Crowdfunding for Prostate Cancer Surgery - Just Shouldn't Be Necessary in Australia.

It has always saddened me to see crowdfunding campaigns to raise money for individuals to undergo live saving surgery in the private hospital sector.  Notoriously, we have seen campaigns for particular specialties and we could go further if we wanted, in specifying particular surgeons whose names come up repeatedly.  I was grateful that this was not something that we tended to see in my specialty of prostate cancer surgery but I guess it was only a matter of time.

The reason why I have thought that this would only be a matter of time was the intense competition that we see for robotic radical prostatectomy cases amongst Australian based urologists. Do a Google search and you will see a plethora of robotic surgery marketing in Australia. The fancy websites will have surgeons boasting about their extraordinary achievements in becoming experts in this aspect of surgery in their quest to entice you to utilise their services. Often there is the line of ‘most', ‘first', ‘pioneer' and so on. I was the first to do a robotic surgery operation in my hospital - I say 'big deal'. There is also the goading of site visitors to seek out a second opinion with the subtle suggestion of an expectation that they will be in better hands if they do so. 

There is also an issue of cost as the out of pocket expenses can be very high.

One reason why the out of expense costs can be high are the costs of consumables.  The consumables are the throw away items associated with the use of the technology.  It’s an amazing cash cow for the technology companies.  Hospitals have to spend huge amounts of money to buy the instrumentation and then have to pay for the privilege to use the machines by virtue of expensive servicing contracts and disposables (consumables).  Private health funds are not obliged to cover the costs of the consumables used in robotic surgery. Some funds will cover part or all of the consumables costs but if your health fund does not cover these costs, you could be up for as much as an additional $4000 out of pocket.  The other reason for the huge out of pocket expenses is that some surgeons feel a sense of entitlement to charge what they think they are worth. In some instances, this out of pocket expense of what is above the amount that can be claimed back from Medicare or Private Health Insurance could be over $10,000.  Robotic surgery is sexy and expensive. 

Thankfully, robotic surgery is available to non-insured patients at Nepean Public Hospital. Most people would not be aware that this is the case. I personally have had no issue in referring patients to Nepean Hospital and stand on my record for doing so.  There is however, no incentive for surgeons to notify patients who have financial difficulties that this service exists.  My colleagues performing surgery at Nepean Hospital are well trained and very competent at what they do.  It would be a brave prostate surgeon to claim and prove that they were significantly better than these surgeons.

I saw this appeal appear in my Facebook feed and not surprisingly caught my attention. I do not know the circumstances behind this case at all. I wish there was some way to tell him that he can receive ‘robotic keyhole surgery’ with a ‘top surgeon’ at the Nepean Public Hospital. He seeks to raise $35000 which suggests to me that he is either uninsured or his surgeon is charging an extraordinary surgical fee.  Most surgeons (I would like to think), no matter how good they think they are, will try to help out with the surgical fee if the patient is experienceing financial difficulties. Once again, I do not know the details of this case but I am saddened see a case of where prostate cancer surgery costs necessitate a crowd funding campaign.

Note:  This blog piece reflects circumstances specific to Australia and may have little relevance to circumstances elsewhere. In Australia, we have a public health system, which in spite of its many faults, will see that all can have access to necessary cancer treatment.


Update - see following related blog piece (click link)