supplemental Plan through their contract with a major insurer, United Health Care. We have zero complaints costs wise! The deductibles are easy to meet each year and we can choose our providers which really matters given our rural location and that some are a poor choice IMO.
Honestly,given our rural location, the transportation is more $ than the services. My Thursday spine specialist is 1.5 hours one way. We use medical visits for our dining pleasure, so all's not lost.
Many in the USA who are among the working poor lack affordable healthcare as the deductibles are ridicoulous. It is not possible to talk more specifics here as it IS political.
Pain is not what it seems. Much is mental as we know it sifts through our brains before we can talk about it. Who hasn't seen an adult who displays childlike low pain tolerance- and I'm not pointing a finger here at all. One person trauma is just another bump for others, is my point. An article I read last year in Smithsonian about a lady who's one of the very few who study pain showed her results to be that many pain meds actually were ditched after development as they didn't seem to help when she found in fact , that they helped certain people. Seems she's learned the pain meds must be very closely tailored to each person and much research has been thrown away that works for some few people.
Like millions of people I have chronic lower back pain and age related chronic joint pains. Other than an NSAID there is no relief for people like me? Perhaps CBD but it's NEVER been mentioned by any provider of mine.
Opoids given to me after surgeries didn't help me as much as I would have liked, after a couple of days of little result and me through the major pain plus the damned things lock you up bowel wise! My septic system must be very pain free?
Side story: last nights local news showed a farmer who must do 24 hour surveillance on his fields of industrial hemp as they sneak in and steal it. The local sheriff helps some by patrols but a combo of staying up all night and cameras helps. They showed a parade of those who've been arrested this season alone.

...and from what I'd heard, under $100 in Japan. Go figure.

Just read an article about families in Kansas getting pulled into court to meet medical debt collectors to discuss payment. If they don't show up, they're jailed for contempt. One mom went to jail because she decided to take her 7 y.o. in for his cancer treatment instead of going to court.

System kind of works for the poor, but between poverty levels and upper middle class, a lot of people just can't afford to get very ill.

BTW, on the opioid issue, apparently in my state, meth use is on the rise, in part because it's easier to slip off in that direction from opiods. We've put millions into opioid treatment (though we don't get most of them), but if you're meth addicted, they can't take you. Go figure.

A lot of companies have been doing similar things lately with old, bad debt. It's a strategy that makes it possible to jail people who don't pay their debts to a private company. Sort of like Debtor's prison. Think about how many people along the way were 'just doing their job' to put that woman in jail.

In the US, we elect a lot of judges. And winning elections takes money.

And then there is the phony numbers games providers play with the insurance companies.

One example I had an MRI in June. On my EOB from insurance company it says Amount billed $2,000.
Amount approved by insurance company $359.99
Amount insurance plan covers $242.39
My share is $117.60

So what happened to the $1,640.01 does the provider get to call that a loss for tax purposes?

And on the drug side of this how do the drug companies get off crying about the cost of developing new drugs when many of them are actually developed in government run labs? And why like just about everything else made does the price of many drugs not go down but instead they go up?

I have also heard that many drug companies do some insignificant tweeks to drug formula's when getting to the point they can go to the "Generic Market" just to claim to be exempt for several more years. This is even is the tweeks have no real bearing on how the drug works!

If you think the $800 gvmnt hammer is too high, hospitals have buried in their statements much worse stuff. My Mom used to require a detailed statement to catch them up but now the billings seem to hide such high priced aspirins, etc..
For the information of our Euro friends: I never pay more than the deductible or the 4%, thus a very expensive surgery is mostly on the cheap. like already said in the USA it's those on the "in between" that suffer.
About 25 years ago I was working up a financial aid form with a student-the FAFSA. I'd do them for people as no mistakes helped us both. I asked her if she had any debts, she replies, yes, I owe the hospital $300,000 plus dollars.
Turned out she'd had a baby out of wedlock and birth was complicated, etc..
Fuzzed me up a few years back when I read that my heart doc shared a $million plus$ payoff with another heart doc-they were whistle blowers on unnecessary heart procedures. fat chance joe blow would collect like that?. Some instances you get blacklisted if you turn someone in. We learned that with chain nursing homes after reporting abuse and wondering why the next place wouldn't take that person.

Don't get me fired up, guys.

I'm still steaming over the $1700 the orthopedist charged to actually touch my broken ankle. Insurance company told me it was for "reduction of a closed fracture." My ass. He wasn't Jesus.

That's in addition to the $350 to sit in the room.

All done in 15 minutes.

Depends... did he give you wine that used to be water. You know... for that kind of money....

People complain about how much my company charges but yeah... Medical costs in the US are insane and shouldn't be legal. Everyone has a right to good medical treatment. It blows my mind that in some even first world countries that is not the case. You shouldn't have to fight with your insurance company for a procedure that was needed. We aren't perfect up here by a long shot but I do prefer how we manage health care.

This thread is going sideways.
Because of some gaps in employment and the mortgage meltdown I'm retiring with a small nest egg. Come hell or high water, I'm retiring at 62.
My plan is to siphon my nest egg into a safe deposit box and cut my work hours at 61 so I can qualify for Medicaid when I retire.
I'm 58, no prescription drugs, don't smoke, drink, no caffeine, normal blood pressure.
I have early arthritis. So I'll have a choice down the road. Opioid addiction or forfeit my immune system with crazy arthritis drugs. I'm not giving up my immune system.

Good luck on all that! I retired @ 58, other than CTS release surgeries and osteo in my hands, all was well except for taking a water pill to get to 115/70 BP. At that time my body began aging such that seasonal allergies which had NEVER bothered me ever began to make me wheeze, sniffle, so on. I still inject an allergy serum to help my immune system try and keep up.
The totality of many years of hard work then kicked in and a progression of joint issues came along-not all that unusual I might note. If iIm addicted to anything it's not knowing when to say stop and just kick back. it's not in my DNA to loiter, I am a doer and i don't mean hopping on my scoot to get a latte.
Medical costs story from my wife's past couple of Alzheimers duty with her Mom. MIL is 95, healthy organs, mind is gone. MIL fell a few weeks back when none of her kids were her caretaker right then. The guy who mows the place was there and his siter was the aide doing the 24/7 routine with my MIL. MIL was "creaky", mow man freaked out, called an ambulance, and local rural KY ER visit takes place. Doc looks MIL over , says no apparent problems and she goes back home. My SIL who pays the help and bills (all to keep my MIL out of the same nursing home that got her 90 yr old sis into a hospital from blatant abuse) tells my wife yesterday the bill came in for that ER visit @ $20,000 & change. Nothing was actually done there except a checkout. Not to be culturally insensitive, but the mower man who's a decent retired guy worked most of his life as a tree trimmer on a road crew. If you've never been to an ER in the USA, it's mindful of a Greyhound Bus Station, IOW's, full of the poor and down and out aspects of our society, mostly African Americans/Hispanics, and itinerants. Thats where they go for some sort of care. Lots can be said as to why they're there or much else politically but fact is that it's not cost effective nor logical place when ya got a sniffle as many there do!
This spring after tearing my meniscus, I tried to get into my own hip doc for a knee checkout as he does only hips and knees. Intake said it would be late summer to which I said well my last THR checkup comes sooner than that date but my knee is screwed up as in NOW!. The intake told me to go to the U of KY ER, nowhere else!!! and then call back for an appt. At that ER, a 3 hour RT from my home and me driving myself over there to creep in walking sideways with a knee that wouldn't bend, I told them my only purpose was to get in and see my own doc ASAP. They wasted $$$ on an xray that wouldn't show tissue damages to begin with but got one as they said so. I then got in to see my own doc within ~ 6 days. The doc apologized as it's all out of his control and I got my 1st cortisone shot. Treatment cost is less than a good meal. lets compare my knee ER visit to my MIL's- mine cost a bit over $2,000 total mostly paid by Medicare and her's and mine were wasted medical visits overall. I see in yesterdays evening news how transparency of those costs is needed. There are zero secrets about what these two ER visits costs-the issue is the wasted visits for no effective result.

I want to know why your BP goal was 115/70?

You asked a question about a BP goal. My so-called goal is to live as long as possible, like most of us. I was saying what my typical BP IS! using what I stated, which is a quite common BP pill. All in all it's TMI. Just saying my BP is fairly normal, that's all...
Honestly, other than thyroid pills when a pre-teen, I had never taken pills until age 58 was sort of my point.

... I read the whole topic (with great difficulty) something I didn't understand and I seem to have understood that many of us inflict the "torture of the scooter" ... or is it a therapy ..?
I didn't understand it correctly. Sorry

You have been the object of a "state of grace", you see the glass as half full and not half empty. God is with you.

I asked because it seems a quite low target for someone your age.
I was assuming it was high, hence the need for prescribing a water pill.

really appreciate others' perspective on pain management, especially as someone who also has somewhat addictive personality, and also have not been able to sleep well for quite a long time.

I've had sciatic pain for most of this year and have had to switch from caging to riding the scoot for office commute. So yah, this is SORTA also a good place to talk about chronic pain?

My experience is of disks in the lower back that are dehydrating and shift a little now and then. If I catch it early, when my right buttock starts going numb, I can slow stretch and stomach crunch it right away, otherwise I need a day or two of anti inflammatory meds.
I have shied away from any sort of surgical fusion as that is a one-way street with no turning back.

What helps for me?
When I sit, I do not sit against a back rest. Use a stool instead or sit forward in the chair. Let your core muscles hold you upright. I used this for years at work and anywhere I sit at a desk or table.
Ride your scoot. The wind against your chest requires your core muscles to work. Any twinge of pain in the back and I am off on the scoot or another naked bike. 20 minutes of riding and I am fine again.
There are stretching exercises that you can perform to reduce the pain and relieve the symptoms. Do them slowly and be guided by your pain threshold. When I reach that, I hold it there for five seconds and release.
I am by no means a fit, athletic,skinny guy and I manage.

For sleeping, the right foam on the top of the mattress helps me best. Ironically, my couch has exactly this foam and when I get pain, I sleep on the couch for a night or two. Alternatively, I sleep in a relaxed sitting position with raised legs where my weight is carried on my thighs and my upper back, giving the lower back time to relax.

Pain relief - cannabis oil or hemp oil. You don't need the narcotic component effect. The herbal content is what helps. South Africa's Constitutional Court has recently decriminalised growing for own use and new legislation has not yet formulated legislative restrictions, so every Tom, Dick and Harry 'wannabe hippy' from the 70's and 80's is now proudly displaying a new kind of "pot plant" on his garden patio. It is sadly amusing in fact. The previous "dope-head" growers here are now being actively sought out for advice on keeping one's little weed patch healthy and thriving. How times have changed?

Of course, USA is still so much under the thumb of the tobacco industry that you may not even possess the stalk of a cannabis plant, let alone the good stuff in the leaves (which are also very high in Vitamin C, by the way.)
Good luck.
REALLY THINK before having the the surgeons drill holes millimeters from your spinal column and screw plates on. I have avoided this for over 25 years now.

I Was getting leg numbness, and foot drop. Left sided, I am going numb and electrical shock feelings also. MRI showed extruded disc at C6. Also had narrowed foramens
and arthritis.
Had disc surgery August 12. Leg numbness is completely gone, arm 70% better already. Riding my Vespa , bicycle, and playing drums without a problem at two months out if you let it go, it will continue to get worse. You don't want to end up in a wheelchair. Badly damaged nerves don't recover well. Better to do it sooner than later. I'm sure glad I did!

No jokes here about 45 and needing to see the doctor?

Happy to take PMs.

MRI costs at the private side used to be high around here too. This all was changed by one (!) radiologist, who thought that it would be easy to make a good living out from this: he established a private MRI center in one of our larger cities first and then gradually a chain covering all major locations in the country. His trick: prices we literally slashed, e.g. 1/10 of the standard level. He knew the real cost levels behind the business and was satisfied with a modest profit that still accumulated plenty of money when the whole chain was up and running.

For the established private hospitals this was tricky, as the profit here comes mainly from the diagnostics side, MRI and labs. In the end, they just had to reduce their prices to avoid having non-used machines standing around. For the public healthcare this also put some pressure to redo cost allocations to the MRI part - that used to be a lazy costing target because the private prices were so ridiculate.

So, a one man MRI revolution - pretty cool, ha? This all remembering our population of ca 5,5 milj. people, so we could be a single city....

Today's price for a MRI by a private operator is below... 200 Eur is about 220 usd.

Free medicines have those who have a chronic disabling condition (I am) if demonstrated with a follow-up visit.
160 EUR for an MRI done in private but waiting time three days, free of charge for the National Health Service but biblical waiting times (even from three to six months).
Complete eye examination equal, EUR 180 private.
Free SSN = biblical times.
If someone from the USA wants to move here to stay a little bit better you can do it but you have to adapt a little ...
It is a pity that we are a people of confusion but, even if with some cases of bad health, we are also in the vanguard for medicine (even for nuclear physics, we are participating in the construction of a fusion reactor in France):

http://www.rainews.it/dl/rainews/articoli/Dentro-ITER-il-megareattore-nucleare-sperimentale-che-copiera-il-Sole-c9e385bb-08e7-4d1e-9b1b-0afb85806a29.html

Tonyc- I had my 1st visit with a spine doc yesterday. He had a new MRI and fresh xrays at his disposal. it folled up a different neurology dept visit ~ 2 weeks back. The differences between the two depts I don't fully understand but one is mani campus neuro and other is Sports medicine joint clinic, different docs and campus all part of U of KY health care.
This last doc was a decent listener but after saying that they don't replace spines like I'd been able to do with my hips and probably soon my knee, I was asked what I expected of the visit. I assured him of my non-medical background and said I'd hoped to learn of a procedure that would get me pain relief and better sleep. All my life I slept great until last few years. 9 episodes of sciatica isn't "normal" as my 1st back doc suggested, when your the one in pain, losing sleep etc..
After what seemed like pulling teeth he said that he could refer me to a pain clinic who could use an injection to help with sciatica. AHA! I told him, now we are talking ideas from your knowledge base! not from my ignorance of whats available. He also suggested a different NSAID if Ibuprofen failed to help me. That one is a questionmark for me for now as Ibuprofen helps a bit but not like it makes sciatica go away either.
Tonyc- ask a pain clinic r.e. that shot? i will say that I've tried an epidural 3 times and never seemed to help but took most of the sciatic episode to get that shot, so who knows really?
i will admitt that me walking into these docs compared to the litteral basketcases they see all day long it makes it clearer why they don't "do a fix" on me as apparently I'm not feeble or decrepit enough-crappy crummy pain aside I guess...

... is it perhaps the fault of driving the Vespa ..?

This discussion contributes to why we're known as "AARP sycophants"

For the record- AARP isn't in my zone.

Wow.... Well-done, Finland!

We do have privately-owned MRI facilities here that have knocked the price down a lot, IIRC paying cash for an MRI it's about $600. Still, that's far above what you're looking at. But then again when your mantra is "Best Health Care in the World!" you've gotta pay more to justify that.

Sorry but the term sycophant here in Italy has been out of use for a hundred years and reading it here caused me extreme hilarity
Italian grammar definition:
sycophant

/ Si · co · fan - te /

masculine noun

1.

In the right of the Greek cities under democratic regime, the person who on his own initiative denounced violations of the law.

2.

Estens. E FIG.

Responsible for reports or calumnies

Funny , I just realized that not only is this an old thread the OP has been banned and our favourite red toaster is on the first page. Old threads don't die, they just fade away. That is until they come back!

lol it's not my either, but the pain/numbness is real, and just to clarify, your spine doctor is not a neurologist? or s/he is? And the sports medicine MD was not a neurologist? I've been sitting on a numb butt/leg for a few months and have been afraid to even make an appointment...

I do not at all recall the banishment.

Me either. But a simple search of the users posts would lead to it I'm sure.

I'm taking care of my better half following her 3 level (L2-L4) lumbar laminectomy two weeks ago. She's had increasing back pain for several years, and recently developed a foot drop that became a real issue on a recent vacation. Oral OTCs weren't working anymore, and she had the spine injection twice in 12 months with minimal relief. In the month prior to the surgery, she was having some pain relief with OTC topical lidocaine cream, at least enough to sleep. Prescription Mobic (meloxicam) is helping her with post surgical pain because she did not like the side effects of the opioids, as you have mentioned.

Long way of saying, her foot drop is already much better, and her leg numbness and tingling have disappeared. Surgery might give you the relief you seek.

Blood pressure targets have recently been lowered, and are not age-related any more. They don't want us to be higher than 119/79 and "normal" is now 91-119/61-79.

So 115/70 sounds about right.

https://www.healthline.com/health/blood-pressure-chart

I remember vaguely....he's been banned in his several incarnations....Raiderfn31 comes to mind....

Lowered several times over a number of years. Just so they can get you on meds.