3 ms·

> In the absence of me showing you the evidence, what is your honest estimate of the probability that it's true? I have no reason to think that U.S. healthcare

> In the absence of me showing you the evidence, what is your honest estimate of the probability that it's true? I have no reason to think that U.S. healthcare, at the high end, is generally superior to that of other rich countries. My guess is that it depends on the field (some do better in, e.g., oncology and others do better in, e.g., brain surgery); that it might vary by hospital or by doctor more than it varies by country; and that results could depend more on operational issues, such as quality control, than on technology or doctor training.

jessriedel 10y ago
I'd claim (and bet, if we could settle) that a wealthy informed person would rather by randomly dropped into the top X% of hospitals in the US than the top X% of hospitals of any other country, for X < 10. Furthermore, that the top location in the world for 90% of specialities is located in the US. Do you disagree, and if so what would your country/numbers be?
- chimeracoder 10y ago
  > I'd claim (and bet, if we could settle) that a wealthy informed person would rather by randomly dropped into the top X% of hospitals in the US than the top X% of hospitals of any other country, for X < 10. This isn't an argument that has to take place in the hypothetical. When King Abdullah (Saudi Arabia) had to get open heart surgery, he booked it in the US[0]. This is not an isolated case, just the most famous one. I have a lot of personal stories about this, but I'll just leave it at this. Medical tourism actually runs in both directions. In the US, people often go to other countries for cheap, routine surgeries. Many Middle Eastern countries, on the other hand, are forming partnerships with US hospitals to bring their (American) doctors to the Middle East for effective 'tours of duty', as their solution to equalizing access to health care. (The very wealthy people living in the Gulf already come to the US for their planned treatments, but the middle class[1] can't quite afford it). If you talk to the most prestigious physicians and surgeons[2] at the top hospitals in the US (like the very, very top physicians at Mass General or NewYork-Presbyterian), you'll find that a sizeable number of their patients are foreigners - often living in the Middle East. There is some medical tourism from the Gulf to Europe, but it's nowhere near as widespread, and the general impression in the Gulf is that the US is the pinnacle of care quality, which is why they're chasing US practitioners and practice groups so aggressively. [0] http://pagesix.com/2010/11/30/saudi-king-takes-up-the-entire-vip-wing-at-new-york-hospital/ http://pagesix.com/2010/11/30/saudi-king-takes-up-the-entire... [1] Yes, contrary to popular belief, there is a sizeable middle class in the Gulf.
  - hackuser 10y ago
    The fact that some people go to the U.S. for medical care does't mean others don't go to other countries for it. A few anecdotal examples don't tell us anything about a population.
    - chimeracoder 10y ago
      > A few anecdotal examples don't tell us anything about a population. Aramco - the world's most valuable company - is leaning on Johns Hopkins to staff and run its entire healthcare system. They're not even the only one forming these partnerships with US hospitals and research university - just the most recognizable mame. That's more than just 'ancedotal'. OP's question was 'which hospital would a wealthy informed person choose'? I'm pointing out that we don't need to speculate, because we already know which one was chosen by the wealthiest company in the world, (owned wholly by the fourth wealthiest country in the world[0]). [0] The country with the second-largest sovereign wealth fund, by the way, is the UAE, which is also forming the same partnerships (Cleveland Clinic).
- hackuser 10y ago
  My speculation on the question would be meaningless; I have no idea. I might as well throw darts at a dartbboard or read tea leaves for the answer.

jessriedel 10y ago

I'd claim (and bet, if we could settle) that a wealthy informed person would rather by randomly dropped into the top X% of hospitals in the US than the top X% of hospitals of any other country, for X < 10. Furthermore, that the top location in the world for 90% of specialities is located in the US. Do you disagree, and if so what would your country/numbers be?

chimeracoder 10y ago
> I'd claim (and bet, if we could settle) that a wealthy informed person would rather by randomly dropped into the top X% of hospitals in the US than the top X% of hospitals of any other country, for X < 10. This isn't an argument that has to take place in the hypothetical. When King Abdullah (Saudi Arabia) had to get open heart surgery, he booked it in the US[0]. This is not an isolated case, just the most famous one. I have a lot of personal stories about this, but I'll just leave it at this. Medical tourism actually runs in both directions. In the US, people often go to other countries for cheap, routine surgeries. Many Middle Eastern countries, on the other hand, are forming partnerships with US hospitals to bring their (American) doctors to the Middle East for effective 'tours of duty', as their solution to equalizing access to health care. (The very wealthy people living in the Gulf already come to the US for their planned treatments, but the middle class[1] can't quite afford it). If you talk to the most prestigious physicians and surgeons[2] at the top hospitals in the US (like the very, very top physicians at Mass General or NewYork-Presbyterian), you'll find that a sizeable number of their patients are foreigners - often living in the Middle East. There is some medical tourism from the Gulf to Europe, but it's nowhere near as widespread, and the general impression in the Gulf is that the US is the pinnacle of care quality, which is why they're chasing US practitioners and practice groups so aggressively. [0] http://pagesix.com/2010/11/30/saudi-king-takes-up-the-entire-vip-wing-at-new-york-hospital/ http://pagesix.com/2010/11/30/saudi-king-takes-up-the-entire... [1] Yes, contrary to popular belief, there is a sizeable middle class in the Gulf.
- hackuser 10y ago
  The fact that some people go to the U.S. for medical care does't mean others don't go to other countries for it. A few anecdotal examples don't tell us anything about a population.
  - chimeracoder 10y ago
    > A few anecdotal examples don't tell us anything about a population. Aramco - the world's most valuable company - is leaning on Johns Hopkins to staff and run its entire healthcare system. They're not even the only one forming these partnerships with US hospitals and research university - just the most recognizable mame. That's more than just 'ancedotal'. OP's question was 'which hospital would a wealthy informed person choose'? I'm pointing out that we don't need to speculate, because we already know which one was chosen by the wealthiest company in the world, (owned wholly by the fourth wealthiest country in the world[0]). [0] The country with the second-largest sovereign wealth fund, by the way, is the UAE, which is also forming the same partnerships (Cleveland Clinic).
hackuser 10y ago
My speculation on the question would be meaningless; I have no idea. I might as well throw darts at a dartbboard or read tea leaves for the answer.