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Not discounting your anecdote, because it's something I too have been incredibly frustrated with. However, how would you possibly know the full out of pocket co

Not discounting your anecdote, because it's something I too have been incredibly frustrated with. However, how would you possibly know the full out of pocket cost for a visit until billing is complete? For simple things, I completely understand the frustration, as an echo should be an echo. However, what if they needed to run more tests, or did more for you as a patient and thus didn't know what to bill until your hospital stay (or even outpatient visit) is completed? As for your point about costs being drastically different in other countries for the exact same thing: I totally hear you, and wish there were more competition. How do you hit that healthy balance of competition and quality, though? Regulation is one way that comes to mind.

rootusrootus 8y ago
When I saw a doctor while visiting Hyderabad, it was pay-as-you-go. Walked in the door, paid a small fee to register as a patient. Consulted with a cardiologist, then paid for an EKG with my credit card. After that, consulted another cardiologist, who said let's do an echo. Paid for that, then had it done (by an actual cardiologist, no less, not just some technician), then visited an electrophysiologist. Got prescribed a beta blocker, went downstairs, paid for that, left. Total bill ended up 4500 INR, or about 75 USD. Then I flew home to the US a few days later, got a Holter monitor for a day and a visit with my primary care physician and a cardiologist. Billed a couple weeks later, 1000 USD. After insurance. For what it's worth, I could buy the Holter monitor and a bunch of disposable supplies for it for about half what I was charged for borrowing it for 24 hours. Our system is so terribly broken.
calvinbhai 8y ago
"Billing is complete" is a term that makes sense in the US, where the health insurance companies, equipment and pharma manufacturers dictate the final price, and the healthcare provider can get only so much from the patient + insurance, which should also cover the costs + profits considering the emergency care where those without money/insurance should also be treated. The main difference with this experience in India and in US is that in the US, the tests and treatments needed may cost a million dollars, but I'm not asked to pay up front. In India, no matter the cost or severity of the situation, unless I pay up front in full I wont get the healthcare attention that I need (unless I have a private insurance) Having seen what regulation did to taxis in US, and how Uber broke the transportation service industry off it's shackles, I think US healthcare market is ripe for disruption. Replicating the Indian healthcare model is certainly not ideal, but there are enough things that can be copied by the US to improve the certainty of costs for treatments and tests.

rootusrootus 8y ago

When I saw a doctor while visiting Hyderabad, it was pay-as-you-go. Walked in the door, paid a small fee to register as a patient. Consulted with a cardiologist, then paid for an EKG with my credit card. After that, consulted another cardiologist, who said let's do an echo. Paid for that, then had it done (by an actual cardiologist, no less, not just some technician), then visited an electrophysiologist. Got prescribed a beta blocker, went downstairs, paid for that, left. Total bill ended up 4500 INR, or about 75 USD. Then I flew home to the US a few days later, got a Holter monitor for a day and a visit with my primary care physician and a cardiologist. Billed a couple weeks later, 1000 USD. After insurance. For what it's worth, I could buy the Holter monitor and a bunch of disposable supplies for it for about half what I was charged for borrowing it for 24 hours. Our system is so terribly broken.

calvinbhai 8y ago

"Billing is complete" is a term that makes sense in the US, where the health insurance companies, equipment and pharma manufacturers dictate the final price, and the healthcare provider can get only so much from the patient + insurance, which should also cover the costs + profits considering the emergency care where those without money/insurance should also be treated. The main difference with this experience in India and in US is that in the US, the tests and treatments needed may cost a million dollars, but I'm not asked to pay up front. In India, no matter the cost or severity of the situation, unless I pay up front in full I wont get the healthcare attention that I need (unless I have a private insurance) Having seen what regulation did to taxis in US, and how Uber broke the transportation service industry off it's shackles, I think US healthcare market is ripe for disruption. Replicating the Indian healthcare model is certainly not ideal, but there are enough things that can be copied by the US to improve the certainty of costs for treatments and tests.