(Or Who Pays what:)

At the moment I'm only clear about down here in the south, in the north it really depends on local situations, everything or nothing may be covered.....

 Doctors

For a start I'm only familiar with Dr. O'Donoghue. If you see him as an outpatient, the only charge is £10, more or less for the use of the room. If you also attend the same hospital for blood tests these will only cost £6.00 each time. The reason these are so low is that St. Pats is a charitable hospital, in part set up by Jonathan Swift.

If you go to see him privately I think the cost is £50 or £60 per session. (I can't find the bill from my session at the moment). If you see an endocrinologist, the costs are of a similar order.

 Drug costs

This used to be quite complicated, but recently it was “streamlined” and now there are only two different cases:

1. Medical holders simply get it on their card.
2. Everyone else should apply for a card from their local health board. These forms are available through your local pharmacy. These cover the costs of any medications over the value of £42 in any calendar month. Unfortunately when this was introduced several medications were “delisted” that were refundable before, so now they are not included in the £42 limit. These include things like EMLA (which is kind of expensive at £40 per pack) and items which are prescribed but are available over the counter like KY.

The individual costs of medication are:

Premarin works out at £20.00 for 4 weeks (4 x 1.25 mg Packs)
Androcur is about £31.00 for 4 weeks (28 x 50mg)
EMLA works out at £39.49 for 10 5mg tubes, one tube will generally last for between one and two one hour sessions

Voice Therapy

Voice therapy can only be obtained privately at the moment.
 Costs (late 1997) worked out at:

• £50 for the initial consultation
   
•  £30 per session after that.

These costs can be claimed against income tax using an Med1 form which is obtainable from your local tax office. You can claim relief on any medical expenses above £100 per year for an individual. This can include up to £360 for drug costs (the remainder should be claimed back from your health board). While you don't have to submit receipts with your claim form, you do have to hold on to them in case you are audited

Electrolysis

Electrolysis is expensive and I haven't found out yet if it is allowable a medical expense. (I suspect not anymore)

The average price seems to be about £20 per hour, but I have seen some places charging as much as £15 for 15 minutes, though some clinics are amenable to reducing the rates if you are liable to be a long term customer (and with electro you will be!)

Operation costs

Actual operation costs are an iffy subject. It depends on the health board in your area. Some areas will fund the complete cost, some will give partial costs (but you have to pay up front and then claim back from the health board) and some just don’t want to pay anything. As far as I know the health board has a legal requirement to fund any necessary operations, if anyone were to ever challenge an individual health board’s decision in court I doubt it could stand. I have heard that a committee has been set up to examine funding in the Eastern Health Board but nothing has happened with that in 3 years or more.

You should be able to at least offset the operation costs against income tax, but again this is a grey area.

Actual costs depend on where you go:

• Britain: From £6,000 to £9,500 Sterling depending on which surgeon you go to
• Belgium: About £4,500
• Estonia: About £5,000
• Canada: About £6,500
• Thailand: About £4,000
• US: From £8,000-£12,000

Plus of course the cost of actually getting there. Also remember that currency costs will come into play here, so the actual cost could be much more than quoted above. It is also a good idea that several surgeons will discharge patients into nearby hotels rather than keep them in hospital. While this does keep the cost down, it means you have to budget for anything up to 5 days extra on top of the surgery costs themselves.