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Medical Care Gets Outsourced Too
Muppy writes "Here's the summary from the most emailed article in The Washington Post today -- about an American who went to India for heart surgery, which he could never have afforded here. U.S.: $200,000 total cost ($50,000 deposit required) for heart operation. India: $10,000 total bill, including hospital, air fare, and a side trip to the Taj Mahal. And the Indian doctors are probably at least as good as those one is likely to get in the U.S. From the article: 'Eager to cash in on the trend, posh private hospitals are beginning to offer services tailored for foreign patients, such as airport pickups, Internet-equipped private rooms and package deals that combine, for example, tummy-tuck surgery with several nights in a maharajah's palace...'"
medical care is efficient and effective. think about that.
£0, but some serious taxes and a wait on a waiting list.
Even so, I must say I prefer universal healthcare.
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There are India doctors as good as American ones. Most of them seem to be in the US as opposed to India. I also know somebody who was misdiagnosed while in traveling in India and nearly died.
Caveat Emptor!
Something economically is going very wrong in our medical system when everywhere else in the world is getting the same goods and services we are for much less...
Remember, perscription medications are very much an IP-based business. The first pill costs millions in research and approvals. Once the pill is ready for mass production, the actual ingredients cost very little to gather and put together. That's the reason why there has to be patents on medications... without that IP-based protection, nobody would pay to do the research that creates new drugs.
Still, when Canada's getting the medications for less than they're being sold in the USA... something's very wrong. It feels like every other first world country has set price controls that the drug makers are bowing to, and because we don't have price limits, they charge us to make the money.
It's an interesting dilema... if we pull out of funding the world's research, that research just isn't going to get done. On the other hand, we're funding the research that the rest of the world is benefiting from and not paying for.
I don't understand all of this "outsourcing" outrage. Doesn't India "outsource" manufacturing of soft drinks to American Coca Cola and Pepsico? Isn't it just progress, that anyone can do what one can do best, no matter where one lives? Why discriminate against people of any given nationality instead of cooperating globally? This is a perfect example. Why should people not be able to get the best medical care only because it is not available in their homeland?
Sincerely,
Pan Tarhei Hosé, PhD.
"Homo sum et cogito ergo odi profanum vulgus et libido."
The USA already outspends Germany and Japan per student. The problem isn't that we spend too little, it's that the money gets pissed away on administrative costs instead of compensating teachers adequately. Add to that the NEA's tooth-and-nail resistance to anything resembling competition or accountability, and you get the mess that is American primary education today.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
American medical care is expensive because of artificial supply constraints at every step. When I went through pre-med in college, anyone could tell you that the process is designed to "weed out" the pool of potential doctors; that phrase is the mantra in every course. The weeds are people without sufficient profit motive to survive the often arbitrary, abusive process. That includes foreign doctors who move to the US for freedom, but without the financial or competitive advantages needed to get recertified. That limited supply of doctors, including less competent ("malpractitioners") in medicine, but committed to their paying careers, means extra demand for doctors for second/third/etc opinions, fixing mistakes, medical makework... If America invested more in educating doctors, the supply/demand crisis would be calmed at both ends, and medical treatment would cost less. Then we'd just have to worry about unnecessary prescriptions, pharmacy profits, insurance profits, and career malpractice fraud lawyers.
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make install -not war
Why would it cost $200,000 to get heart surgery? (Or $100,000, or whatever).
I'd definitely go to India rather than face that kind of horrorific bill. It makes me think medical costs are truly out of control, and frankly, I don't want to pay them.
D
India is also the place where the locals bring their own sharps to the hospital to avoid contamination from inadequately sterilized second-hand needles. They've also got a really major AIDS problem.
But this isn't too far from reality. There was a group of cardiologists who decided to totally refuse any kind of third-party payment. No Medicare/Medicaid, HMOs, or even health insurance. If you wanted service, you paid for it, in cash, at the time of service. Their patient volume, as might be expected, fell by about three-quarters. Their income doubled.
Why? Because the government only pays about 30 cents on the dollar. This means that HMOs and health insurance companies pay a few cents less than that. So if the hospital bills for $200k, they're unlikely to get more than, say, $70k, which is only a little more than the total cost in India. If the hospital knows a procedure is going to cost $10, they'll bill for $30, because that's the only way they can cover their costs.
Governmental intervention in healthcare has shafted the very people it was designed to help: the poor. If you don't have health insurance and aren't eligible for Medicare/Medicaid, you're screwed, because while the government and major health insurance corporations can force providers to take a bath on two thirds of their costs ("Oh," says Uncle Sam, "Don't like what we're paying? Turn down a single patient and you can't treat Medicare/Medicaid patients for years!"), you can't.
Want to cut down on the spiraling cost of healthcare? Start paying what it costs rather than having bean counters in Minnisota who have never been to medical school and never treated a patient in their life determine, without any first-hand experience, what your surgery is supposed to cost.
You can thank the insurance companies for the cost of health care today. Malpractice insurance for doctors and surgeons in the USA can top $1,000,000 a year depending on their area of practice.
The cost of the insurance is a secondary effect of juries that are willing to give out millions of dollars whenever Shit Happens. After all, it's just insurance money, right? It's not like it comes out of the Doctor's pocket, is it?
You can thank John Edwards and his buddies in the Trial Lawyers' Association for those costs. This will continue until either 1) doctors simply refuse to work without an ironclad malpractice liability waiver that isn't trumped by a state law, or 2) everyone who needs major surgery will routinely fly to Mexico, Canada or India.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
That's what all the media tells me: Canada's healthcare is falling apart! Canadians pay more! Canadians have hoooje waiting lists! The sky is falling!
Pah.
Canada may not have perfect healthcare, but we sure as hell aren't (a) paying for heart surgery; and (b) taking off to India to get it.
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Don't like it? Respond with words, not karma.
Perhaps for a routine non-emergency procedure this is a great choice. My Indian buddies tell me it takes 24 hours to get to India from Los Angeles, so this is definitely not for emergency procedures.
The school district here, decided that it was a good idea to spend several million dollars for football field upgrades. Until we decide that education has a higher importance in our EDUCATIONAL system than playing games, we are screwed.
I haven't seen a school yet that hires an economics teacher, and has them fill in as a coach, but they all seem to be fine with hiring a coach and asking them to fill in as an economics teacher.
I have a friend who went to Canada to get her Laser Eye Surgery real cheap.
I don't know about you or your friend, but I wouldn't want the words "laser," "surgery," and "real cheap" together anywhere near *my* eyes.
"...always new atoms but always doing the same dance, remembering what the dance was yesterday." -Richard Feynman
has been concoted by doctors unwilling to police themselves, afew bad lawyers and cases, who out of hte millions, get overreported, and most of all, the GOP/right wing conspiracy to shift this country into a darwinian dog eat dog capitilist mode.
The United States of America (our medical establishment) is primarily concerned with symptom/disease treatment. This is especially apparent in obesity and obesity related illness, where Insurance companies (for the most part) would rather dodge paying for expensive heart surgeries than a gym membership. As the saying goes, 'an ounce of prevention prevents a pound of cure.'
Costs are high because of several factors, first is the medical billing system. In our country we have countless carriers and each has a different form and another person you have to higher in order to understand what they will and what they won't pay for. This can add up to about 40% of a hospital's operating budget. A single payer health care system could take care of this, or a more standardized set of forms and practices.
Second is malpractice insurance. We are a lititgious society (in the United States) and punitive damages can get out of hand much of the time. For the most part, doctors are not being willfully malicious when there is an accident, or mistake. It is a high pressure job and they are there trying to help people. WHile they should be held accountable for their actions, this accountability should not become a barrier for treatment. Rather than capping punitive damages, Good Samaritan laws could be strengthened and applied to doctors and other emergency service workers, but that's just my opinion.
A single payer system isn't going to fix the problem, it's going to take a lot more than that, and we're not even talking about health care access.
and probably speak three or four languages, too. Damn furriners.
Do not mix price and quality. Higher price doesn't necessarily mean higher quality.
Free XBox, PS2
As a Canadian, I'll chime in with a "me too."
As a US resident, I'll add "The more fundamental issue is that while Americans are increasingly eager to capitalise on the benefits of a nationalised health system, they are adamant in their insistence that such such systems are akin to something between a violation of human rights and communism, and implementing one will lead to disaster."
I disagree. Americans are medically-obsessed. I work at a boarding school, and I end up in the dorms fixing stuff quite a bit. I have yet to see a room without a bottle of 'scripted antibiotics in it. The school newspaper just made a joke about how much ritalin and adderal is abused for 'studying'. We overpay for every piece of plastic and metal that goes into medical care. The list goes on.
When I got a fungal ear infection and my doctor prescribed me antibiotics, which are exactly WHY I got the fungal infection, I stared thinking about it. I haven't taken a prescription since.
When I had to get my wisdom teeth out, I decided to do it at the dentist's office instead of the oral surgeon, I saved over $1200, and the fact that I was awake and could cooperate with the dentist meant that the surgery went smoother and safer, and I recovered much faster because they can really 'beat you up' when you're unconscious. I walked home with some cotton to soak up the blood and a bottle of advil for the rest of the week.
Why on earth would insurance pay for a full-on surgery to extract wisdom teeth? It can be done easily at the dentist's office for a third of the cost.
I really don't think the problem is litigation, it's certainly a problem, but not the major factor in medical costs. The major factor is American aversion to reasonable amounts of blood and pain, coupled with excessive trust in the medical institution and it's practitioners.
"Sometimes, I think Trent just needs a cup of hot chocolate and a blankie." -Tori Amos on Nine Inch Nails
God or no god, you're just fucking up the natural balance of things. I think the fact that you bitch about the price but then talk about your 'MSCS' just goes to show that you are an arrogant prick, and I hope your kid catches a case of the crib-death.
Nobody is "in need" of IVF. There are more than 6 billion people on Earth. Sustainable carrying capacity is estimated at about 3 billion. Billions of people are going to die. Your expensive child may be one of them. Adopt.
We where in need of IVF (in vitro fertalization) and this is typically not covered by insurance companies in the US
Forgive my callous analysis, but 'needing' IVF is a subjective take on it. You wouldn't die or be sore or suffer in any objective terms if you were unable to conceive. While I feel for you, I think that any insurance company that did cover it would be driving up costs and doing a disservice to people who just wanted to stay well and not pay through the nose if they were injured or ill.
Adoption, while also expensive, is also a viable option. If you REALLY want your own biological baby so bad, pay for it yourself. don't burden the others on your insurance policy with paying for something that is unnecessary. And it seems you did, which is great.
The idea that the Netherlands mandates insurance for it is ridiculous. Sometimes life deals you a bad card. That's just the way it is.
Reason, free market capitalism, and individualism
If a couple lacks the native ablilty to reproduce unaided then perhaps it is for a reason, no?
That hurts man. Seeing that someone believes that crap about 'devine reason'. If it was available, would you have gotten the flu vaccine or is it meant to be that more people will die this year because of the flu vaccine shortage? If a condom can stop VD's and prevent unwanted pregnancies, are you really claiming that we shouldn't use them? Do you take responsibility for your actions? Do you think for yourself? Columbine or 911, was there a devine reason?
My wife has Endometriosis and there is no reason for this. IVF provided us with the ability to raise our biological offspring. Why is this important? Because our brain makes us think it is. Yes it is hardcoded in our brain to produce offspring, and though we have the capability to ignore our basic instincts it takes an effort. Going with the natural flow of things is, well, natural.
So do your sister a favor. Let her listend to her body while you listend in private to your god.
Have a happy life.
I worked (in IT) for Lasik MD in Montreal, which services thousands of US customers a year. I saw many many happy patients pass through their doors, from the US and locally. The prices are very competitive when compared to the US, but by no means is it 'cheaply' done.
Reasons: Doctors make less in Canada. Laser eye surgery clinics are owned by the doctors, reducing cost to patients. US dollar is favorable here (well maybe not this week lol). Laser eye surgery clinics are private, so they don't have to charge more to foreigners like public institutions do.
Forgive the parent's poor choice of words; the meat of his message is of value.
It's plaintiffs lawyers (like John Edwards) suing doctors with junk science, judges not doing their jobs, and gullible juries. And of course the "defensive medicine" (runing every test just to CYA) that doctors practice to avoid suits.
And of course, legitimate malpractice claims.
Insurance companies just run the numbers and tack on a profit - they really are the least responsible.
If they doctors in India can do as good a job as the ones in the USA at a lower cost, I'll be traveling overseas if I have to have another surgery.
A BIG "if." What evidence do we have of this? Medical school admission in the US is extremely competitive, likely the most competitive academic process in the US. I'd like to see some evidence that "Indian doctors are probably at least as good as those one is likely to get in the U.S." There are competitive schools in India, but to make a blanket statement about Indian doctors is ludicrous. After all, don't a lot of brilliant Indians come to the U.S. to attend grad school?
Of course, if something goes wrong, don't look for a lawyer to sue - they are all in the U.S.!
Slashdot "libertarians": Small government for me, big government for those I disagree with. -1, I disagree with you
Of course, there is no doubt about the quality of the professors etc once you are inside the reputed colleges - they are top class.
Sounds like we need to open source the education system. Let's put these great teachers on the net so we all can benefit. I know some places are doing it. MIT?
What?
Yes, the Canadians love their government-run healthcare so much that the private sector medcial centers are growing. I don't even like Rush Limbaugh so I'll use the actual Canadian news sources.
Canadians want 2-tier health: poll
British Columbia is looking to expand its use of private medical clinics
Private medical clinic opens in Montreal
Pettigrew open to discussing role of private MRI clinics
Even the Canadian medical pot users complain that "He doesn't need government-grown schwag that costs $150 Canadian per 30 grams"
I suppose you are going to aruge that Rush Limbaugh controls the Canadian media because they disagree with you? Do you own research, folks! Blindingly following Socialists is as danagerous than blindingly following the Republicans or Democrats.
1f u c4n r34d th1s u r34lly n33d t0 g37 l41d
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All your Sybase are belong to us.
Oh its easy to do that, simply cap the amount that lawyers get from the lawsuit at a fixed (not percentage) amount and a change in the way awards are done. Pain and suffering? Here's a trustfund to cover your painmeds and a shrink for as long as you need them. Punitive damages? If whatever was done was SO bad, throw the doc out of the profession. (and I'm not talking about the doctor who takes on the risky brain cancer operation that the patient was going to die in months without and patient doesn't survive even though the doc did everything right, or the people who sue the OB who delivered the baby for brain damage when their kid fails to get into Yale.)
Of course, you're not going to see the LAWYERS in charge around here fixing their profession anytime soon.
If I have been able to see further than others, it is because I bought a pair of binoculars.
If something goes wrong, can you hold someone responsible? This is an issue in the USA, but it might be more difficult overseas.
The medical industry is booming. Huge hospital corporations and drug companies are raking it in by the truckload. Medical insurance companies (which sell malapractice insurance to doctors and also medical coverage to patients through different branches) are also doing business like viking raiders in a monestary.
People in Canada, New Zealand, and Australia pay about 1/2 of what we do for medical care, and live as long or longer.
A better way to characterize the Medical Industry today is to say that it is were the American Automobile industry was in 1970. Those dental trips to Mexico ? Think of them as the VW Beatle. The heart trips to India ? Those are the Toyota Corolla, baby -- and a lot of rich Republican doctors and hospital board members and insurance executives will never see it this good again.
Ah, the moderation system in swift action (insert rolling eyes smiley.)
...when we're talking about tech or IT jobs, but its really good when ordering medication or getting healthcare that is 'as good as here'? Make up your minds people.
I think we do need some tort reform, and I do think that if it is done right, that it will result in significant savings.
The bulk of costs are not in settlements but actually in legal fees (discovery, court costs, etc). Therefore I propose the following changes:
1) Doctor's insurance covers patients up to a certain dollar ammount due to medical error. Dollar ammount is set by a government regulatory agency.
2) Patients also can purchase additional insurance for medical errors covering them up to a larger dollar ammount. This will be included, presumably, in the medical insurance.
3) Malpractice should be limited to those cases where one can demonstrate that the doctor should not be practicing medicine. However, medical error should automatically provide the patient with an insurance settlement.
Now--- I don't think that that I trust any candidate to do this so....
LedgerSMB: Open source Accounting/ERP
The percentage of people who have the personal resources to personally pay for the worst case health problems is in the low single digits. That means that health care gets rationed here in the USA, too. It's just a different system; people who have full-time jobs at large corporations usually get first priority. (Why does the size of your employer have anything to do with health care? Who knows.) Then come the perfectly healthy people who are allowed to buy individual policies, and people who work at small employers where none of their coworkers are too sick to lose the group plan. Lowest in the rationing pecking order are uninsured who rely on emergency room triage.
Oh, I forgot that half of the healthcare in this country is fully socialized. It's just for everyone who is old enough to get on medicare so that they can get free coveraged paid for by those of us who actually have to work (but don't get to actually benefit from the socialized healthcare we pay for ourselves).
At the end of the day, almost nobody is actually directly paying for their healthcare in the US anyway.
"Frivolous lawsuits" are less than 2% of the total, and hardly register in terms of actual dollars. No, the skyrocketing cost of medicine in the US can be firmly laid at the feet of PharmaCorps and the out-of-control insurance companies. Lawsuits actually went down in the past couple of years, yet malpractice insurance fees continued to rise.
In fact, ridding frivolous lawsuits and capping patient recoveries would not put a dent in medical costs. All that would do is take power out of the hands of judges who should be the final arbiters of what is and isn't a frivolous case and destroy the ability of plaintiffs to adequately address what, due to its nature, is a rather grievous harm.
You want to bring down the costs of medicine? Reign in the skyrocketing costs of drugs and insurance that doesn't adequately cover the insureds.
I have something in common with Stephen Hawking...
Funny thing, if you put people's money into a pool, and a Central Committee doles it out and dictates what can and can't be done, we call it Socialized Medicine -- EVIL!!
But if the people who dictate what can and can't be done also get to own the whole thing and rake off enough to get rich, we call it an Insurance Industry -- GOOD!!
I wonder if that's at least partially because Cuba has been denied access to American hamburgers, potato chips, donuts and soda pop (not to mention 1/10 mile car trips)?
A lot of Cubans work in the fields for months every year. No need for a gym!
Not to mention a lower rate of vehicular death - no cars going over 40 MPH...
And less murder - no money to buy drugs, no gangbangers.
50 years ago, there wasn't much that could be done for you beyond a couple of thousand dollars. Most people could be expected to pay for their own healthcare.
Now it's not unheard of to spend more than 1 million dollars on a single patient (one of my former employers mentioned in a benefits meeting that they had 5 $1 million patients in the previous year). Any reasonable person needs to have insurance, unless they're willing to die for the principal of frugality.
Health savings accounts are fine, as long as everybody qualifies, and as long as they always come with full insurance past some deductible that most people can afford. I do think that all health insurance plans should be required to have a high deductible to encourage people to shop on price. However, I also think that one way or another, there should be a single risk pool that amortizes the risk evenly over the whole population. This would greatly reduce both the outrageous costs of accounting in the insurance industry and the stress most people needlessly experience when they change jobs.
I will support Universal Heath Care when they come up with a system such that each and every citizen recieves the exact same heath care---starting with the President. If I have to sit on a waiting list for 6 months for surgery so should the President, Legislature, etc.
Knowing that is never going to happen I am completely against Universal Health Care. Do you actually think you and John Howard recieve equal care? Heck, politicans here won't even trust their kids to public schools let alone public health care!
Health Care--like food and land and every other resource--is a limited resource. Not everyone can eat lobster everyday and live in a mansion and afford to go to an Ivy league school. Not everyone can receive the top best healthcare. That is just reality.
What happens in "Universal Health Care" is that the powerful get their health care while what is left over is spread out thin between everyone else. At least in our system if I work hard enough and have a good job I can get good health care. To me that is much more fair than having my health care decided by whether or not I'm in politics or by "who I know".
Brian Ellenberger
malpractice insurance costs are a significant but relatively small portion of the increase in healthcare costs in this country over the last couple decades
Malpractice has had an indirect effect upon the cost of healthcare in the US: it has raised the standard of care, at times to ridiculous levels.
Practicing defensive medicine, in order to reduce the risk of getting sued, results in many referrals that aren't strictly necessary. Trivial example:
30 years ago: Kid breaks arm, primary care doctor sees him ($), reads xray himself, puts a cast on, done.
Today: Kid breaks arm, primary care doctor sees him ($), refers to orthopedic surgeon ($$$), who orders xrays, which are read by a radiologist ($$$ for the consult), puts a cast on, done.
These days, if the primary care doctor takes care of it all himself, and the outcome is less than perfect, he'll get sued, and he'll lose because he didn't refer the patient. My point is just that American medicine has overused specialty consults for so long that it's become the standard of care, and now anyone who doesn't make the costly, unnecessary CYA consult risks getting crucified by a lawsuit. The obscene state of malpractice laws in this country have created enormous hidden costs in these uneccessary referrals.
Of course, everbody wants their sprained ankles seen by an orthopedic surgeon because, as you pointed out:
Once they hit their deductible they don't care what it costs at all.
This is just one more reason why socialized medicine is a bad idea. The absolute last thing the US needs is another layer of insulation between patients and the real cost of health care.
Well with all these old sick people, I have one great solution;
1. legalize medicinal pot, that will
A) fix lots of sick people for virtual no cost, who cares if there is no patent and some big corp gets no money out of it, I can live with dieing companies (those ceos can live on their 10M+ bank accounts easy), not dieing people. And I am not saying they have to smoke it, any one with 1/2 a point of IQ will realise that you can get the THC oils out and apply as a vapor or orally.
B) reduce the wasted (fake) war on drugs which does nothing, but ruin peoples lives by getting in goal or getting records. Or generally just giving them the 'criminal' label which stuffs up their career prospects (damn evil Dupont screws)
C) reduce wasted $$$ on police force/prisons etc... AHH BUT wait, theres private prisons and people are making money, and thats all they care about, not the people.
But I dont expect that to happen, since they are all so currupt and evil , worse than any pot smoker could ever be. May god strike them all down with cancer that will be expensive for their children to pay for.
Liberty freedom are no1, not dicks in suits.
In some countries government programs can be very effective. In the US, however, there is no tradition of that, and the mind set for effective government programs just seems to be completely absent. I think that in the US, a universal health care system could be even worse than what exists now.
Finally! A year of moderation! Ready for 2019?