WOW!
HET? I'll assume it's a typo and you meant HRT; please correct me if you mean something else.
Now I'm on 250 mg of T every 2-3 weeks but we're going to switch to something slower-release under the name Nebido. The LH counts are back within a normal range, indicating that my brain is no longer missing T.
The funny thing about the system we have here in Germany is that it's basically Hillarycare with some additional Obamaesque stuff thrown in, for those of you old enough to remember that. Doctors are private and you can choose among them. But there's 'managed competition' plus an individual mandate in the insurance market, with big discounts for poor people. I pay about 15% of my gross salary in the form of health insurance payments. Prices are capped by law, and insurance companies compete based on how invisible they can make themselves to you, the customer. Health insurance is the one place where I've had no problems with customer service.
This has all had several effects. It's gotten universal coverage and the ER is an unheard of institution, and there's a lot of patient choice which is essential; in general my new GP is fairly good though it took some work. But the Germans have 'bent the cost curve' by cutting back on things like cleanliness, service, and competence. Waiting rooms and recovery rooms are crowded, doctors underpaid and overscheduled, and this interacts with the laid-back German culture (no, really, they are!) in odd ways. And middle-income wage earners are really getting pinched because they're subsidizing everybody else's health care, and Germany had a bigger baby boom and then bust than did the US. This is beginning to hit really hard, and it will begin hitting the US soon.
Health insurance serves two major functions: Actually insuring against unforeseeable one-time things, like a car crash or house fire, and acting as a transfer system between well-off people and sickly people. The Germans have combined both of these things at great expense while the Americans can deal with the first thing well (since this is something that people can do voluntarily) but are debating on how to deal with the second thing for people who aren't destitute or elderly. The second thing is really about inequality and how it relates to health, and that is what universal coverage + mandates + guaranteed issue is about. Young workers are the biggest losers in this process, while cancer patients, illegal immigrants, and 64 year olds are the biggest winners.
But the German system is arguably more private than the American one (where the government itself paid about half of all health care costs, last time I checked). Those crazy socialists. :p
If I were to go in again, how would I be able to convince a doctor that having a pair of dead gnarly nuts in my sack is not in my interests, or theirs? Or is there any other option where I can have them, and preferably my sack, removed? I know that Thailand's clamping down on anything elective, and I know of nobody who does elective procedures in Europe, though there are apparently some in the US if you inquire persistently enough. I can actually probably get letters attesting to my sanity; the hard part is finding a surgeon anywhere in the world (especially in Germany) who will do the dirty work. Their thinking is, if it isn't bleeding or obviously cancerous or gangrenous, they don't want to remove it.
). More precise lab, smaller reference range.