Medical Care Gets Outsourced Too 1184
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...'"
This is news to ANYBODY? (Score:2, Interesting)
Canada too, eh? (Score:4, Interesting)
Re:This is news to ANYBODY? (Score:5, Interesting)
I'd do it if it came down to it (Score:5, Interesting)
Makes me wonder why someone doesn't just get a ship anchored in international waters off the coast of california to offer similar cut price procedures.
our story (Score:5, Interesting)
Given that I am in the top 5% income bracket we opted for just taking the treatment and paying for it. Still not a great thing considering that it could take several treatments after which there is still no gaurantee of success (other then losing the money).
We got lucky. First time was a success.
I have been wondering how the millions of other couples in america for whom this procedure might be the last chance are dealing with the cost. Going abroad maybe?
Would you bet your life on that? (Score:2, Interesting)
The surgeons may be almost as good, but how good are the hospitals? Where's your recourse if they fsck you up? Sue for malpractice internationally for a pittance?
Things may be bad in the US, but not that bad, I hope.
How about a child's education, too? (Score:4, Interesting)
Should have gone to Bangkok (Score:3, Interesting)
On a less serious level, it's long been a well-known spot for budget travellers to get some dental work done, or pick up new glasses, cheap, safely and reliably.
It's even (IMO) a nicer place to visit. Sorry Indian readers
Re:Caveat Emptor! (Score:2, Interesting)
Re:American prices out of line... (Score:5, Interesting)
I read a newsarticle a couple of months ago where they pointed out that not even Medicare is "buying in bulk" but rather "individual packages" depending on how it goes.
Imagine all of Medicare got their act together and would negotiate ONE price with the supplier? Suddenly the prices would drop.
That's whats going on in Canada, and they are currently fighting over a Federal Pharmacare plan which would probably decrease the costs even further.
I've been doing this for years (Score:2, Interesting)
and get all my dental work done and any blood tests/whatever for maybe a 1/8 of the price I would pay here.
I have been to a dentist in the US and IMO the Brazilian ones are much better...
I have family members down there who got hair implants/breast implants/eye surgery/whatever for a much lower price than it costs here and they are all still alive, well, and had no problems with the work performed...
Next up... cheap organ donors! (Score:2, Interesting)
Re:Would you bet your life on that? (Score:5, Interesting)
Almost every country in the world will let Anybody sue for serious screw ups, but in almost every country in the world, the burden of proof of error is much higher. You have to prove:
(A) It was directly their fault, or their fault due to non-action or ignorance.
(B) That your quality of life is lower then if nothing had happened to you at all (after recovery and such).
(C) That the doctor did not make normal and standardized efforts for your care and recovery
(D) Also that, in the case of an accident, that if the doctor did not take Reasonable and standard steps to minimize risk.
This is vastly different then in the USA, especially in point A is a big one. In the USA, you could theoretically the doctor that delivered your child for them not making it into college, and would have a pretty reasonable chance of winning (don't doubt it).
Being able to sue, and a criminal system is important, but when it gets corrupt and full of greedy people, things like the ENTIRE MEDICAL SYSTEM get more and more expensive for everybody.
On a semi-unrelated note, I am planning to apply to medical school in Canada, and through my research, its rather disturbing how little standards some USA medical schools have. Many schools will take people with MCAT scores less then 20/45 (while its almost impossible to get in here with a 30/45) and some of the USMLE grades for students are insanely low. Often your residency programs for the same programs are a year or two shorter then here in the Great White North. As mentioned somewhere else in this article, unless you can keep some of the most trained professionals in your country as being quite smart, well educated, and socially aware, your will run into problems.
Countries like India and China have been focusing on building up that qualified and trained elite. While many/most of the people in those two countries have seen little growth in paycheck or quality/standard of life, they have, behind the scenes, a social system being developed to support first class societies.
While I hate to seem exclusionary, I think that we need to redesign the school systems across all of North America. Schools should be focusing on providing two distinct services, one is well-designed life skills training, and hard and aggressive knowledge training. Things like calculus and advanced chemistry should be introduced at as young as 9 or 10. While many will/cannot do this work, the ones that will are the important future engineers, doctors, scientists and professionals that we need.
Re:Unless we spend more on education... (Score:3, Interesting)
I, personally, wouldn't call it the "best in the world". And I think a lot of that is a matter of opinion. Other nations certainly do a much better job of providing a range of services to everyone. Canada has universal health care, and is often used as an example of what the US should do. In a recent poll, however, 2/3 of Canadians thought their system was "in crisis". In fact, the same attitude can be found among the French, Swiss, Swedes, and in the United States. No system is perfect. [smh.com.au]
Re:Don't get too excited, people (Score:5, Interesting)
That's complete nonsense. Sure, public hospitals in India (which are free) are in a horrible state, but no one's talking about them. In private hospitals, as the blurb mentions, the quality is about as good as in the U.S. I know, I'm from India. So quit spreading FUD.
Result of monopolistic market (Score:3, Interesting)
The existance of a monopoly has more effect than even insurance. There is little to no competition among doctors because the number that the AMA allows to be licensed every year is so small. I've heard all the stuff about limiting the number to make sure they are all competent, but that is a crock of shit. How do I know? Because I know some very competent doctors that were rejected a few times before they were accepted. There simply weren't enough spots for them in the schools. Eventually, they got in, became doctors, and lived happily ever after.
The situation reminds me of the cab drivers here. The city council created a fixed number of licenses. Then, they made it so that the license holders have control over new licensees. The effect is that there can never be any new licensees unless the law changes. So you have to pay someone for their license, and they are running at about $40,000 each. That's right, because the people whose income depends on their ability to restrict others from the market are in charge of that market, they will exclude everyone else to increase the value of their license. It is the same with the AMA putting doctors in charge of licensing doctors, and getting the force of law behind it.
Of course, if you try to add medical schools (which have to be AMA certified) they will balk that you will kill people with all the unqualified people that will get in. FUD, it's not just for breakfast anymore.
Oh, and the medical insurance costs don't help, either. And most of the problem with that is the juries. "Shit Happens" should be a valid medical defense for most of the suits. They are cutting you open and moving things around, things will sometimes not go right. If you have a problem with that, don't go in. If they operate drunk, sue them. If you agree to a proceedure and decide later that if it were done a different way the outcome may have been different, then you should sue yourself for being stupid and not getting a second opinion.
Re:without lawyers putting doctors out of business (Score:2, Interesting)
No, they just get paid actual damages.
In the few cases where there SHOULD be "punitive damages" (i.e. due to gross negligence rather than things that just happen because medicine is and never will be perfect), it should be awarded to the state to benefit everyone, and the lawyer should get no cut of it.
Re:American prices out of line... (Score:1, Interesting)
also bear in mide that Viagra was supose to be a blood presure medication and its only flaw was that it gave the patient a raging hardon.... but it turned out to be a benefit in the end and was able to be repackaged as a different drug.
Re:Sounds good to me.... (Score:1, Interesting)
I would think American Slashdotters could at least appreciate the desctruction outsourcing has done to this country. Why is it okay to outsource drug manufacturing but bad to outsource other things? I say it all sucks.
Re:Unless we spend more on education... (Score:2, Interesting)
According to Nationmaster.com [nationmaster.com] the U.S. far out-spends India in education. Fact is, practicing medicine in the U.S. is far too expensive. My father in law talked my wife out of a career in medicine (he's a pathologist). He told her just about all his peers would choose a different path if they had a chance to do it again.
Why? Malpractice.
The problem in the U.S. is not that we don't have enough doctors. It's that we have too many lawyers.
Re:Unless we spend more on education... (Score:3, Interesting)
An Indian's take on the article (Score:3, Interesting)
The very best Indian doctors and hospitals are, for all practical purposes, as good as any in the West. Unless you are looking for technologies and treatments that are on the very bleeding edge, chances are that it is available in India for a lot less than you would pay here.
The average Indian doctor and hospital are, however, a lot worse than what you get here. Over here, I can walk into any doctor's office, any hospital, and can be assured of a fairly decent standard of treatment. That is not so in India. Outside of the few top hospitals (most of which are located in the major urban areas), it is a total crapshoot. You may get a good doctor but it is equally likely that you will get a complete incompetent who would have had his license revoked many times over in the West.
I lost an uncle of mine to such a quack - in Bangalore of all places (where you would expect a decent level of medical expertise). He was hit by a truck and the idiot doctor who attended to him did not realize that while he didn't look too bad externally, he could be bleeding fairly severely on the inside. So they just sat and watched him bleed to death over the space of several hours.
As far as the cost advantage is concerned, it is there but will slowly get less over time. Medical treatment in India is getting dramatically more expensive each year
- HCE
Re:our story (Score:3, Interesting)
Anyway, here are some things to consider.
Indeed we where not in 'need' of IVF, more in 'want'. Though we wouldn't have died the other things would have applied. In this particular case my wife was suffering from Endomitriosis and Fibroid tumors of which one had allready been removed through an myomectomy a few years back. Not a pleasant operation. The successfull IVF has had an interesting side effect. Her pregnancy is now stopping the growth of the fibroids and even reducing the endomitriosis. So yes, it did prevent some kinds of sore.
Not claiming this is the reason we did IVF ofcourse, that is the 'suffering in an objective' term. Not sure at what point you are in your life, but by the time you experience the 'need/want for kids' thing you might be wondering where this need comes from. I believe that it is a natural need that is encoded in our genes. Among other places this is mentioned in the book 'Mind wide open' [amazon.com]. So not being able to fullfill our natural need one will indeed suffer.
Not that we wouldn't be able to overcome this suffering. We where allready getting ready for the adoption process and would have most likely lived happily ever after with an adopted kid too.
If life deals a bad card, and you have the money to change that card...isn't that what all this hard working is all about? Well, a socialist standpoint to distribute that wealth and change the bad cards of a group of people isn't all that bad (in MY opinion). But I am rather biased there...being from the Netherlands and all
Re:Spending isn't the problem. (Score:2, Interesting)
You don't need standardized tests to ensure a good education. Parents know a good school from a bad school by talking to the teachers, seeing what their kids learn, and comparing the school's performance to other schools. Among private schools, accreditation associations provide the objective measure and comparison of a school's curriculum.
i heard this somewhere else (Score:3, Interesting)
"the us is a good place to get a heart attack, and canada is a good place to get cancer"
mainly because the us healthcare system is set up in such a way that sudden major healthcare crises are well handled (pay later), but chronic long-term problems are not well-treated (pay first)
meanwhile, canada is the opposite
the fact is, in spite of this article, the rich of the world come to the us for their healthcare, because although affording american healthcare is difficult, it really is top notch in the world (mainly because of all that money)
there's no such thing as a free lunch, and eventually we all die, so healthcare, no matter how you slice it, is a triage system
always was, always will be a triage system: you have a limited amount of money to spend, and you have to decide where to invest it, and there are infinite ways to spend the money, because someone always has a health complaint
therefore, we will always be unhappy with our healthcare no matter what we do, because of the nature of the beast: we are human beings, we fall apart every day, and none of us have enough money to ensure all of us fall apart gracefully
Did you really expect any different ? (Score:1, Interesting)
Wake up guys, this sort of thing was inevitable and will probably only increase in time until the vested interests buy off some more of your politicians to legislate against it somehow.
It's such a shame that the US public at large has been victim to the levels of subtle indoctrination that they have been over the last 50 years. A good example, the main reaction to this sort of news coverage by the Good Ol' Boy flag waving American when told of other countries superior healthcare systems is "Ahhh..but that's SOCIALISED medicine!, like SOCIALISED childcare or education, and that's SOCIALISM, which is tantamount to COMMUNISM and if we go down that path next thing we'll be waking up with Russian tanks on 1St Avenue and Stalin in the White House because Fox News told me so!" which plays right into the hands of the multinationals.
It's all about balance people, balance! I call myself a capitalist, I'm a small business owner actually, but that doesn't mean I agree with rampant, unfettered rapiciousness by the Big End of town. Have you ever wondered why genetically modified foods didn't take off in places like Aust/NZ and Europe?....because we're all greenie, hippy, leftie communist Luddites??..think again!
It was because the populace here is sophisticated enough to realise the bullshit being handed out by the US multinationals was just that, bullshit.
Large American (lets face it, most of them are American) companies are interested in only one thing...shareholder profit!. That's it, not you, not me, not the country, just their earnings and shareholders. That is why the government must ensure they are kept on a short leash. Do you think the pharma companies give a rats ass about you, in Hicksville USA with your sick wife ??, you're just a CONSUMER to them. If they can rope you in and then jack the prices up wayyy high, squeeze you so hard you bleeed, well, all the better for them.
THIS is why the USA is garnering so much distrust now around the world. It's perceived as falling more and more into the sway of a small group of insanely powerful corporate interests who would ring you out to dry if they thought there was a dollar in it and they have a pet Administration in the White House that is allowing them to do just that !
The idea that the richest, most powerful nation the world has ever known can't even adequately feed, clothe or house and educate ALL its citizens while its multinationals run riot and avoid paying their fair share of taxes is just insane.
Re:Unless we spend more on education... (Score:3, Interesting)
Cosmetical surgery (Score:1, Interesting)
Do you want free trade? let the workplace free too!
Numbers, people, numbers (Score:5, Interesting)
1. Healthcare is expensive in the US because of high malpractice insurance. ... Moreover, he added, a New York heart surgeon "has to pay $100,000 a year in malpractice insurance.
From the article: Trehan, 58, a former assistant professor at New York University Medical School who said he earned nearly $2 million a year from his Manhattan practice
This guy was making $2mil a year, and paying $100K for MI; just 5%.
2. Doctors there are bad
The founder (as quoted above) was an Asst Prof at NYU, making $2M a year. In fact, a lot of the doctors you find here (in the US) are graduates from the same Indian schools. And many of them working at these top hospitals are those who returned from US/UK. You'll find a good number of them holding advanced degrees (like FRCS) from institutions in US/UK. A good friend of mine (an Indian who finished his residency here) is going back because he couldn't get into the top school he wanted for research. He has his choice of places where he can practice, but he prefers to go back because he says "if I'm going to practice, might as well do it at home". There, the good doctors are put on a pedestal and have a lot of clout in society.
3. Facilities are bad
The hospital mentioned, Escorts, is top-notch and was founded by an Asst Prof at NYU who gave up a $2M/yr package to go back. Here's another quote from the article: Escorts is one of only a handful of treatment facilities worldwide that specialize in robotic surgery,
4. Quality of care will be bad .8 percent. By contrast, the 1999 death rate for the same procedure at New York-Presbyterian Hospital, where former president Bill Clinton recently underwent bypass surgery, was 2.35 percent, according to a 2002 study by the New York State Health Department.
From the article: the death rate for coronary-bypass patients at Escorts is
5. It is cheap because it is bad
Again, from the article: For example, a magnetic resonance imaging (MRI) scan costs $60 at Escorts, compared with roughly $700 in New York
I will relate a personal story. A very good friend of mine hurt his back (slipped disk) while travelling in India in 1997. He had to be hospitalised, and operated upon. After operation, he got 1 month of in-home nursing care. The total bill? $4000.
When he came back, he told his insurance company about this. They asked him to go to a local doctor. He checked him out, and said that the job the Indian doctors had done was as good as anything they would have done locally. And the insurance company paid the $4K even though he hadn't followed procedure (called them and sought approval), saying that just the MRI alone here would have cost $4K. There, the MRI, surgery, post-operative care, etc. all came at the price of just an MRI here.
Ain't no choice at all (Score:3, Interesting)
However, when it came to dental, we got screwed. I went to get my ancient fillings replaced, and was told it would cost something like $6-7000, and my "insurance" would only cover half. Furthermore, my "insurance company" was so bad at paying their bills, the dentist had hired a full-time person solely to try to get them to pay. It had gotten so bad that the dentist refused to honor the insurance... I would have to pay in full, then they would give me the appropriate paperwork, and I would have to seek restitution from my "insurance company."
Cut to: I go to Colombia. Guess what, they have the same high-tech dentists' offices as in the USA, some with bilingual dentists trained in the USA. And to replace my fillings only costs a few hundred bucks. Cash.
Let's see: $6-7000, plus a raftload of paperwork and headaches to try to get my worthless, deadbeat "insurance company" to pay up. Or, $1400 for airfare and an awesome week's vacation, plus dental work.
Like Mr. White says, ain't no choice at all.
Re:Unless we spend more on education... (Score:2, Interesting)
If you define it as "having universal healthcare", then no, we don't.
If you define it as "actually being able to get treatment in a timely fashion", then that is a different story.
In Canada, which has universal healthcare, a diagnosis of cardiac disease is virtually a death sentence. Most Canadian heart patients die while sitting on the waiting list for the next available OR, for surgery that is absolutely routine. The ones who can afford it, or have friends, simply cross the border into the United States, and they generally are rolling into an OR less than 24 hours after they clear customs.
Some years ago, I had to have both hips replaced. The orthopaedic specialist broke the news to me on Thursday. The first non-emergency OR we could get was Tuesday morning. This was OK, as it gave the rest of my doctors a few days to get my strength back up for the surgery. In Canada, the AVERAGE wait for hip replacement surgery is THREE YEARS.
For a while, I was on a mailing list for asthmatics. The list moderator was a wonderful woman in Canada. She was dying. Her regional healthcare administrators were killing her, one day at a time, by refusing to let real specialists look at her and maybe make a difference in her life. That would have cost money.
Canadian hospitals ROUTINELY close to all but emergency cases for the last couple of months of the year, when they run out of money. If you have a non-emergency in November, you will just have to wait until January and the new fiscal year. Or you could wait for it to become an emergency, and gamble your life on being able to make it to the hospital... Having lived through an asthma exacerbation that should have killed me, having survived ONLY because I was already in the hospital when I crashed, I'm not too keen on this approach.
So you tell me who has the better healthcare.
Re:Sounds good to me.... (Score:3, Interesting)
Yes, it does freak people out. In high school and college I had people asking me to put my watch in my pocket when we took tests. Should have seen the looks on their faces when I showed them I was wearing a digital watch!
Of course, it does make it difficult to be a ninja or assassin, so I settled for being a sysadmin.
Re:Unless we spend more on education... (Score:3, Interesting)
Er, what sort of business are we talking about? A corner sweet shop or a business that might actually have to deal with customers all over, including Brazil? Plus, maybe just knowing the name of Milton might not be very useful, but understanding the lesson of Paradise Lost, namely that even great bosses are going to have disgruntled employees, who are disgruntled merely because they *aren't* the boss, certainly is useful for *any* business,
Re:Unless we spend more on education... (Score:2, Interesting)
IMHO education is critical - both tradition schooling as well as vocational. Education provides direction and discipline. I know, learning the capitals of some country soudns pointless (probably is) but the fact that some things stick with you after those classes can be the seed for future interest.
Without schooling how would a person know that a world exists beyond they're block? And I mean a 'real' world, not the crap world portrayed on TV
I think education helps a country (or in general a civilization) by making people think - about opportunities, possibilities - and in addition I'd go so far as to say provides direction.
And before people get apoplectic about discipline/rigor/straitjacketing etc, I realize there will be people who are fine without schooling. The problem is these people are the minority and will be highly motivated. These people will do fine on their own. But that does'n tmean we should expect everybody to be so.
Re:Unless we spend more on education... (Score:1, Interesting)
By nearly all accounts regardless of party lines, if you strip out the costs for pain and suffering on the upper fraction of liability cases, this would pay for the insurance of 40 million Americans yearly. That's how much is going to the lawyers.
This is not hard to fathom or equate considering the typical settlements or cases won, which are both compounding by doctors leaving because of high liability insurance (driving costs up more since you have fewer doctors; supply, demand) as well as higher liability insurance itself (to pay for those million dollar losses).
The question is SHOULD we revise the tort system for this purpose as opposed to funding it elsewhere. That is up to debate, but don't discount that lawyers have a heck of a lot to do with inflated costs.
Re:This is news to ANYBODY? (Score:3, Interesting)
That's because everyone is foolish. 50 years ago everybody *did* pay for their own healthcare plans. But during WW2 employers were not allowed to increase wages of their employees. To compensate the employees(instead of raises) they paid for health care and other benefits. Eventually everyone got used to it, and now you have our modern healthcare and benefits packages.
However, these days since everyone changes jobs every couple of years they get screwed. Transfering between employer health care plans when you have downtime, 'applying for health care', and getting screwed by 'pre existing conditions'. All these problems go away if you just pay for it yourself.
Unfortunatly people feel they aren't getting 'all that they can' out of their employer if they do this. However that means they get screwed when they change employers. I pay for my own health care because I'm a contractor, and all I hear are insane stories about people who switch jobs and get screwed.
This is going to change hopefully, President Bush established a HSA(Health Savings Account) [hsainsider.com] plan which encourages people to manage their health care themselves. This not only encourages investment but makes health care costs cheaper. I've opened one and I know I'll have reasonable health care costs.
Where's your evidence. (Score:2, Interesting)
The definition of "frivilous lawsuits" is slippery--there are plenty of highly paid "expert witnesses" who will solemnly swear that Dr. X egregiously breached the standard of care, when any other physician who hears about the case will call the allegations pure BS. Also note that frequently every doctor who saw the patient gets sued once the lawyers get started. So even if the suit itself may have some merit against 1 physician, 9 or 10 other pysicians are also sued without true justification, all in the same suit. Such suits may not be labeled as frivolous, but for 9 of the 10 defendents it is.
I'll grant that I'm biased on this. I am a physician, and I've been sued for malpractice once. By a patient who I had never seen who had been in a hospital I had never set foot in. Despite the fact that I had nothing to do with this person in any way, it took 9 months to get myself dropped from the suit (which involved ~10 other doctors and 2 hospitals for charges that were BS). So I've had an intimate experience with this issue.
Re:This is news to ANYBODY? (Score:2, Interesting)
The US spends more per capita than any other nation on earth-- so why don't we have the best infant mortality rates and life expectancies?
My theory is that we're being robbed-- what's your explanation?
Re:Unless we spend more on education... (Score:3, Interesting)
But, it is true that healthcare is rationed in Canada: each province only permits a certain number of each kind of medical "procedure" in a year (doctors are paid by the province by procedure performed, and this is how costs are controlled). Toward the end of the year, the caps are reached on an increasing number of procedures.
Re:Canada too, eh? (Score:2, Interesting)
The FDA's rationale for refusing to approve wavefront? It's a little bit TOO good. Laser eye centers in Canada were advertising BETTER than normal vision to people with nominally normal vison -- and achieving it often enough for lots of people with technically normal vision to get the procedure done.
As we all know, the FDA (and its evil twin, the DEA) has a long-standing institutional bias against "normal" people using drugs/surgery to become "supernormal". The last time I checked, they granted it "provisional" approval last year for "humanitarian" procedures (read: people with problems that can't be corrected via glasses or contacts), but still weren't in any real hurry to approve for general use.
Re:But... I thought *Canada* had the sucky healthc (Score:4, Interesting)
I pay $500 a month for insurance that has a $2500/yr
deductable. Why, because I'm self employed and dont have my employer paying part of the bill. Dont forget, in hte US, for the most part, you employer does pick up part of the bill.
The reason for keeping it, if I ever have to go in for anything, having insurance keeps the bill down. If I went in for anything and had no insurance, I'd have to about 3-5X more. That's the way it works..
Re:American health care costs (Score:3, Interesting)
Perhaps the problem is that health care just follows the laws of supply and demand. In this case, demand is essentially infinite. Therefore, price rises until it literally consumes EVERYTHING.
After all, if you only had a dollar to your name, were on your deathbed, and in pain, you'd probably spend it on an aspirin pill. If you had $100,000 dollars, you'd spend it on some experimental surgery even if it most likely would add one week to your life. And so on...
The only way to reduce prices is to tell people they can't have treatment. And that raises BIG ethical issues.
Still, I think a lot can be done to at least reduce the need for people to pay for the treatment of others. It is one thing to spend your last dime on treatment. It is another to run up a trillion dollar medicare debt. Sooner or later, you have to pull the plug, and that is never pretty...
Re:to paraphrase steve jobs... (Score:3, Interesting)
Ever listen to "Amused to Death" by Roger Waters. It seems to make more and more sense to me as time goes by.
Jedidiah.
Re:This is news to ANYBODY? (Score:5, Interesting)
You are absolutely right. I used to sell health insurance and I am currently CTO of a company that provides medical practice automation software (which includes claims processing).
When I have had to pay for my own health insurance I get a policy with at least a $5,000 deductible and high maximum benefit. I also open an MSA (Medical Savings Account). That way I pay for my family's routine visits out of my own pocket (cheaper than comprehensive insurance over the course of a year) and I am still protected against a major medical catastrophe.
The next layer to add to this is to, before telling the MD you'll be paying cash, ask if you can get a discount for cash. Sometimes (often?) you can since, on average, it saves the MD about 20% to not have to go through the claims process.
The result is a health insurance set up which is portable and relatively affordable.
Re:UK Total Cost... (Score:4, Interesting)
For a while I was living and working in NZ and my brother was living and working in the US. We were each earning the same amount in local currency. New Zealand has Universal Healthcare, and as we all know, the US does not. Naturally my tax bill was much higher than my brother... except, it wasn't. By the time all the Federal and State taxes, along with various Social Security levies and whatnot, were added up, my borther had a larger tax bill than me.
The US healthcare system is in some weird sort of limbo land where they can't bring themselves to commit to either course of action: they do spend a lot of money of various forms of government subsidising healthcare. I've heard that the US government spends more per person on healthcare than Canada, yet Canada has Universal healthcare*. Now, I haven't seen figures so I don't know if that's true, but I do know that in the US you end up paying as much or more in tax as most of the various "Socialist European countries".
Jedidiah.
* (Canada has its own issues: Fearing the rise of a "two tiered healthcare system, and hence refusing to allow a parallel private system to ease pressure on the public system).
First Hand Experience and a break down of salaries (Score:3, Interesting)
Re:Your statistics are scary! (Score:1, Interesting)
Middle Class Canadian - waits 8 days.
Poor Canadian - waits 8 days.
Rich American - waits 1 day.
Middle Class American - waits 5 days.
Poor American - dies due to lack of coverage.
Seeing as I'm on the poorer end of things and the rule of wealth is still that the wealthy make all the rules, I'll vote for the Canadian system thanks.
Re:It's not the insurance companies (Score:5, Interesting)
I've had to TA pre-med students and while some were bright it was their incessant grade-grubbing that made them stand out. While in grad school I've also had three pre-med students working in lab for me. All three were smart but only one was what I'd call brilliant. All three got into med school. One declined and went to grad school because she thought it'd be more challenging. One got in because her dad made a bri^H^H^H donation, and much to her credit she's having a serious moral dilemma about accepting the spot. The appalling thing is that "donations" to try and influence the admissions committee are not uncommon. As in most things if you're rich then the rules can easily be bent, and the ones that go to med school are disproportionately from wealthy families--so much for academics. The third is now a third year med student at USC and it's largely from her (and from my having to tell a MD that antibiotics don't work on viral infections) that my opinion of med students and MDs has dropped through the floor. Her classmates almost without exception are from wealth and privilege, brought up by maids and nannies and carefully insulated against the world. She was one of the few with real-world experience (academic research, paramedic, firefighter, crisis intervention worker); most simply were memorization machines with high grades but weak problem solving skills--her opinion as a fellow med student, mind you. Most were utterly clueless when it came to dealing with patients or figuring out a diagnosis.
Perhaps this sums it up best: One of her classmates somehow made it to age 24 and was still under the impression that women have a cloaca. Nevermind never having a gf or never seeing any porn, he thought that women only have one opening down under after passing an undergraduate-level human anatomy lab! At least it being USC there's no shortage of porn stars to come in to be model patients for the med students' gynecology exams so that got straightened out real fast.
Re:Subsidized drugs? (Score:2, Interesting)
- Detergent
- fluoride
- pesticides in vegetables
- chemically expanded meat
Here you go, these are the 4 things US government love, since they are as good a population control tool as HIV. In the meantime everybody ca$hes in.