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The Almighty Buck United States News

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...'"
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Medical Care Gets Outsourced Too

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  • by Anonymous Coward on Friday October 22, 2004 @06:32PM (#10604360)
    "Thank you...come again.!"
  • Canada too, eh? (Score:4, Interesting)

    by clockmaker ( 626182 ) on Friday October 22, 2004 @06:32PM (#10604361)
    I have a friend who went to Canada to get her Laser Eye Surgery real cheap. Apparently the company has an office here in Seattle, and a shuttle to Vancouver, B.C.
  • by gamlidek ( 459505 ) on Friday October 22, 2004 @06:33PM (#10604364)
    Now we don't have to worry about having doctor's in the US anymore, also... we can just get on a plane and go to India for medical care.

    Add sarcasm tags where appropriate.
  • by Pacifix ( 465793 ) <zorp.zorpy@com> on Friday October 22, 2004 @06:33PM (#10604371)
    ... the US will quickly becoome a second-world country. China and India understand that an educated population is the only way to make it in today's world. We prefer to spend our money on tax cuts and trickle-down economics. The best medical care in the world should be in the US, but the way our schools are now, there are just no students to provide that service.
    • by (SM) Spacemonkey ( 812689 ) on Friday October 22, 2004 @06:38PM (#10604433)
      I am an Australian, but since America is so powerful, I take note in what you guys do. I kept hearing your President in the debates saying you have the best healthcare in the world. America doesn't even have a universal healthcare system. You lag behind Australian and most of the countries in the European Union. I don't understand how your media doesn't through your leaders to the wall for such outrageous lies.
      • As others have noted, the best care in the world is available in the US. But you have to pay for it. It also means the care isn't rationed by the government and you're free to shop around, with your own money, to get the care you want. I can call up my doctor and be seen the same day. I can get many common treatments (flu, mild infections, etc) at a mini-clinic with no appointment, no wait, and only $15 cost.

        I, personally, wouldn't call it the "best in the world". And I think a lot of that is a matter of o
        • Actually, I just got on this very subject today with a contract coder we employ occasionally in our US based college. The contractor, who is Canadian, said he'd much rather have the American system for medical coverage. When I asked him about it costing more, he'd said that cost wasn't his issue with the Canadian system, it was the waiting time. He mentioned a story about his mother needing some form of cancer tumor cut off her arm and it took her 6 months to get in and have it removed and by that time i
      • by back_pages ( 600753 ) <back_pages AT cox DOT net> on Friday October 22, 2004 @08:04PM (#10605314) Journal
        Because the American media system is a complete and total failure to the American people (and to the people of the world to the extent that they are concerned with American news.) Our media does not consider this a problem because they are in a profitable position. Our broadcast and cable TV channels are swamped with the cheap-to-produce "reality" shows that generate huge sums of advertising dollars. Why would a media corporation risk the backlash of telling us what we don't want to hear when they could cash in by assimilating the "reality TV" formula?

        There's a news article today about how a healthy majority of Bush voters think that Bush is popular in the rest of the world, Islamic nations support Bush's international war on terrorism, and that Bush supports the Kyoto air pollution agreements and the landmine anti-proliferation agreement. He is, in fact, openly against the Kyoto and landmine anti-proliferation agreements. (I'm not trying to argue the pros or cons of that political stance.) There is a clear and unquestionaly disconnect between the President's political agenda and what his own supporters believe is his agenda. How can this happen?

        Our media has completely failed us. How is it that our health system is in crisis? Because most Americans are not aware that it could or should be different. Many Americans do believe that we have the best health care system in the world (not just quality of care, should you be able to afford it.) Why don't they know? Because our media has completely failed us.

        "The first stage of fascism should more appropriately be called Corporatism because it is a merger of State and corporate power"

        -Benito Mussolini
        (1883-1945), Fascist Dictator of Italy

      • by Grishnakh ( 216268 ) on Friday October 22, 2004 @08:16PM (#10605408)
        I kept hearing your President in the debates saying you have the best healthcare in the world. America doesn't even have a universal healthcare system. You lag behind Australian and most of the countries in the European Union. I don't understand how your media doesn't through your leaders to the wall for such outrageous lies.

        It's not exactly a lie: if you're super-rich, the USA probably does have the best healthcare in the world for most procedures. Now, if you're not rich, then you're not important. And if you don't even have insurance, then you aren't even human and don't count. This is the President's point of view, BTW, not mine.
    • by jcr ( 53032 ) < .ta. .rcj.> on Friday October 22, 2004 @06:38PM (#10604437) Journal
      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.

      • by Belial6 ( 794905 ) on Friday October 22, 2004 @06:49PM (#10604577)
        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.
      • Actually we really don't spend nearly as much per student as you think, but this has already been addressed in other responses. What hasn't been addressed is the fundamental difference in the responsibility of the parents in their children's education. I've had to teach in an inner-city (read: poor) school in Boston, and most of the parents either didn't care how or what their children were doing (either in school or out of school) or were too busy blaming the teachers for their children's poor grades. I
    • by cubicledrone ( 681598 ) on Friday October 22, 2004 @06:50PM (#10604591)
      We prefer to spend our money on tax cuts and trickle-down economics.

      We don't "spend money" on tax cuts. That implies the money belongs to the government in the first place.

      By the way, we still tax Social Security benefits. Read that again. We TAX SOCIAL SECURITY BENEFITS. We tax people who get married. We tax people who sell their house. We tax people who make just enough to eat. We tax everything at enormous, ridiculous rates.
    • by InfiniteWisdom ( 530090 ) on Friday October 22, 2004 @07:38PM (#10605089) Homepage
      We prefer to spend our money on tax cuts

      While I do oppose Bush's tax cuts which have led to massive deficits, I think this is a very strange characterization. That seems to imply that our money belongs to the government from the start.-
  • UK Total Cost... (Score:5, Insightful)

    by ProudClod ( 752352 ) on Friday October 22, 2004 @06:33PM (#10604372)
    £0, but some serious taxes and a wait on a waiting list.

    Even so, I must say I prefer universal healthcare.

    • Re:UK Total Cost... (Score:5, Informative)

      by servoled ( 174239 ) on Friday October 22, 2004 @06:40PM (#10604471)
      From the article:
      But the same hospitals now are starting to attract non-Indian patients from industrialized countries, and especially from Britain and Canada, where patients are becoming fed up with long waits for elective surgery under overstretched government health plans.

      "If you can wait for two years for a bypass surgery, then you don't need it or you're dead -- one of the two," Trehan said. "Similarly, if you're wobbling on your frozen joints for two years because of a waiting list, it's a human tragedy."
      Some people can't wait the required time for a doctor to become available, so they end up doing flying over to India to get it done. Universal health care isn't perfect either.
      • Re:UK Total Cost... (Score:5, Informative)

        by rainman_bc ( 735332 ) on Friday October 22, 2004 @06:43PM (#10604503)
        If you're critical you jump to the top of the queue. If you're non critical you're on a waiting list. That's how it works in Canada. My fiance's father had to get a pacemaker in. He jumped everyone to get it in. His heart beat was under 30bpm... That's critical.
      • by ProudClod ( 752352 )
        Of course, there are a few people I know who've gone over there to have ops done. However, in the fact that if you're ill in the UK, you don't even need the "small" amount of $10000 to get treated, means that I prefer our system - people may have to wait longer, but they don't have to wait until they earn the money, or even put off vital treatment to save cash.

        As for the rates of tax, for me, when I look at my tax bill, I can at least look at where it's being spent and think - yeah, that's worth it.

        I'm no
        • Re:UK Total Cost... (Score:4, Interesting)

          by Coryoth ( 254751 ) on Saturday October 23, 2004 @01:28AM (#10606919) Homepage Journal
          As for the rates of tax, for me, when I look at my tax bill, I can at least look at where it's being spent and think - yeah, that's worth it.

          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".


          * (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).
  • by Moby Cock ( 771358 ) on Friday October 22, 2004 @06:34PM (#10604380) Homepage
    I went to Asia Minor and all I got was this lousy Left Ventricle...
  • by dillon_rinker ( 17944 ) on Friday October 22, 2004 @06:34PM (#10604387) Homepage
    I sent my sinuses to Arizona
    I sent my liver to Peru
    I sent my lungs and my kidneys
    For the summer to Sydney
    But I'm sending my heart to you!
  • by grahamsz ( 150076 ) on Friday October 22, 2004 @06:35PM (#10604394) Homepage Journal
    Places like india and south africa end up supplying plenty doctors to western countries and i'd feel pretty confident that they'd do a good job.

    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.

    • by ajna ( 151852 ) on Friday October 22, 2004 @10:53PM (#10606248) Homepage Journal
      It's quite difficult to become certified in the US if you are trained as a doctor overseas, so your statement that "Places like india and south africa end up supplying plenty doctors to western countries" is disingenuous at best.

      First off, they must be approved by the Educational Commission for Foreign Medical Graduates (ECFMG), then pass the United States Medical Licensing Examination(TM) (USMLE(TM)) board exam ("the boards" that you may hear med students grumbling about), and then they must complete a residency (3-7 years depending on specialty) in the US even if they were certified and practicing in their home nation. Source: ECFMG fact sheet [].
  • by thewiz ( 24994 ) * on Friday October 22, 2004 @06:35PM (#10604396)
    As someone who has had three open-heart surgeries due to a congenital heart defect, I can see this as a viable option if I ever have to have another surgery. I've had my aortic valve rebuilt once (valvoplasty) and had it fall apart, replaced with a Hancock prosthesis (pig's valve) which calcified when I went through a growth spurt at 16, and then had it replaced with a Saint Jude's valve. I've been ticking (literally) for the past 22 years. Yes, I had my brother tell me that I am like a Timex watch :->

    My first surgery cost about $5,000 (in 1969); the second about $30,000 (in 1976), and over $80,000 (in 1982). 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 more delicate the organ they work on, the more they pay. In order to stay in practice, they have to charge the patient more. The patient's insurance company pays more, they raise the cost of the insurance, someone sues the doctor for leaving a sponge in them, their malpractice insurance rates go up, etc.

    IANAL and I don't know about India's legal system, but I don't think they have the sue-for-every-mistake mentality we do here. Remember, doctors are people too and they sometimes make mistakes. 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.
    • Reason being I personally know one of the world's best heart surgeons who currently practices in India. He has done thousands of open heart surgeries, on people from virtually all rungs of life, politicians to business magnets to children from Iraq.

      Infact I have been thinking to start my own little medical tourism practice on the side to encourage people to seek medical help in India. India has some of the world's most renowned doctors and some of the cheapest rates. The care you will experience will be to
    • by unassimilatible ( 225662 ) on Friday October 22, 2004 @07:54PM (#10605223) Journal
      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

      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.!

      • by Bowling Moses ( 591924 ) on Saturday October 23, 2004 @02:38AM (#10607165) Journal
        "Medical school admission in the US is extremely competitive, likely the most competitive academic process in the US."

        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.
  • our story (Score:5, Interesting)

    by Traa ( 158207 ) * on Friday October 22, 2004 @06:35PM (#10604398) Homepage Journal
    My wife and I considered going abroad for the treatment we where facing too. We where in need of IVF (in vitro fertalization) and this is typically not covered by insurance companies in the US. Some numbers [] suggest up to 2 million americans are in need of this procedure. Looking at about $15,000 per procedure without a guarantee of success we considered getting treated in Canada (less then $10k per try) or even going back to the Netherlands where it is insured by law reducing the patients cost to ~$1200 per try.

    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?
    • Re:our story (Score:3, Insightful)

      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.

      • Re:our story (Score:3, Interesting)

        by Traa ( 158207 ) *
        thanks for the proper objective reply. Man I didn't think I would get flamed so hard for my story (by other people).

        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 s
  • by LostCluster ( 625375 ) * on Friday October 22, 2004 @06:37PM (#10604420)
    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.
    • by MKalus ( 72765 ) <[mkalus] [at] []> on Friday October 22, 2004 @06:48PM (#10604555) Homepage
      You can thank the "everybody for himself" mentality that is what the Us is all about.

      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.
      • by John Newman ( 444192 ) on Saturday October 23, 2004 @12:21AM (#10606675)
        Imagine all of Medicare got their act together and would negotiate ONE price with the supplier? Suddenly the prices would drop.
        What a brilliant idea! Why didn't someone in Congress think of that?

        Oh, right, because the Administration and Congressional Republicans made it explicitly illegal for Medicare to negotiate bulk prices when they passed the recent Medicare prescription drug benefit. The VA's been doing it for years, but Medicare is forbidden by law.

        Are you Canadian? Then I guess you can't help us undo this bit of absurdity. For all you other Americans out there, though, I hope you know why Medicare doesn't do it, who to blame, and in less than two weeks you can help the guy who's promised to undo this ridiculous restriction to reach office.
    • There is a big difference in the US for pills. The various companies spend as much on marketing as they do on research and development. Ultimately that marketing has to be paid for. In other countries it is usually the case that pharmaceutical advertising is very restricted, and in most cases useless since you can't go to your doctor and demand they give you what you just saw on TV.
  • by Pan T. Hose ( 707794 ) on Friday October 22, 2004 @06:37PM (#10604421) Homepage Journal
    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?
    • by Colonel Panic ( 15235 ) on Friday October 22, 2004 @06:45PM (#10604513)
      Doesn't India "outsource" manufacturing of soft drinks to American Coca Cola and Pepsico?

      Well, not quite. The soft drinks that are sold in India are probably actually made in India as it would cost too much to ship bottles of Coke over from Atlanta. Yes, the American companies get some small amount of money from each bottle sold, but no American workers were employed in the process. ...besides: which would you rather have insourced:
      Software Engineering and Surgical jobs or Softdrink jobs?
  • by craXORjack ( 726120 ) on Friday October 22, 2004 @06:37PM (#10604422)
    You even get to pick which street person will be the lucky donor.
  • by Doc Ruby ( 173196 ) on Friday October 22, 2004 @06:38PM (#10604443) Homepage Journal
    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.
  • by mc6809e ( 214243 ) on Friday October 22, 2004 @06:39PM (#10604445)
    For the $10,000/child/year we spend now on public education, you could probably send your child overseas and have him personally tutored by people with PhDs.

  • by jmason ( 16123 ) on Friday October 22, 2004 @06:40PM (#10604459) Homepage
    Seriously, he should have gone to Bangkok. Last time I visited, I met an Aussie who'd retired to Thailand for the cheap healthcare, and heard of several "surgery tourists" who also did the same. Reportedly the hospitals (at least the ones a paying tourist would use) are spotless, with english-speaking nurses and excellent care.

    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 ;)
  • by daviddennis ( 10926 ) * <> on Friday October 22, 2004 @06:41PM (#10604474) Homepage
    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.

  • by Killswitch1968 ( 735908 ) on Friday October 22, 2004 @06:46PM (#10604529)
    Here's the weird thing about the Canadian academic medical system.
    Fact 1: Canadian doctors, especially rural family doctors, are in critical shortage.
    Fact 2: It is hard as hell to get into Canadian medical schools (GPA: 3.8, MCAT 30-31 + Extracurricular)
    Fact 3: There are hundreds of immigrant doctors in Canada driving taxi cabs.

    If you said "WTF?" you're not alone. The reason why it's hard to get into medical school is easy enough to explain: When the government pays 70% of your tuition, you're gonna get high demand for a fairly well paying job (about $7000 USD/month).
    But what makes very little sense is all these perfectly good doctors roaming the country with crappy little McJobs. The reason is because they can't get into residency programs to get certified. And they can't get into residency programs because Canadian graduates get first pick, and whatever's leftover goes to the immigrants. Since there's always never enough residency spots, and the one's that go to the immigrants are less desireable (family medicine).
    That means we could have the world's best opthmalogist living in Canada, and the most he can hope for is it run a rinky-dinky clinic off in the boonies, if he's lucky.

    Not sure how it relates to the story, but an interesting tidbit nonetheless.
  • by FFFish ( 7567 ) on Friday October 22, 2004 @06:46PM (#10604532) Homepage
    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!


    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.
  • India is far (Score:3, Insightful)

    by blackmonday ( 607916 ) on Friday October 22, 2004 @06:49PM (#10604566) Homepage
    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.

  • This works both ways (Score:3, Informative)

    by PIPBoy3000 ( 619296 ) on Friday October 22, 2004 @06:52PM (#10604611)
    I work for a healthcare organization and one of our hospitals is in Bellingham, WA. We get a reasonable amount of business from Canada. Evidently there are people who aren't fond of waiting lists.
  • Medical Costs... (Score:4, Insightful)

    by softspokenrevolution ( 644206 ) on Friday October 22, 2004 @06:58PM (#10604666) Journal
    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.
  • by AK Marc ( 707885 ) on Friday October 22, 2004 @07:14PM (#10604840)
    The US market for doctors is a monopoly. The AMA gets final say in who is and is not a doctor. They limit entry into the field. They regulate those that are in the field.

    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.
  • by HC_Earwicker ( 636561 ) on Friday October 22, 2004 @07:46PM (#10605154)
    I am an Indian living in the US. My parents are both doctors - working in one of the hospitals mentioned in the article. Here is their take on the entire Indian medical system.

    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 ... and Indians are taking a cue from the US and filing malpractice lawsuits in increasing numbers. So, if you are looking to India for cheap medical treatment, better go there quickly. It isn't going to remain that way for a whole lot longer!

    - HCE
  • by circletimessquare ( 444983 ) <circletimessquare&gmail,com> on Friday October 22, 2004 @08:18PM (#10605426) Homepage Journal
    forgot where:

    "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

  • by Quixote ( 154172 ) on Friday October 22, 2004 @08:43PM (#10605604) Homepage Journal
    There are several numbers quoted in that article that will put to rest some of the popular misconceptions being touted here.

    1. Healthcare is expensive in the US because of high 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 ... Moreover, he added, a New York heart surgeon "has to pay $100,000 a year in malpractice insurance.
    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
    From the article: the death rate for coronary-bypass patients at Escorts is .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.

    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.

"I have not the slightest confidence in 'spiritual manifestations.'" -- Robert G. Ingersoll