Sunday 25 September 2016

The big-ticket health bills facing Irish men

As one hospital stint could cost more than the average wage, can you afford to be ill, asks Louise McBride

Published 10/07/2016 | 02:30

Cartoonist: Tom Halliday
Cartoonist: Tom Halliday

Irish men are facing bills running into the tens of thousands of euro to get treatment for the typical health problems they are likely to run into over their lifetime. Life-saving surgery could cost more than the average industrial wage. Many men don't have this kind of money.

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Private health insurance bills can add up over the years - but without it, you could find that you cannot afford hospital treatment for a serious illness when you need it. Having private health insurance usually means you can get seen privately - and quickly. Waiting lists for treatment through the public system on the other hand could run into months or years - and sick people don't have time on their side.

So what are the typical health problems which land Irish men in hospital - and what bills could they face should they have to pay their own way?

Bad heart: €40,000

Irish men will be the fattest in Europe in less than a decade, according to a study published by the medical journal, The Lancet, earlier this year. The same study found that Irish men already have the highest Body Mass Index (BMI) in Europe. The higher your BMI, the higher your chance of being overweight and developing certain illnesses, including heart disease.

Heart disease is already the biggest cause of death in Ireland. So it's no surprise that many Irish men end up in hospital to get treatment for heart disease.

The TAVI (Transcatheter Aortic Valve Implantation) procedure is a new treatment for heart disease which doesn't require open heart surgery. It can be a life-saving procedure for people who are too ill for open heart surgery - but who need to have a heart valve replaced. It costs between €36,000 and €40,000 to get this procedure done privately.

Blackrock Clinic, which is one of the five hospitals where you can get the TAVI procedure, generally charges around €40,000 for the treatment. "That includes the cost of the procedure, device - and hospital costs for the recovery period," says a spokeswoman for the Blackrock Clinic. "TAVI is covered by health insurers, but it has to be pre-approved. This is because insurers require proof that the patient would not withstand the more traditional, more invasive and less costly procedure."

Should your family have a history of heart disease, check the exact heart procedures which are covered by your private health insurance. Consider changing your policy to one that covers the likes of TAVI should you feel the need to do so. For example, only some VHI plans cover TAVI. The procedure is fully covered on VHI's HealthPlus Extra, HealthPlus Choice, HealthPlus Premium, HealthPlus Platinum and Forward Plan Level 1.

Coronary angioplasty, a procedure which opens clogged arteries (the main blood vessels supplying the heart), is one of the most common types of treatment for heart disease. Stents can be inserted in an artery during such surgery - and you can expect to pay at least €5,000 for a normal stent procedure, according to Dermot Goode, health insurance expert with totalhealthcover.ie. "If a cardioverter defibrillator device is fitted, the cost is anything from €15,000 to €20,000," says Goode. "You'll typically pay between €4,500 and €5,000 for a pacemaker."

A heart bypass operation typically costs between €20,000 and €25,000 - plus €2,000 for each night spent in an intensive care unit, according to Simon Nugent, ceo of the Private Hospitals Association.

Prostate cancer: €20,000

About 3,000 Irish men are diagnosed with prostate cancer each year. The DaVinci prostatectomy procedure is a new type of treatment for prostate cancer. The advantages of this surgery for patients, according to medical experts, are faster recovery and less bleeding. However, it could cost between €13,000 and €20,000 to get this surgery privately. The procedure is only offered by a small number of hospitals - mainly the Mater Private and Galway Clinic.

Cancer: €14,000 plus

Men are more likely to die from cancer than women, including lung cancer and colorectal cancer, according to various studies.

Cyberknife is a new cancer treatment offered by the Hermitage Medical Clinic. One of the main advantages of this procedure, according to the clinic, is that it can treat cancers which are in difficult or dangerous positions, such as near the spinal cord, prostate, lung, brain, liver and kidney.

The treatment costs at least €14,000 once consultant fees have been paid. Although it is covered by private health insurers, this will depend on your policy. Should your policy not cover treatment in the Hermitage, you would have to foot the bill for Cyberknife yourself.

Life-saving cancer tests: €1,000

Detecting cancer at an early stage can give you a better chance of fighting it. Some tests which can help detect cancer include a colonoscopy (which examines the inner lining of your large intestine) and a gastroscopy (which examines your stomach and the lining of the oesophagus).

"If you wanted to get an urgent colonoscopy or gastroscopy, you could wait months to get one under the public system," says Goode. "You might only have to wait a few days to get tested if you go privately."

It costs around €1,000 to get a colonoscopy or gastroscopy done as a daycare procedure and that cost is usually fully covered by private health insurance, according to Goode.

Public patients face waits of up to 480 days for tests used to diagnose cancer, according to a report published by the Irish Cancer Society and the Irish College of General Practitioners earlier this year. Waiting times for MRI brain scans were estimated to be on average 20 times higher in the public system than the private. "The grim reality of our health care system is that the difference between life and death can come down to your ability to pay for healthcare," says Donal Buggy, head of services and advocacy at the Irish Cancer Society.

Depression: €18,000

Depression is a very common illness in Ireland. Irish men are between four and five times more likely to take their own lives than Irish women. A short stay - that is, around 28 days - in a mental hospital could cost anything from €15,000 to €18,000 and upwards.

"Most people who go into a mental hospital are usually in for between three and four weeks," says Goode. "These facilities usually cost at least €500 a day."

Most private health insurance policies cover up to 100 days a year in hospital for treatment for depression. Some cover up to 180 days.

Without this cover, many people would struggle to afford the bill for depression treatment - and to get the care when they need it. Any delay in getting the treatment could ultimately cost an individual their life.

The St John of God (SJOG) Hospital, which offers treatment for depression and addictions, has seen an increase in the number of people over the age of 65 seeking care there in the last two to three years. "We have also seen an increase in people presenting with high stress, anxiety and depression," says Emma Balmaine, chief executive of SJOG.

Treatment for a psychiatric condition in SJOG is usually covered by private health insurance, according to Balmaine - though the patient may need to pay a contribution towards the cost of their care, depending on their policy. "Not all policies cover the independent and private psychiatric facilities," explains Belmaine. "Some policies cover day cases only -that is, treatment of a diagnosis on a day - rather than on an inpatient [where you stay in hospital overnight] basis."

The cost of treatment for depression is a "massive issue" for those who don't have private health insurance, according to Goode. "You could be fighting and waiting for between three and six months to get a place in a mental hospital under the public system." says Goode. "There's a major shortage of places in the public system for adolescents with such problems. You could pay between €25,000 and €30,000 to get a teenager treated for depression in a specialist centre. You do not want to be relying on the public health system if you need quality care for a mental health illness."

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