Extreme Medical Costs

[Old_Dr_Skull]

IMTU, I've set up the system for medical intervention so that characters who have been killed, but immediately treated by a doctor and preserved in a low berth can be revived at a high tech hospital (TL 12+).

I set up the rules for the treatment in advance, not really thinking it would come up too often. However, in the second session of my new campaign a character was killed, standing next to an extremely skilled Doctor, very, very close to an available Low Berth.

What I didn't think about ahead of time was the cost for the revival services. I imagine in a session or two the frozen corpse of Dorkon the Hunter is going to arrive at a hospital on Rhylanor tended by Old Doc Spurlock.

What should I charge for the access to the high tech hospital services?

 

[far-trader]

Never mind the expense (high I would imagine, starting at MCr1 at least*) have you considered the other aspects?

The service may be backlogged (limited resources and large demand) such that it will be months or years before the patient is treated. And being in stasis hibernation that's no issue for the patient, but it is for the others. Unless they decide to "chill out" while waiting by joining a local Timers club and spend the wait in lowberths themselves.

The successful treatment won't mean an immediate return to adventuring imo. There's bound to be weeks if not months of healing and rehabilitation. Again with more expense, and again more waiting around for the others to decide what to do about.

* maybe, I dunno, off the cuff ruling of MCr1 plus MCr0.1 per point of injury leading to death and 1 week of recovery and rehabilitation per point of injury leading to death after the reconstruction operation, and a wait time for said reconstruction operation of 1D6 x 1D6 months AFTER arrival and payment is secured

EDIT: On re-reading your post you seem to imply you've thought out some rules, and you seem to be asking about the cost for a PC doctor to access the hospital to do the job of reanimating the corpse themselves? I don't buy that. The doctor would have to be known to the hospital in some way before that would ever happen. Even then he will need the support of a whole medical team for the procedure. No, I don't think the hospital will just say "So you want a Reanimation Special. Would you like a Buff with that? We have a special on. No. OK, Wing A, 59th floor, ER 12. That'll be KCr29.99, have a nice day. NEXT!"

 

[tater]

What drives large medical costs (now anyway) are facility fees, not professional services. My wife can get paid a few hundred bucks for doing a survey where the hospital charges thousands for the OR, and thousands more of the time on the wards, etc.

Strikes me at high TL in traveller, the need for facilities (and facility costs include loads of labor) might be reduced.

never really thought about medical costs in traveller, lol.

 

[CosmicGamer]

As with most things, it can vary from system to system.

Starports in Imperial space are Imperial territory and perhaps it's government supplemented "free" medical care. Want those spacers healthy and trading to keep that tax revenue coming in.

TAS membership? They have connections and might give an assist/discount for local services.

 

[rancke]

What should I charge for the access to the high tech hospital services?

It really depends on how accessible you want revival to be to your PCs. But if you want something that sounds reasonable, I suggest you find out the cost of, say, open heart surgery (or some other major procedure) and then read dollars as CrImp. That would make revival cost about 3-4 times as much as open heart surgery.


Hans

 

[CosmicGamer]

What happened to medical insurance in the future?

 

[far-trader]

Do you think PCs are the type to think about getting coverage? Or that most adventuring types would be able to get affordable coverage? Or any coverage?



Might make a neat mustering out benefit though

 

[DangerousThing]

What I didn't think about ahead of time was the cost for the revival services. I imagine in a session or two the frozen corpse of Dorkon the Hunter is going to arrive at a hospital on Rhylanor tended by Old Doc Spurlock.

What should I charge for the access to the high tech hospital services?

All I know of hospitals and medical expenses are from the US medical system and Lee's extensive history with it.

First, doctors can't work at hospitals they don't have admitting privileges at, though they can order tests at such hospitals. Perhaps in the OTU there is some sort of subsector or sector wide organization doctors could belong to which would allow them admitting priviledges at participating hospitals. However, I would expect that there would be a high fee for joining as well as a high annual fee. Plus there would be required certifications, as much as yearly, or perhaps every other year.

Second, there seems to be a multi-tieded payment system in the US depending on whether you have insurance (including medicare/medicaid) or not. For instance, when Lee has an MRI we see there "real" charge which is $800+, then the price that the insurance is willing to pay, say around $29.99 and we don't have to deal with the rest. (OK, the negotiated price with insurance is higher than that, but it's a whole lot less than people without insurance pay - I was shocked the first time I saw the difference.)

Third, at a major medical facility, you pay partially for the possibility of needing all of their benefits, such as extra doctors and equipment and such; in 2003, Lee went in for what was supposed to be a simple removal of ovarian cysts which turned into something very different when she showed endrometriosis everywhere, and then ovarian cancer (caught in time) - in addition to the first doctor, a general surgean and a urologist were brought in to help. Medicine is neither pretty nor cheap.

Perhaps a better mustering out benefit for Traveller would be medical insurance.

 

[Magnus von Thornwood]

Yea for T5!

Do you think PCs are the type to think about getting coverage? Or that most adventuring types would be able to get affordable coverage? Or any coverage?



Might make a neat mustering out benefit though

Actually, in Traveller 5 some Careers do have Life Insurance as a Muster Out Benefit. It rocks!

 

[Thuffer]

Costs...

I can tell you from experience with my father that a triple bypass plus three weeks divided between the intensive cardiac unit, regular intensive care,another intravascular surgery and support services came out to about half a mil in 2008. I can also tell you from work experience that that is actually a very very very high amount by even US standards. The average for surgical stays I see is going to range from 15-50K. I'm not going to touch the whole "what insurance pays versus what you pay" argument other than to point out that if a hospital wants to get paid they MUST take what the insurance company offers else the pt must pay and thereby the hospital never will get paid. Now of course you have to take into account what current US standards would translate into imperial credits. Now as for the service you're talking about think what would be needed. The surgeon and team gather at leisure assessing the pt's injury while they're still a popcicle. They then plan out the surgery bringing in specialists as needed. Then somebody flicks a switch on the waffle iron and the guys go to work. So what does that really cost? Not much more than an average trauma case in any ER. Also think about the consequences to this. Wouldn't even ambulances carry low berths for severe trauma cases? This could allow planets to be served by one large well equipped hospital and many doctors offices and urgent care enters.

Edit: The above would tie into Dan's idea about back logging though and thereby would mean that a character could wait for months before being thawed. Also while the surgical and hospital costs are and would be rather high I forgot about one thing that would drive the cost up dramatically. Physical therapy and cloned replacement parts made on demand from the patient's own tissue. Even after surviving the trauma surgery and recovering to a state where therapy and replacement could begin for damaged/destroyed parts you would have to expect months of time spent on followup surgeries and therapy to regain full use of a limb, etc.

 

[Enoki]

I'd think it would depend on just how dead someone is. I mean resurrecting them after being turned into a charred paste by a fusion weapon would be alot more costly than say having been electrocuted.
Being blown up with lots of reconstructive surgery would be more costly than dying from a bullet wound or three.

I'd say it is much like 'Miracle Max" put it in The Princess Bride "There's mostly dead and then there's all dead. All dead you go through the guy's pockets...."

 

[CosmicGamer]

Do you think PCs are the type to think about getting coverage? Or that most adventuring types would be able to get affordable coverage? Or any coverage?

Yes and No. PCs cover a wide range of possibilities. I thought one concept was that the PCs were not munchkins, just "average Joes" who happen to find themselves in not so average situations.

Is it outrageous to consider being retired from military or government includes medical benefits?

Insurance could be something included for crew on a respectable ship, especially when backed by a corporation or Noble.

 

[Old_Dr_Skull]

I'd think it would depend on just how dead someone is. I mean resurrecting them after being turned into a charred paste by a fusion weapon would be alot more costly than say having been electrocuted.
Being blown up with lots of reconstructive surgery would be more costly than dying from a bullet wound or three.

I'd say it is much like 'Miracle Max" put it in The Princess Bride "There's mostly dead and then there's all dead. All dead you go through the guy's pockets...."

I actually do have 2 levels of "Dead"--Dead and Destroyed, you can't come back from Destroyed.

 

[epicenter00]

What should I charge for the access to the high tech hospital services?

This is the Imperium. There probably is no standard for medical fees. Most Imperial standard planets sound like they're cutthroat planets where they'd charge ridiculous fees for treatment similar to the US currently.

Perhaps you could actually have an adventure to get to the worlds where they don't have attitudes like that. It doesn't have to be Planet Socialized Medicine; it might be the search for those worlds we all love where you have like TL16 and low Law Levels where you can apparently you can buy anti-matter ammo for your ACR in the local 7-11. Worlds like that might have fully-stocked operating facilities that you can rent and pay for what you use. In return, nobody cares if you have a medical certification - that's your concern. A place like that might be pretty cheap.

You might have your ship and crew troll around the frontiers looking for those new TL12 colonies where they have all the equipment but no qualified doctors and so the players can cut a trade of, "We let you resurrect your friend, and if it works, we have a dozen people who need the same who've been sitting on ice for eight months waiting for someone like you to come by..."

What happened to medical insurance in the future?

I sort of wonder how you'd really prove you'd have medical insurance in a universe where it can take months to get an answer about something like that. Do you just show your card and the hospital gambles that isn't a forgery? It seems as iffy and problematic as those "banking in the Imperium" threads that erupt on here every so often.

Perhaps subsector sized areas might have "insurance circles" where X-boats deliver lists of subscribers every month or something? If you're on the list you're considered to have insurance. If you're not on the list, the hospital takes something as collateral (I'm thinking the starship), treats you, and then waits to see if your insurance is valid. You pay for the cost of the query, of course. You have to wait for months for an answer. Or you can just pay up in cash and leave.

 

[Nick Nova]

Medical Treatment

Old_Dr_Skull, if you have access to the old 'Journal of the Travellers' Aid Society', there is a nice article in issue 11, page 22-25: "Medical Treatment for Traveller". It covers procedures and costs for wounds up to and including recovery from death. Quite handy and it saves re-inventing the wheel. That article saved my characters life more than once, back in the day.

If you don't have it, I think it can be picked up at DrivethruRPG.

 

[robject]

What should I charge for the access to the high tech hospital services?

This seems like a "Speed Of Plot" type of situation - in other words, the referee has wide latitude in setting the cost, based on the facilities he ends up in, the calibre of technicians and equipment, the prestige attached to the institution, the time it takes to get there, administration fees, ambulatory fees, time spent in a stateroom in the hospital (Cr 10,000 per week?), etc ad nauseam.

All of which may (or may not) be waived by a Grant from the Gaagnir Foundation. Or the needs of a prospective patron. Or maybe the institution is a charity (Sisters of Vlandian Mercy?) or perhaps a questionable institution ("THOSE guys? They're all quacks. But they do know how to revive the dead.")

 

[BytePro]

Yeah. Just like in the real world, the answer would be - depends.

Price things to achieve an objective... do your players need some ingame motivation to obtain credits? do they need to be liberated of some credits? does the game just need to move on without a player creating a new PC?

Make sure your players understand, like in the RW, not only are there not really any set prices for things, but they may not even know a price up front.

 

[rancke]

Yeah. Just like in the real world, the answer would be - depends.

Whenever you want to go for realism, the answer is always 'it depends'. But when you want to play an RPG, you often prefer gamability to painstaking realism and when you do, the answer is usually quite simple. What does an automatic pistol cost? Realistically, it depends. But for game purposes, it costs what the equipment list says it costs, with no if and buts about it.

So, yes, it depends. But mostly it depends on how much the referee is willing to bother with details. If he just want to get on with the game the answer very often is one specific figure.


Hans

 

[Icosahedron]

Perhaps the Imperium, like certain other forward-thinking cultures, ( ) has free healthcare paid from your taxes, and that's why it hasn't been mentioned.

But if you really must go with a US analogy, most Traveller 'adventurers' are actually either haulage contractors (who should have no problem getting insurance) or mercenaries (who probably arrange their own medical evacuation along with their repatriation clause.

Adventure is the exception to most PCs' lives - we just happen to be gaming out the exceptional chapters of their lives.

 

[Enoki]

Perhaps the Imperium, like certain other forward-thinking cultures, ( ) has free healthcare paid from your taxes, and that's why it hasn't been mentioned.

But if you really must go with a US analogy, most Traveller 'adventurers' are actually either haulage contractors (who should have no problem getting insurance) or mercenaries (who probably arrange their own medical evacuation along with their repatriation clause.

Adventure is the exception to most PCs' lives - we just happen to be gaming out the exceptional chapters of their lives.

I can't see "free" / welfare state anything Imperium-wide being enforcable. Communications and travel time being what it is it would be extraordinarily tough to collect the necessary taxes, then redistribute those to the various worlds along with providing the necessary level of services.

Just the wide disparity in tech level suggests otherwise. I would think that medical serivces would be run world by world or, maybe within a handful of systems in a subsector that formed some local coalition.

Now, one I could see the Imperium managing is having a fleet of hospital ships that move from system to system on a fixed or semi-fixed route that provide periodic routine care and are available for major disasters when they occur. Those could be supported like the Imperial Navy and would be available for military service if necessary.
Maybe such a ship escorted by a destroyer or cruiser would be appropriate just to deter any attempts at piracy too.