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NA by Kline
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02/01/2006 23:36
Randy H.

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02/01/2006 23:36
Randy H.

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~dq~Such a Deal~dq~

Perhaps in time ".", but Eaton & Co. are up to their eyeballs in spite of the fact that NA is still available elsewhere. The problem is not what *they* charge, but travel expenses incurred by NA's continued relative scarcity. Once everyone can *drive* to and from an NA appointment, $500 - $700 is a deal compared to the alternative.

02/01/2006 23:36
Frances

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02/01/2006 23:36
Frances

not registered

Speculation

Hi Randy,

Let's talk money. Whether it is a dentist or doctors visit there is a limit as to how much per year any insurance company will be willing to pay for
treatment(s), and if those visits are too high then the insurance companies will only allow one treatment/year cutting out regular treatments for the more aggressive forms of DC and therefore reducing the effectiveness of NA. However, if the prices are lowered, then the people need NA more often will get it, the doctor will earn more in the long run because of repeat clients, and their patients will walk through the door with hands that are in better shape so they will not have to work as hard to straighten them. It's a win-win situation.

After all...the Europeans have been doing this for over thirty years and have done their math too, lower prices makes NA more accessable, therefore their patients return more often. Slow and steady wins the race my friend.

Frances

02/01/2006 23:30
Randy H.

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02/01/2006 23:30
Randy H.

not registered

Even More Speculation

Hey Francis,

All good points. But what you didn't addressed is the fact that health care is *far* *far* more expensive in North America than Europe to begin with. The reasons aren't clear to me, but I'm sure if I waved a Red Flag about this point we could get any number of passionate opinions from our fellows as to the underlying reasons. Regardless, we aren't going to change that any time soon. So that's the *main* reason US NA is so much more than Euro NA.

I'm I free market kind of guy. "Invisible Hand" and all. (no pun intended). The more qualified NA practitioners there are, the greater the pressure for a price adjustment. NA may well fall significantly lower *IF* the free market economics within the overpriced medical establishment will suggest it.

Eaton set his price at approximately $700 per session for reasons only he knows. One might speculate, however, that in making himself and his successful practice a Ginny Pig for this procedure, he set it plenty high. And he should have. And he deserves every penny for championing our cause.

When the dust settles, hopefully NA *will* be a lot less. Right now however, I'm in favor of *ignoring* the price and focusing on education and recruiting CHS. While fervently preaching the Gospel of NA to open-minded CHS, do we at the same time want to be telling them how much to charge?

02/01/2006 23:39
Sean 
02/01/2006 23:39
Sean 
Dupuytren~sq~s

I think you are forgetting something. Dupuytren's is not a "big deal" for most hand surgeons. At least that is what I have been told by two hand surgeons. Much of their work is considerably more serious. NA will not be valued less than the other aspects of their practice, no matter how many are doing NA. My surgeon told me that his practice would not suffer if he never did another Dupuytren's surgery in his career. He certainly wouldn't get into a price war over Dupuyten's/NA.

02/02/2006 23:54
Frances

not registered

02/02/2006 23:54
Frances

not registered

Profiling the NA patient

Hi Guys,

According to stats that came out this week, Paris is the fifth most expensive city to live in the world. Only Oslo, Tokyo, Oska out price them. Now don't get me wrong, I'm all for making money, the surgeons who have gone over and learned NA without doubt have a right to earn the big bucks, and it's wonderful to see patients supporting the North American doctors but...NA has been here a couple of years now and it's time for many sufferers to have a second go at their hands. It would be a shame if this NA-thing were to fail because of financial restraints - people turning to surgery that they can receive locally because a second, third or fourth NA is overall financially prohibitive. *Everyone* will loose in that situation. The studies would then reflect a percentage of clients who do not return for NA leaving them open to the misinterpretation that the NA itself failed.

As for making NA less attractive to new surgeons because of lowered fees, no I don't think so...they too will be looking at a long-term client base....and besides...they know they chose not to take the risks...someone else went up to bat first then made lions share of the money...that's how life works isn't it? Earlybird gets the worm and all of that?

Frances

02/02/2006 23:27
Randy H.

not registered

02/02/2006 23:27
Randy H.

not registered

Profiling the NA patient

Francis,

Right now, NA's shot at the big time is contained in the *only* acceptable clinical data file large enough to turn heads. That's Eaton's Data. I would propose to you that the people who previously had the means to fly to see him (and that's the majority of his patients ), will continue to have the means to see him or someone else closer as needed. I believe a *very* low number of people in his records will opt for OS for financial reasons.

So, while you do bring an interesting risk to our shared goal, I think your fear is unfounded. The price of NA will reach an acceptable level for CHS, not for patients. I don't think they even think in terms of repeat business. As Sean mentioned, Dups procedures are *not* a big part of what they do in any case.

(Isn't it nice, though, to be discussing the price of NA rather than it's unavailability as it was 3 years ago? :)

02/03/2006 23:51
Frances

not registered

02/03/2006 23:51
Frances

not registered

Profiling the NA patient

Hi Randy,

The laws of supply and demand are currently in force which is why the prices are so high.

The fees are reflective of the type of clientel who are showing up for NA....someone who has thier own computer, is educated enough to think about looking up DC, has money and.... the risk-taking gene to be willing enough to go against their doctor. That does not describe the majority of the population. Plus like everyone has said, NA is not rocket science and should be placed appropriately on the fee scale.

Frances

02/03/2006 23:29
Randy H.

not registered

02/03/2006 23:29
Randy H.

not registered

Profiling the CHAS

Hi Francis,

I don't think we really disagree. I can see you're thinking Long Term. I'm thinking just Short Term. I see the end game as being Eaton's presentation, whether this year or next. If that doesn't light a fire, nothing will. Once over that hump, it's all downhill, including prices. The supply of NA trained CHS should increase exponentially.......Even in Canada :)

But all I'm looking at is getting over the Presentation hump. Sure, prices should reflect a one hour office visit with a CHS, with an assistant, a few needles, some medication and a pair of gloves. But don't you agree, American CHS will *always* charge more for NA than French non-surgeons? And it would now appear that their safety record will be superior as well.

02/03/2006 23:12
Larry #1

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02/03/2006 23:12
Larry #1

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Slight Statistical Advantage

What are you talking about Randy? The french have an excellent "safety" record... virtually no tendon ruptures, virtually no infections.

02/03/2006 23:19
Larry #1

not registered

02/03/2006 23:19
Larry #1

not registered

Slight Statistical Advantage

I think part of the reason costs are higher here than in France is due to the litiginous society we have here. I'm sure it's not just this procedure - the whole health care system in the usa is driven by malpractice lawyers. Unnecessary tests done due to threat of malpractice claims etc.

My insurance co allows $503 as reasonable reinbursement for "percutaneous fasciotomy", which is what NA is called, and Medicare allows $238.

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