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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...'"
£0, but some serious taxes and a wait on a waiting list.
Even so, I must say I prefer universal healthcare.
Gamers Europe - Gaming News. Reviews.
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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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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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
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
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.
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.
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!!
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 $1 million patients in the previous year). Any reasonable person needs to have insurance, unless they're willing to die for the principal of frugality.
Health savings accounts are fine, as long as everybody qualifies, and as long as they always come with full insurance past some deductible that most people can afford. I do think that all health insurance plans should be required to have a high deductible to encourage people to shop on price. However, I also think that one way or another, there should be a single risk pool that amortizes the risk evenly over the whole population. This would greatly reduce both the outrageous costs of accounting in the insurance industry and the stress most people needlessly experience when they change jobs.
malpractice insurance costs are a significant but relatively small portion of the increase in healthcare costs in this country over the last couple decades
Malpractice has had an indirect effect upon the cost of healthcare in the US: it has raised the standard of care, at times to ridiculous levels.
Practicing defensive medicine, in order to reduce the risk of getting sued, results in many referrals that aren't strictly necessary. Trivial example:
30 years ago: Kid breaks arm, primary care doctor sees him ($), 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.