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CONSUMERS/POLICY: Real people really travelling

Via HISTALK, a really interesting column about people traveling to India for surgery. Essentially the total cost slightly exceeds the co-insurance for those with insurance and of course the cost is remarkably lower for the uninsured. The people featured are those in the 50-65 age group who are pre-Medicare and finding it harder and harder to get health insurance are the obvious candidates.

And of course they are the ones for whom the health insurance crisis is biting home, and the ones who will be the swing voters about this issue. I for one cannot believe that this group of Americans will accept that they all need to travel to India and pay out of pocket, over and above whatever catastrophic coverage they are also buying. So when a politician comes up with a believable universal solution, this type of story will be behind what gets it through the Congress.

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Eric NovackTom LeithpgbMDLynncary Recent comment authors
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Peter
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Peter

pgbMD, It seems you have a little bad taste in your mouth for overseas competition. Do you also share that bad taste with workers here that lose their jobs to lower priced labor and cost-of-living overseas? Or do you embrace free trade, the workers be damned, and the “it-costs-me-nothing” mentality?

pgbMD
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pgbMD

I would like to know how much an orthopedic surgeon makes for a hip replacement in these concierge hospitals in India. Here in the US I believe it is now down to around $2000. Maybe there will be a brain drain of US surgeons to India and Thailand!!! No malpractice to worry about and I am sure much less headaches and paperwork. Even if they are compensating only $1000 per hip replacement to the surgeon the cost of living and overhead are much lower than here in the US. After these overseas concierge hospitals business models mature, maybe we can… Read more »

John Fembup
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John Fembup

“the luxury hospitals put ours to shame”
No they really don’t, except in terms of their cost. You are far too eager to trash American hospitals.
Many hospitals in Western Europe and a few hospitals in Central/South America, Africa, and Asia do provide equal or marginally better care as in the U.S. at a fraction of the cost here. That is what I mean by “21st-century health care”. That combination of high quality and low cost may well re-define patient expectations in the U.S.

Peter
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Peter

Actually the 10 hour plane ride is also for a vacation as a $100,000 hip replacement for $25,000 allows for some R&R. Don’t discount Indian or Thai healthcare done in hospitals geared to foreign patients, the last thing they need is quality problems as that would dry up patients pretty fast. 60 minutes did a show on this and the luxury hospitals put ours to shame. Nurse to patient ratio is also quite high. Many Indian docs are trained in U.S. and return to help build their country, no big bucks to cloud their health decisions.

pgbMD
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pgbMD

“2. Would those in favor of overseas medical care, but would rather not be on an 10 hour plane trip (or longer) actually be in favor of implementing reforms in the US that would place the same level of regulation, medical liability restrictions, pure economic-based quality and availability of care, border control limiting illegal aliens access to their health system, etc. here in the USA?”
You hit it on the head.

Eric Novack
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1. so-called medical tourism is great— but given the greater than 1 BILLION outpatient doctor visits alone last year in the US, it will never be more than a tiny segment of the picture. 2. Would those in favor of overseas medical care, but would rather not be on an 10 hour plane trip (or longer) actually be in favor of implementing reforms in the US that would place the same level of regulation, medical liability restrictions, pure economic-based quality and availability of care, border control limiting illegal aliens access to their health system, etc. here in the USA? 3.… Read more »

pgbMD
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pgbMD

Prisoner organs are risky business because of the high rates of Hep C and HIV. As healthcare tourism increases, I think the insurers will have to address this issue of paid organ donation. I doubt Medicare will go this way, but who knows. As far as the floating hospital ship goes, I don’t think there will be any CABGs or delicate neurosurgery done onboard secondary to the motion of the ocean. Even huge hospital ships like the USS Mercy/Comfort still move up and down while at sea. The hospital ship question is interesting. Since the hospital ship would be in… Read more »

Peter
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Peter

Yes John, rip what it sews not reap what it sows. I’ve always been a worse speller than typist. Anyway, I think that in surgical terms rip/sew has more meaning. :>D

John Fembup
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John Fembup

“what if you didn’t have to fly to India for your 1/3-the-price surgery, but instead could take a 15 minute helicopter ride?”
And perhaps at that range you could persuade the surgeon of your choice to accompany you and perform the surgery.

Tom Leith
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Tom Leith

Dr. Borboroglu writes: > If Medicare allows one to go to India for > example for a kidney transplant, will it > also allow the patient to buy a kidney > from a donor? Something worse than what you’re asking about is already happening, and its probably just a matter of time before big US insurers or even Medicare take part. Organ Harvesting from Chinese Prisoners Media outlets and the US Department of State have confirmed that China is harvesting organs for transplantation from executed prisoners. According to the Asia Times newspaper, hundreds of well to do Japanese have traveled… Read more »

Vince Kuraitis
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Just to add to the out-of-the-box thinking that this article has sparked, let me add one more twist.
I remember reading about a startup company that was evaluating building a hospital ship and parking it in international waters off the U.S. coast. So what if you didn’t have to fly to India for your 1/3-the-price surgery, but instead could take a 15 minute helicopter ride?
U.S. healthcare might be resistant to “The World is Flat”, but not immune.

pgbMD
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pgbMD

In the case of kidney transplantation the hospital typically bills Medicare $80000. The surgeon bills $1800. I think this medical tourism will be effecting the hospitals more than the doctors if it grows. If Medicare allows one to go to India for example for a kidney transplant, will it also allow the patient to buy a kidney from a donor? Lots of interesting questions.

John Fembup
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John Fembup

“In the case of medical jobs going to Asia and India I think it levels the playing field for people stuck with a system that rams full chargemaster rates down their throats.” I think the emergence of “medical tourism” is a sign that 21st-century health care is being defined in other countries, not here, and that American medicine is not sufficiently prepared to deliver it at this time. At the present time medical tourism is a curiosity that a very small number of Americans have used. I think its significance lies in its potential to tap into the rising expectations… Read more »

Peter
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Peter

John, I’ve never been in favor of fully open free markets unless we all understand what we’re giving up. Health and safety regs, environmental laws, availability of quality healthcare (getting harder and harder here. Our gain is often at terrible cost to someone else. Workers here always get their jobs and compensation cut but have to endure real estate and transportation costs that don’t also compensate. In the case of medical jobs going to Asia and India I think it levels the playing field for people stuck with a system that rams full chargemaster rates down their throats. Part of… Read more »

Lynn
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Lynn

Although physicians do charge sizeable fees, I’ve had better luck with getting a discount from them than from my local non-profit hospital. ($105 to pee in the cup–not making this up!) Look who is touring for healthcare…the uninsured (or underinsured) middle class. Those who chose not to go bankrupt for major but schedulable procedures. Unless these are “trend leaders” in their respective communities, there will not be sufficient numbers to dramatically change American healthcare. I’ll know it’s caught on when my state’s Medicaid program begins to outsource sick folks. Until then this is only an interesting trickle of patients. But… Read more »