Time for a decision..inputs welcome

[Captain1117]

I need to decide on an implant surgery and here are my choices:

Managed to talk to a surgeon in Toronto who is looking at surgery date in September. Three piece with one night hospital stay and everything else included will cost me 3,500 CAD.This surgeon was recommended by local Coloplast person and he has high ratings in rateMD as a Urologist.His penile implant case data on internet search is almost zero..which is usually the case with all Canadian surgeons.

Other option will be to take a loan and go with Dr.Kramer. Around 35,000 CAD plus extras..flights and stay.Under current financial climate a loan is not looking tempting.
I was expecting a property sale ..which got delayed due to covid etc..which will happen by year end hopefully.

Are there any Cons :
If I go with the Canadian surgeon in Sept and get back the erection and keep daily cycling and using the implant when I can.
In case the results are not great, I can go to Dr.Kramer next year for a revision, by then the world financial situation would stabilize and hopefully I will have the cash in my hand from property sale.
The Coloplast person mentioned to me the surgeon has a good track record. I guess I am asking what is the worst he can do( he is an Urologist MD in Canada..I dont think he has any motivation to not do a good job)..that might worsen my situation...such that Dr.Kramer cant recover it an year later.

Thanks in advance.

[544kenmatt]

I guess it depends on how painful $35,000 plus will be to your finances. It's hard to turn down the same procedure for $3500.

The other issue is Covid. If we have a resurgence, and a lot of states are still rising in number of cases; how long will you have to wait to even get across the border?

If, god forbid, something goes wrong after the Kramer surgery: how do you get treatment from Canada? It might be a logistical nightmare. Will a Canadian doctor even touch you after having had the procedure in the US? How many thousands of dollars will it cost you if you have to get readmitted to a US hospital?

I'm telling you: it will be A LOT. They can charge whatever they want, and it's usually at least double what the insurance companies will pay them. This should be illegal but it's not.

I know I sound like a downer but im trying to think of what could possibly go wrong. Dr Kramer has a stellar record but nobody's perfect and everyone heals differently.

So, It looks like Im leaning towards you staying put.

Best of luck in your decision.

[merrix]

So here is what I have to say, which will probably surprise many. But if so, they haven't really got me in the past...

Sounds to me you should do it in Canada.
I am from a Scandinavian country. Free health care. We basically pay 25 dollars for whatever needs to be done. Doesn't matter if it is getting a prescription for antibiotics or if it is heart transplant surgery. Cost is still 25 dollars.

So if I turn back the clock 20 years, when my financial situation was way, way different than it is today - there is no way I would have paid 35 KUSD for a penile implant in th US when I could have done it for free back home.

And as the poster above says, you don't know if it will stop at the 35 K. Might get worse if things go wrong. And this forum has plenty of cases where guys have needed revisions etc after Kramer surgery. Nothing major, but still. It apparently happens that he fucks up as well. I am sure he still is one of the best in the world, but even going to him is no guarantee.
So if 35 KUSD is not something you can spend without major sacrifice and impact, I'd do it back home.
Money is money, and if we don't have them, we don't have them.

My rant about go to a world class doc, is under the assumption that one has the money and possibility. I am always questioning people who think the trip is too far from Boston to NY and go with a local instead of e.g. Eid because they don't want to take a short flight and stay a few days at a hotel. But your case is different.

As you say, if your doc fucks up - use those money at that stage when (if) you really need an expert.

Good luck.

[Captain1117]

I guess it depends on how painful $35,000 plus will be to your finances. It's hard to turn down the same procedure for $3500.

The other issue is Covid. If we have a resurgence, and a lot of states are still rising in number of cases; how long will you have to wait to even get across the border?

If, god forbid, something goes wrong after the Kramer surgery: how do you get treatment from Canada? It might be a logistical nightmare. Will a Canadian doctor even touch you after having had the procedure in the US? How many thousands of dollars will it cost you if you have to get readmitted to a US hospital?

I'm telling you: it will be A LOT. They can charge whatever they want, and it's usually at least double what the insurance companies will pay them. This should be illegal but it's not.

I know I sound like a downer but im trying to think of what could possibly go wrong. Dr Kramer has a stellar record but nobody's perfect and everyone heals differently.

So, It looks like Im leaning towards you staying put.

Best of luck in your decision.

Thanks a lot for your valuable inputs.

I was only comparing 3,500(possibly low to moderate volume surgeon) to 35,000(high volume surgeon)...what I missed is the basic philosophy behind the two countries healthcare system.
Also This 3,500 is because of the difference between a malleable to three piece..everything else is paid by taxpayers(I am one of them too).If I chose a malleable I think it will be free for me.

If I understand the Canadian health care system correctly, any secondary revision, hospital stay, other expenses due device failure or other medical reasons etc will also be covered by the govt healthcare system. In the US system it can be unlimited financial exposure for the patient.

[Captain1117]

So here is what I have to say, which will probably surprise many. But if so, they haven't really got me in the past...

Sounds to me you should do it in Canada.
I am from a Scandinavian country. Free health care. We basically pay 25 dollars for whatever needs to be done. Doesn't matter if it is getting a prescription for antibiotics or if it is heart transplant surgery. Cost is still 25 dollars.

So if I turn back the clock 20 years, when my financial situation was way, way different than it is today - there is no way I would have paid 35 KUSD for a penile implant in th US when I could have done it for free back home.

And as the poster above says, you don't know if it will stop at the 35 K. Might get worse if things go wrong. And this forum has plenty of cases where guys have needed revisions etc after Kramer surgery. Nothing major, but still. It apparently happens that he fucks up as well. I am sure he still is one of the best in the world, but even going to him is no guarantee.
So if 35 KUSD is not something you can spend without major sacrifice and impact, I'd do it back home.
Money is money, and if we don't have them, we don't have them.

My rant about go to a world class doc, is under the assumption that one has the money and possibility. I am always questioning people who think the trip is too far from Boston to NY and go with a local instead of e.g. Eid because they don't want to take a short flight and stay a few days at a hotel. But your case is different.

As you say, if your doc fucks up - use those money at that stage when (if) you really need an expert.

Good luck.

Thanks Merrix. for your inputs
National health care is the way to go.
If I think of "upgrading" in a year or two..who knows newer and technologically better implants will be in the market by then.

[Canuck67]

Captain,
I will go the other way. Im from Canada also and I read too many botch implants from Canada surgeons.

For me when Im ready, I will go to Eid, Kramer Or other high volume surgeons at the time and get the best. For me money is not an issue and I want the best outcome possible and I dont see this from surgeons in Canada.

From what I read here in the last few months, most that got implanted from surgeons in Canada got short changed or needed a revision shortly after.
I only have 1 dick and I wont let a low volume surgeon screw it up. Unless you get reference from implanted guys from this doctor I wouldn't do it.

[Gt1956]

A few things to consider. First off, most of the prices talked about in the USA health system are just plain fake. Insurance companies negotiate a discount percent on the procedure. The doctors & hospitals raise the price so that after the discount they make money.
I know that non Americans look at the price differences & go wow. The reality is that the true difference is less that you think. Most of their healthcare systems get large sums of money out of the taxes that they pay. The money in the USA isn't mixed together as much. We like lower tax rates. I seem to recall that my Federal taxes worked out to 12.5% for 2018. My state income taxes are pretty close to a flat 5%. Compared to what my wife's cousin pays in the Netherlands. My healthcare is free.
The cost of building materials, professionals educations, large specialized machines like scanners don't vary by much. Those costs are being paid out of the tax payer side of the funding. So I think It's a bit foolish to believe that healthcare is cheaper in Canada. The money just comes out of a different pocket under a different name.
I understand Merrix's point. My drugs only cost me $25 for a 3 month supply. So not everything is outrageous here. My daughter was uninsured. I bought her anti depressant meds mail order from Vancouver Canada. Yes they were cheaper but not by huge amounts. As soon as a generic version was on the market, the USA price fell to a similar level.
Her is the real question for Captai117. You are living in a higher tax country looking at a price for healthcare in a lower tax country. He'll get hit financially twice. Is it worth it. My personal opinion, that is totally worthless. Pay the Canadian upgrade to a 3 piece implant price. It is a gamble, but some people win, some lose. Hope for a win. Bitch in your system for a revision if you lose. Make sure that you have a very long talk with your sugeon about your expected results & if he can either get really close or meet them. Do your god honest best effort to find some prior patients to talk to. See if there is any referrals that the implant liason people can give you. Ask here on FT for guys to contact you privately thru messaging about their experience.
I feel that I should point out that a local cardiologist fled the Canadian system & moved to the USA. My primary care physician that knows him claims that disgust with the Canadian system was one of his reasons for moving. I also am not comfortable with a system that is only willing to give you a maleable as a first choice. But hey, at least sex is possible. Not very compassionate in my opinion.

[Captain1117]

Captain,
I will go the other way. Im from Canada also and I read too many botch implants from Canada surgeons.

For me when Im ready, I will go to Eid, Kramer Or other high volume surgeons at the time and get the best. For me money is not an issue and I want the best outcome possible and I dont see this from surgeons in Canada.

From what I read here in the last few months, most that got implanted from surgeons in Canada got short changed or needed a revision shortly after.
I only have 1 dick and I wont let a low volume surgeon screw it up. Unless you get reference from implanted guys from this doctor I wouldn't do it.

Thank you for the inputs. I cant seem to find any Canadian surgeons results here, except one happy patient in Montreal. Couple of months ago one more positive case was reported by happy patient of Dr.Krawkoki in Toronto.

[jump.ship]

Wow. The tone of the forum has changed after I stopped using it for a few months!

I am in the exact same situation as you. I can get it done for free at home here in the UK with no messy travel. Or pay threw the nose to travel to Eid.

I decided to travel and now because of Covid I'm stuck with nothing, waiting. However, I am so determined to get the job done correctly I am willing to wait on a vaccine!

I am very surprised merrix is advising to stay put despite all his other posts to the contrary. My own position was shaped very much by his position.

I agree that if you do not have the means, then get it done local. But from your post you are going to have the cash by the end of the year, so what is the issue here?

The plan to get it done local and then fixed by Kramer is a non starter. If you have a floppy head, scar issue will form and might hinder a cylinder refit. The first implant is crucial.

The point about escalating cost doesn't make sense. You should get this priced BEFORE your initial operation. I have a price for my implant and then a second price to cover a salvage operation should I get an infection. And you can get help locally if you really need it, as you state.

Maybe Covid has spooked everyone into staying local, and rightly so. I am NOT traveling while it's going on. If vaccine does NOT appear (we will know more in the autumn), I will then need to revise my plans. But with a vaccine, it's game on.

I am lonely, depressed and utterly desperate for this implant. But it's exactly because it means so much to me that I am willing to wait this out.

Best of luck.

[merrix]

Of course, our health care is not really "free". We pay it through taxes.
But you are sort of stuck in the system you are. It's a bit of a stretch to have a moderate salary, pay 40% taxes, and then skip your already-paid-for health care and go overseas and pay the total cost. That means you literally pay twice for the surgery.
Of course, if one have the money, like I luckily had, then fine.
But if those 40% taxes have meant you have nothing saved (which you in some way don't need in Scandinavia, since schools for kids, universities, health care is all "free" (i.e. tax paid)), then you are stuck with using the services you have paid for all your life.

So my advice is still the same. If you can afford it, then go to Eid (rather than Kramer).
If that would wreck your financials for decades, then go domestic with the absolutely best you can find.

Finally, since we are discussing tax systems here, In my country people with high salary literally pay the surgeries of low salaried people.
People with high income pay the universities for the kids of parents with low salaries.
Our tax system is heavily progressive.
Back home I would pay 55% income tax on my salary, and then 25% VAT on most goods and services bought.
A guy at McDonalds would pay less than 25%.
55% of a lot is 5 times more than 25% of a little. So I literally would pay 5 times income tax every month than the McDonalds guy. Plus the VAT difference from my higher spendings.
But that is a political discussion which I should refrain from giving my opinion of any preferences on.
All I will say is that I think it is sort of ok with a high total tax burden if the country is doing great. If schools are top class, health care is fast, available and high quality. Infrastructure is great. Criminality is low. Then that high cost was maybe justified. But if not - then what the F am I paying all those taxes for..?