6 ms·

Great read. This just show how evil for-profit medicine really is. The fact that the pay is so high in the west is disturbing. I really pray we see a single-pay

by forca 12y ago

Great read. This just show how evil for-profit medicine really is. The fact that the pay is so high in the west is disturbing. I really pray we see a single-payer socialised system in our lifetime in the US. Growing up with socialised medicine has shown me the truth. No doctor, no matter how talented, needs to make what they do. All of this should be government run as a non-profit. Government should mandate and force all pharmaceutical companies into non-profit status as well for the good of mankind. I'm sick to death of not being able to go to hospital here in the US, even with insurance, because what with the co-pays and deductibles, it costs a fortune. I just don't go, and I am in need of surgery that I cannot afford. QUESTION: Would an Indian facility in India treat me for a relatively small amount of money? Even after the flights, it would still be cheaper than the $22k I've been quoted here by multiple sources.

GFK_of_xmaspast 12y ago
Maybe? Medical tourism is a well-established thing.
- toomuchtodo 12y ago
  I've often thought about establishing a medial tourism non-profit. Think Watsi.org, but for first-world consumers of healthcare, taking them to near-first-world country locals where the cost of the same quality service is much lower.
DanBC 12y ago
> Would an Indian facility in India treat me for a relatively small amount of money? http://www.bbc.co.uk/news/health-10837726 http://www.bbc.co.uk/news/health-10837726 While there are some good ideas the ruthless efficiency is a bit scary.
- Scoundreller 12y ago
  Why is it scary? Is there something inherent about health care that prevents an industrial philosophy towards production?
  - DanBC 12y ago
    Best practice around canula tells us to do one thing. But if you have all these patients and you have your own data you can drop the standard a little bit. You've saved a bit of money, and raised risk by a tiny bit. While no surgery is risk free it's kind of odd to increase risks to save a few dollars. I guess I don't mean scary, just, it's something to think about.
- cpwright 12y ago
  If they have good outcomes, which they seem to it makes sense. While there may be a place for a hospital that does it all, it makes perfect sense that you would have a hospital that does just heart surgery and a lot of it. You probably have less contagious people around; you're going to have staff that is familiar with the various complications available all the time; and you can probably negotiate better prices based on volume for the various tools and disposables; it just makes good sense.
FlyingLawnmower 12y ago
Just a note: Most often, it is not the doctors' salaries or time that is the major contributor to the cost of surgery. Instead, the ridiculous fees are created by the hospital administrators as a result of a long history of negotiations between insurance providers and hospital admins. Simple parts that cost $0.10 to manufacture will be billed at $20, rooms will be billed at $8000/night, etc. To my knowledge, most doctors are trying to actively reduce healthcare costs on the end user. They don't see much of the profit, that just lines the coffers of the billion dollar for profit hospitals out there.
- McDiesel 12y ago
  It's not their salaries? Watch them come to work, note the care they drive. Follow them home, note the house they live in. I've yet to see a dr in the US come to work in a civic, or live in a modest house...
  - FireBeyond 12y ago
    Right, the answer is somewhere in between. When I worked on an ambulance, I'd be at the hospital several times a day - in the ER doctor lot, a sampling of the cars: - multiple Tesla S's - 3 Porsche Cayenne - 2 Audi S5s - several Escalades Whilst there are two sides to the story, let's not pretend that doctors live hopeless lives, saddled with a lifetime of crippling student loan debt, barely able to keep their heads above water to selflessly help people. There is a medical group in Kansas/Indiana, I think, that was trialling the novel idea of "fixed price surgery"... looking at right on $100K for cardiac bypass. Me? To look at my explanation of benefits, the billing for my kidney stone last year peaked at over $60K.
    - Domenic_S 12y ago
      Did you see the age of those same doctors? Virtually guaranteed none of them were < 40. A fair calculation of salary is some evaluation of (years of training required * intrinsic skill required * benefit to society). If you accept that, then doctors are surely near the top.
    - 12y ago
refurb 12y ago
Great read. This just show how evil for-profit medicine really is. There are no for-profit hospitals in India? From what I've seen from a quick google search, all the best ones are private, for-profit.
- praneshp 12y ago
  Americans are quick to brand things evil. Of course there are for-profit hospitals in India. All the private ones are. Its just that the system has not deteriorated so much as the US, that price of basic care has shot up so much. The procedure described in the article is reasonably simple. I am not a doctor; the reason I know is my dad had the same procedure, once in 2005 and once in 2013. Once the procedure was done, his doctor had a post-surgery chat with my mom and me, and gave us the box the stent came in. The cost of the Stent was approx Rs 150000. The whole cost was about 200,000 (including preliminary testing, doctor's fees, stay, surgery, post-surgery, and a ride home). We did it at one of the top hospitals in India (http://www.madrasmedicalmission.org/ http://www.madrasmedicalmission.org/), and talking to some folks there, I was told that the profit was made in the cost of the Stent. Even though the box quoted Rs 150000, the hospital acquired it at 1/10th that price directly from the manufacturer (Abbott).
malchow 12y ago
The question is: would you be comfortable being treated in India if India had 19th century medical equipment and a 19th century medical practicum? Because that, effectively, is what you are condemning your great grandchildren to.
yummyfajitas 12y ago
Great read. This just show how evil for-profit medicine really is. I think you mean how evil semi-socialized, heavily regulated medicine really is. India's medical system is as close to free market health care as I've ever encountered. You walk into a hospital, ask the price, pay it. If you don't like the price, you can go to a different hospital and ask them. If you have insurance, you send them the bill afterwards. That's basically it, and most hospitals are for-profit. In my experience, the government hospitals are significantly dirtier than the private ones. Employer sponsored health insurance isn't a big thing. Doctors who won't talk to you without insurance [1] are more or less nonexistent. Most likely an Indian facility can treat you. The cost is unlikely to be more than 1 or 2 lac (e.g. $3k tops), depending on your condition. Throw in another $1k for the flight + $1k for a decent hotel. If you want to learn more, send me an email. [1] In the US I'm willing to pay cash for care before treatment, but most doctors won't talk to me. I'm told it attracts undesired regulatory attention.
- forca 12y ago
  Interesting, but I want, in my lifetime, to see a more or less tax-based system that means I see my GP and pay nothing save what I'm taxed in my pay packet every fortnight. There needs to be caps on costs. Costs determined by government, not for-profit entities. In essence, health care is a basic human right. I don't mind a slight ~10% uptick in my taxes to pay for it. That 10% is still orders of magnitude less than I pay annually for health insurance, which is sinfully expensive. I'm praying Hillary Clinton, when she gets elected, will finish what she started.
  - vonmoltke 12y ago
    > That 10% is still orders of magnitude less than I pay annually for health insurance, which is sinfully expensive. I don't think you understand what "order of magnitude" means. You pay more than your gross salary for health insurance? If 10% is "orders of magnitude less", then you must pay at least 100%. Also, I don't know where you are buying insurance from, but I can get insurance for about 4% of my gross salary.
    - 12y ago
dguaraglia 12y ago
Yes! I don't know about India, but if you went to Argentina you could probably get treated for pretty much anything for that amount. I have my own story about how shitty the US health care/insurance system is, but I've told it before.
jasonlotito 12y ago
> Great read. This just show how evil for-profit medicine really is. To be fair, I can share an appalling story of how Canadian healthcare abused my son for more than a year, and how it wasn't until we started making plans to move to the US that we saw much better care (in the US).
- ceejayoz 12y ago
  Please do.
  - jasonlotito 12y ago
    I told my story many times. I'll give the short version. My son got an initial diagnosis of autism as 18 months while living in Quebec. Despite laws stating otherwise, after a year of waiting (and being flat out lied to and dealing with gross negligence), we'd had enough and moved to the US, where we were able to start getting care faster than it took to get our stuff moved down here, all at no cost. In Canada, the wait time was over 3 years for public care, and going the private route was still a 1 1/2 year wait at a cost of $30k+ a year. In the end, I'm left with the knowledge that I trusted in the Canadian Healthcare system for over a year, and the price was putting off my son's early intervention. My younger son (also autistic) received care at 18 months, and is doing much better. To this day, I still can't share this without getting really angry at all they did, or didn't do.
TheMagicHorsey 12y ago
You have no idea what you are talking about. India's hospitals are run as profitable businesses. There is literally no government support. In fact, practically speaking, there is almost no government regulation period. Reputation and successful past patient experiences are the signal that consumers use to select a medical institution for care. The American system is the one that is highly regulated and semi-socialized. The Indian system is free to innovate as any start up can innovate. That is why American doctors are stunned when they go to a private Indian hospital and see the amount of digitization and high tech involved in Indian care. You should watch this so you become enlightened as to how entrepreneurs in India are reducing the cost of health care, but still getting world class outcomes: https://www.ted.com/talks/thulasiraj_ravilla_how_low_cost_eye_care_can_be_world_class https://www.ted.com/talks/thulasiraj_ravilla_how_low_cost_ey...
larrys 12y ago
"This just show how evil for-profit medicine really is. The fact that the pay is so high in the west is disturbing. " Pay for which workers? More than Physicians are involved. I would say that the average billing clerk in the US and the average nurse in the US and even the person who runs the mechanical systems and drive the emergency vehicles as well as any supplies (if they are sourced locally) are much much much cheaper in India than in the US. Separately in the US I know of Indian doctors who could practice in India but fail to do so. And they have even pointed out how much "help" they could have (they actually called them "servants") if they lived over in India. Labor is much cheaper in India. This may not account for all of the price differential but running a Hospital in the US is almost certainly way more expensive than in India.
- philjohn 12y ago
  So a better metric is % of GDP spent on healthcare, and the relative outcomes. The US spends a much greater proportion of GDP[1] on healthcare compared to many other industrialised nations, and the outcomes are broadly the same as those who spend far less. [1] http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2012+wbapi_data_value+wbapi_data_value-last&sort=desc http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wba...
wehadfun 12y ago
>No doctor, no matter how talented, needs to make what they do You are blaming the wrong person.
robk 12y ago
You have no right to the free labor of others. Why should a doctor work under indentured servitude to whatever this nonprofit decides to pay him or her after over a decade of study. That's outright theft.
kamikazi 12y ago
forca, email me? I'd like to help you out and I can probably do so. So don't hesitate. Let's talk. I'm based in India and you haven't described your condition, but I can tell you that yes world-class healthcare is available in India and compared to US at relatively affordable prices. I would like to help you out to arrive at an objective decision. There's no contact # or email in your profile so I can't reach you.

by forca 12y ago

GFK_of_xmaspast 12y ago

Maybe? Medical tourism is a well-established thing.

toomuchtodo 12y ago
I've often thought about establishing a medial tourism non-profit. Think Watsi.org, but for first-world consumers of healthcare, taking them to near-first-world country locals where the cost of the same quality service is much lower.

DanBC 12y ago

> Would an Indian facility in India treat me for a relatively small amount of money? http://www.bbc.co.uk/news/health-10837726 http://www.bbc.co.uk/news/health-10837726 While there are some good ideas the ruthless efficiency is a bit scary.

Scoundreller 12y ago
Why is it scary? Is there something inherent about health care that prevents an industrial philosophy towards production?
- DanBC 12y ago
  Best practice around canula tells us to do one thing. But if you have all these patients and you have your own data you can drop the standard a little bit. You've saved a bit of money, and raised risk by a tiny bit. While no surgery is risk free it's kind of odd to increase risks to save a few dollars. I guess I don't mean scary, just, it's something to think about.
cpwright 12y ago
If they have good outcomes, which they seem to it makes sense. While there may be a place for a hospital that does it all, it makes perfect sense that you would have a hospital that does just heart surgery and a lot of it. You probably have less contagious people around; you're going to have staff that is familiar with the various complications available all the time; and you can probably negotiate better prices based on volume for the various tools and disposables; it just makes good sense.

FlyingLawnmower 12y ago

Just a note: Most often, it is not the doctors' salaries or time that is the major contributor to the cost of surgery. Instead, the ridiculous fees are created by the hospital administrators as a result of a long history of negotiations between insurance providers and hospital admins. Simple parts that cost $0.10 to manufacture will be billed at $20, rooms will be billed at $8000/night, etc. To my knowledge, most doctors are trying to actively reduce healthcare costs on the end user. They don't see much of the profit, that just lines the coffers of the billion dollar for profit hospitals out there.

McDiesel 12y ago
It's not their salaries? Watch them come to work, note the care they drive. Follow them home, note the house they live in. I've yet to see a dr in the US come to work in a civic, or live in a modest house...
- FireBeyond 12y ago
  Right, the answer is somewhere in between. When I worked on an ambulance, I'd be at the hospital several times a day - in the ER doctor lot, a sampling of the cars: - multiple Tesla S's - 3 Porsche Cayenne - 2 Audi S5s - several Escalades Whilst there are two sides to the story, let's not pretend that doctors live hopeless lives, saddled with a lifetime of crippling student loan debt, barely able to keep their heads above water to selflessly help people. There is a medical group in Kansas/Indiana, I think, that was trialling the novel idea of "fixed price surgery"... looking at right on $100K for cardiac bypass. Me? To look at my explanation of benefits, the billing for my kidney stone last year peaked at over $60K.
  - Domenic_S 12y ago
    Did you see the age of those same doctors? Virtually guaranteed none of them were < 40. A fair calculation of salary is some evaluation of (years of training required * intrinsic skill required * benefit to society). If you accept that, then doctors are surely near the top.
  - 12y ago

refurb 12y ago

Great read. This just show how evil for-profit medicine really is. There are no for-profit hospitals in India? From what I've seen from a quick google search, all the best ones are private, for-profit.

praneshp 12y ago
Americans are quick to brand things evil. Of course there are for-profit hospitals in India. All the private ones are. Its just that the system has not deteriorated so much as the US, that price of basic care has shot up so much. The procedure described in the article is reasonably simple. I am not a doctor; the reason I know is my dad had the same procedure, once in 2005 and once in 2013. Once the procedure was done, his doctor had a post-surgery chat with my mom and me, and gave us the box the stent came in. The cost of the Stent was approx Rs 150000. The whole cost was about 200,000 (including preliminary testing, doctor's fees, stay, surgery, post-surgery, and a ride home). We did it at one of the top hospitals in India (http://www.madrasmedicalmission.org/ http://www.madrasmedicalmission.org/), and talking to some folks there, I was told that the profit was made in the cost of the Stent. Even though the box quoted Rs 150000, the hospital acquired it at 1/10th that price directly from the manufacturer (Abbott).

malchow 12y ago

The question is: would you be comfortable being treated in India if India had 19th century medical equipment and a 19th century medical practicum? Because that, effectively, is what you are condemning your great grandchildren to.

yummyfajitas 12y ago

Great read. This just show how evil for-profit medicine really is. I think you mean how evil semi-socialized, heavily regulated medicine really is. India's medical system is as close to free market health care as I've ever encountered. You walk into a hospital, ask the price, pay it. If you don't like the price, you can go to a different hospital and ask them. If you have insurance, you send them the bill afterwards. That's basically it, and most hospitals are for-profit. In my experience, the government hospitals are significantly dirtier than the private ones. Employer sponsored health insurance isn't a big thing. Doctors who won't talk to you without insurance [1] are more or less nonexistent. Most likely an Indian facility can treat you. The cost is unlikely to be more than 1 or 2 lac (e.g. $3k tops), depending on your condition. Throw in another $1k for the flight + $1k for a decent hotel. If you want to learn more, send me an email. [1] In the US I'm willing to pay cash for care before treatment, but most doctors won't talk to me. I'm told it attracts undesired regulatory attention.

forca 12y ago
Interesting, but I want, in my lifetime, to see a more or less tax-based system that means I see my GP and pay nothing save what I'm taxed in my pay packet every fortnight. There needs to be caps on costs. Costs determined by government, not for-profit entities. In essence, health care is a basic human right. I don't mind a slight ~10% uptick in my taxes to pay for it. That 10% is still orders of magnitude less than I pay annually for health insurance, which is sinfully expensive. I'm praying Hillary Clinton, when she gets elected, will finish what she started.
- vonmoltke 12y ago
  > That 10% is still orders of magnitude less than I pay annually for health insurance, which is sinfully expensive. I don't think you understand what "order of magnitude" means. You pay more than your gross salary for health insurance? If 10% is "orders of magnitude less", then you must pay at least 100%. Also, I don't know where you are buying insurance from, but I can get insurance for about 4% of my gross salary.
  - 12y ago

dguaraglia 12y ago

Yes! I don't know about India, but if you went to Argentina you could probably get treated for pretty much anything for that amount. I have my own story about how shitty the US health care/insurance system is, but I've told it before.

jasonlotito 12y ago

> Great read. This just show how evil for-profit medicine really is. To be fair, I can share an appalling story of how Canadian healthcare abused my son for more than a year, and how it wasn't until we started making plans to move to the US that we saw much better care (in the US).

ceejayoz 12y ago
Please do.
- jasonlotito 12y ago
  I told my story many times. I'll give the short version. My son got an initial diagnosis of autism as 18 months while living in Quebec. Despite laws stating otherwise, after a year of waiting (and being flat out lied to and dealing with gross negligence), we'd had enough and moved to the US, where we were able to start getting care faster than it took to get our stuff moved down here, all at no cost. In Canada, the wait time was over 3 years for public care, and going the private route was still a 1 1/2 year wait at a cost of $30k+ a year. In the end, I'm left with the knowledge that I trusted in the Canadian Healthcare system for over a year, and the price was putting off my son's early intervention. My younger son (also autistic) received care at 18 months, and is doing much better. To this day, I still can't share this without getting really angry at all they did, or didn't do.

TheMagicHorsey 12y ago

You have no idea what you are talking about. India's hospitals are run as profitable businesses. There is literally no government support. In fact, practically speaking, there is almost no government regulation period. Reputation and successful past patient experiences are the signal that consumers use to select a medical institution for care. The American system is the one that is highly regulated and semi-socialized. The Indian system is free to innovate as any start up can innovate. That is why American doctors are stunned when they go to a private Indian hospital and see the amount of digitization and high tech involved in Indian care. You should watch this so you become enlightened as to how entrepreneurs in India are reducing the cost of health care, but still getting world class outcomes: https://www.ted.com/talks/thulasiraj_ravilla_how_low_cost_eye_care_can_be_world_class https://www.ted.com/talks/thulasiraj_ravilla_how_low_cost_ey...

larrys 12y ago

"This just show how evil for-profit medicine really is. The fact that the pay is so high in the west is disturbing. " Pay for which workers? More than Physicians are involved. I would say that the average billing clerk in the US and the average nurse in the US and even the person who runs the mechanical systems and drive the emergency vehicles as well as any supplies (if they are sourced locally) are much much much cheaper in India than in the US. Separately in the US I know of Indian doctors who could practice in India but fail to do so. And they have even pointed out how much "help" they could have (they actually called them "servants") if they lived over in India. Labor is much cheaper in India. This may not account for all of the price differential but running a Hospital in the US is almost certainly way more expensive than in India.

philjohn 12y ago
So a better metric is % of GDP spent on healthcare, and the relative outcomes. The US spends a much greater proportion of GDP[1] on healthcare compared to many other industrialised nations, and the outcomes are broadly the same as those who spend far less. [1] http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2012+wbapi_data_value+wbapi_data_value-last&sort=desc http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wba...

wehadfun 12y ago

>No doctor, no matter how talented, needs to make what they do You are blaming the wrong person.

robk 12y ago

You have no right to the free labor of others. Why should a doctor work under indentured servitude to whatever this nonprofit decides to pay him or her after over a decade of study. That's outright theft.

kamikazi 12y ago

forca, email me? I'd like to help you out and I can probably do so. So don't hesitate. Let's talk. I'm based in India and you haven't described your condition, but I can tell you that yes world-class healthcare is available in India and compared to US at relatively affordable prices. I would like to help you out to arrive at an objective decision. There's no contact # or email in your profile so I can't reach you.