Do not underestimate private clinics in Europe. They saved my life after multiple rounds of doctors in the Washington D.C. area could not prevent me from getting repeated ear infections which led to eventual moderate hearing loss. The clinicians in a central European country took a fundamentally different approach to diagnosing me and resolved my health issue rapidly. I spent years of my life going to a dozen doctors in the Washington D.C. area without resolution prior to this. Give medical tourism a shot, it is legit.
Ask HN: How can you buy high quality healthcare?
31–40 of 114 posts
Re: Ask HN: How can you buy high quality healthcare?
#32The term you're looking for is "concierge healthcare". Check r/fatfire for recommendations - the abysmal state of US healthcare is a frequent topic of discussion.
This is an excellent recommendation since there are a few threads that specifically discuss this. I suspect your conclusion might end up being travel to the Mayo Clinic for a few weeks for diagnostic testing.
Some employers have their own health concierge in their benefits package that often goes mostly unused. I've heard positive feedback about the Stanford Health Navigation Service.
Re: Ask HN: How can you buy high quality healthcare?
#33Private clinics/hospitals in Europe can do this, and I'm assuming at a lot less of a price than 50k. I always go to private clinics in Europe and for getting your entire body tested costs, in Estonia, maybe a few thousand USD. I recommend Confido ( https://www.confido.ee/en/ ). No health insurance or residency or anything required, just make an appointment, and pay for it. That's it. In Spain I was very happy with Sa…
Thank you!
You should also check out the Netherlands. It's a private system but if I'm not mistaken prices are largely set by the government. Not sure if that applies only to residents though.
Re: Ask HN: How can you buy high quality healthcare?
#34Also try being less polite and demanding better service.
Re: Ask HN: How can you buy high quality healthcare?
#35Since many folks have mentioned medical tourism, I'll mention three other options.
1) Forward Medical - I have had nothing but good experiences with them but they are not going to solve, just help diagnose & are a replacement to primary care.
2) Working from your symptoms to try to find a community online that has built up around this. There are several, I know that I listened to a notable podcast recently about the person figuring out their diagnosis related to lyme disease when doctors couldn't figure it out. Once you figure out a pathway, then you find a specialist and test yourself. Doctors are not great at looking outside the box for stuff, so if you have something uncommon it's going to be hard.
3) Related to 2, once you have an idea, connect with some top doctors, especially researchers at top tier institutions (think Stanford, Zuckerberg hospital, Mayo, top clinics (one in Berlin I can't remember), etc. Maybe ask a friendly doc to also post on Sermo for you (a medical focused social network) to get a broader audience. I just read the new Michael Lewis book about the pandemic and there's this guy Joe DeRisi at UCSF whose lab I guess basically looks at absolutely crazy things and fields requests all the time, might be worth calling although it's a long shot.
Re: Ask HN: How can you buy high quality healthcare?
#36Concierge healthcare. It's also gotten more widespread than when it first became a thing, so even there I would make sure to do due diligence to see what level of service you're getting. But if you're willing to fork over the money, the level of care that you're supposedly given seems far better than even anything in stories you hear about in Europe or Asia. Seems like you should expect to pay five digit amounts per…
This is what I came here to say - the answer is "Concierge Medicine"
In my experience, that's generally a primary care doctor that has on the order of 1/4th or fewer as many patients, but they all pay a membership fee in order to make that sustainable. That means they can spend significantly more time - like hours every week - with you.
That doctor is then well connected in the community, and can call up a friend at the local specialist/hospital/etc and cut the line for some treatments, as well get recommendations for the "best" folks in whatever speciality is needed. They'll be persistent on your behalf, and listen to you instead of dismissing.
It's unfortunate that this is necessary, but it can be had for a few hundred dollars a month, which is a pittance if you're a high earner.
Re: Ask HN: How can you buy high quality healthcare?
#37consider moving to Europe where there are multiple countries with excellent free healthcare systems
"Excellent free" might still get OP to the same delay loop he tried to escape. His US doctor might work "for the insurer" but the doctor in the free health care system might equally feel they are working "for the state". In my experience the state provided health care is mostly excellent for minors except for psychiatry which is underresourced, but for adults its roll of the dice (outcomes ranging again from excellent to abysmal) with long queues for specialists (Finland).
Re: Ask HN: How can you buy high quality healthcare?
#38So, other medical systems around the world are cheaper, but that doesn't make them magic. Chronic pain - especially back pain - is often an unsolvable quagmire for most doctors.
Not a doctor, but several family members have had to go through something similar. So here is my advice:
- Get imaging tests (Xray, MRI). And screen out the any of the worst case scenarios (like tumor or etc). But if there is nothing inherently obvious and doctors are sending you down obscure test panels, cut bait early - they're out fishing and you shouldn't expect anything worthwhile.
- For back pain, there is almost no medical solution other than surgery. If surgery is optional, don't take it. The recovery from a back surgery is brutal and long and can come with unintended consequences.
- Talk to a fitness instructor. Especially one with a formal education. This is the most underrated option - these are the true experts on kinesthesiology and recovery. You'll be surprised how much good advice they can give you in a single session - identifying which sets of muscles can be developed to take strain off your back, giving you targeted workouts to try, pain management techniques, etc.
- Patience. My father-in-law spent a year recovering from back problems. Despite trying every medical intervention under the sun, his recovery ended up taking exactly as long as his original doctor said it would. But the important thing was lifestyle interventions to prevent reaggravating the problem.
Re: Ask HN: How can you buy high quality healthcare?
#39Private clinics/hospitals in Europe can do this, and I'm assuming at a lot less of a price than 50k. I always go to private clinics in Europe and for getting your entire body tested costs, in Estonia, maybe a few thousand USD. I recommend Confido ( https://www.confido.ee/en/ ). No health insurance or residency or anything required, just make an appointment, and pay for it. That's it. In Spain I was very happy with Sa…
Having lived in Estonia I caution you a bit, while the medical treatment I received there was fine, it wasn't at American standards imo (I tried both public and private over my ~2yrs of living there). If you want top tier service, I would focus west, I've heard Germany has some great clinics (e.g. Charite)
Re: Ask HN: How can you buy high quality healthcare?
#40Direct Primary Care might be a good place to start: https://www.dpcare.org/ I gave it a try last fall, and the difference is night and day: my current Dr actually works for me, whereas the last one very obviously worked for my insurance company. Rereading your post, this is exactly what you want. He had me do a whole bunch of tests right off the bat and set about optimizing different things. His job is to keep my bod…
This is awesome! The questions is why is zero advertising for this kind of service? Looking at the website I've found two providers near me, so I'm definitely going to check it out.
It’s hard to get the message out in the face of the marketing dollars behind the established system.
I pay my dr like $80/mo and it’s a bargain. Having a dr whose interests are genuinely aligned with mine has been life-changing.