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My adventures in medical tourism

chrisstucchio.com

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Re: My adventures in medical tourism

#101

Post by maxerickson »

chimeracoder wrote: post #67
itg wrote: post #4

Earlier quoted context omitted.

Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. Here's another example: https://www.washingtonpost.com/business/economy/new-machine-... "Anesthesiologists tried to stop Sedasys. They lobbied against it for years, arguing no machine could possibly replicate their skills or handle…

> Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. The AMA is a common scapegoat, except that the AMA has literally nothing to do with the number of of doctors supply-side. You're probably thinking of the AAMC, which has nothing to do with the AMA, and is responsible for the numb…

Why can't some other entity fund residency programs?

What if the Gates Foundation decided it wanted to fund 1 residency position? Is there some structural roadblock in the way of its money?

Re: My adventures in medical tourism

#102

Post by draw_down »

jasonlotito wrote: post #43
clamprecht wrote: post #26

I should mention that Paul Buchheit wants to fund the Uber of medical tourism: https://twitter.com/paultoo/status/566379518261088258 The tweet: "I want to fund the 'Uber' of medical tourism Needs 5 star service, simplicity and safety Let me know if you apply - http://www.ycombinator.com/apply/" It really has to happen. Health care in the US is just fucked, and everyone knows it.

> Health care in the US is just fucked, and everyone knows it. And yet people still move here for the "fucked" health care because it's cheaper, better, and available unlike other countries held in high regard, such as Canada. I am one such person who was lucky enough to be able to do that, and would never return to Canada after the abusive treatment handed out by the health care "professionals."

I don't think people move here for the health care, I really don't. I'm sure US has better health care than where many come from, but if that was your express interest in emigrating you could do a whole lot better than the US.

Re: My adventures in medical tourism

#103

Post by r00fus »

tacon wrote: post #95
r00fus wrote: post #50

Earlier quoted context omitted.

I went through this a few years back trying to get enough FSA to cover my portion of my daughter's long awaited eye operation. It was insane that I couldn't even be given an exact figure for my portion of the bill to plan for FSA - it's like it's all negotiated at time of operation or after the fact. Now some of that is that if a complication occurs, there will be additional cost, but I was just asking for a baseline…

I have not yet run into having to get a price out of a medical facility for a future procedure, but I read a lot of anecdotes. Alas, these stories lack any real emotion that could be used to turn public opinion for a change. I've always thought we should build a massive audio archive of people calling for a medical quote and getting the runaround. I know I'd have my phone on record if I ever had to start calling. I l…

While I agree with your approach (to gather call data to shame the insurance companies), you may want to confirm the jurisdiction that the other caller is in - interstate calls could involve both jurisdictions [1] and if the insurance representative is in a 2-party consent state, you could be C&D'd/sued. It's a shame, but in our money-fuels-everything society even winning a lawsuit can be costly.

[1] http://www.vegress.com/can-i-record-calls-in-my-state

Re: My adventures in medical tourism

#104

Post by staringispolite »

JamesBarney wrote: post #78

It's true that healthcare is terrible in the U.S. if you don't have health insurance, but he overstates his case. Chris compares a 1 in a 1000 nightmare scenario to his very average experience. A $112,000 error happens in the U.S. but is rare. Typically the type of surgery he mentions costs between $20,000-$50,000. Or 50-100% of a the U.S. gdp per capita. This is smaller than in India where the cost of his surgery wa…

An error that large may be rare, but the overall experience of massive/unexpected financial load is fairly common via my experience hearing from customers (full disclosure: I founded a medical tourism startup called Emissary two years ago: https://www.emissarymed.com)

We talk to people all the time who don't have insurance (20-30M last time I checked), don't have dental insurance (~150M), or whose insurance comes with coverage caps as low as $1K-$2K that render insurance effectively useless for them in large operations. Most of the time, customers we talk to actually don't even get as far as the author did, because they can't afford the estimate, let alone the risk of over-shooting it. They just avoid getting treatment (and often get worse in the meantime).

The trick then is how to find a doctor you can both afford AND trust. If you'll excuse the plug, we started Emissary to solve that when a friend's mother had this problem. Our mission is to help connect people to high-quality options they can afford, regardless of where they live in the world.

Re: My adventures in medical tourism

#105

Post by Someone1234 »

FireBeyond wrote: post #87
JamesBarney wrote: post #78

It's true that healthcare is terrible in the U.S. if you don't have health insurance, but he overstates his case. Chris compares a 1 in a 1000 nightmare scenario to his very average experience. A $112,000 error happens in the U.S. but is rare. Typically the type of surgery he mentions costs between $20,000-$50,000. Or 50-100% of a the U.S. gdp per capita. This is smaller than in India where the cost of his surgery wa…

Not three years ago, with "comprehensive" insurance, I paid $7000 for a kidney stone, with a full total approaching $50-60K. For a kidney stone. I had to have two surgical procedures, admittedly - they went in to remove the stone, found long-standing infection, closed up and catheterized. A week of antibiotics later I had it shocked. But still... $60K for a kidney stone.

That can no longer happen (since January 1, 2014). Insurance policies now have out-of-pocket maximums thanks to Obamacare. The 2016 limits are: $6,850 for self-only coverage and $13,700 for a family plan.

So you would have stopped hemorrhaging money at $6,850, and then the insurance company would have been 100% responsible for the rest.

Re: My adventures in medical tourism

#106

Post by squozzer »

HarryHirsch wrote: post #48
Symmetry wrote: post #40

Earlier quoted context omitted.

Other notable problems with our medical system would be the RBRVS[1] and Nixon's scheme to limit hospital competition[2]. [1] https://en.wikipedia.org/wiki/Resource-based_relative_value_... [2] https://en.wikipedia.org/wiki/Certificate_of_need

Other people would think that fixed reimbursement rates are a feature - it's what they do in my country to hold down costs, and it works well. You can ask to be paid beyond published rates, but you better have a good case when you present the bill to the insurance company. As far as overbuilding hospitals goes, you'd think that physicians and administrators will try to fill those beds at any cost, cost that is billed…

The Roemer Effect has never been proven, as no country has ever had the luxury of too many hospital beds. It's based on a certain plausible logic - similar to saying welfare makes people lazy - but no one has ever presented evidence to support either.

Re: My adventures in medical tourism

#107

Post by bambax »

His symptoms sound very similar to the ones described in the book "The mindbody prescription" by John Sarno.

I would very strongly recommend reading that book (which will set you back a whopping $10) before undergoing any back surgery.

(I'm not a doctor, this is not medical advice, YMMV and all that. Still. If you suffer from chronic back pain, or carpal syndrome, read the book.)

Re: My adventures in medical tourism

#108

Post by oldmanjay »

r00fus wrote: post #103
tacon wrote: post #95

Earlier quoted context omitted.

I have not yet run into having to get a price out of a medical facility for a future procedure, but I read a lot of anecdotes. Alas, these stories lack any real emotion that could be used to turn public opinion for a change. I've always thought we should build a massive audio archive of people calling for a medical quote and getting the runaround. I know I'd have my phone on record if I ever had to start calling. I l…

While I agree with your approach (to gather call data to shame the insurance companies), you may want to confirm the jurisdiction that the other caller is in - interstate calls could involve both jurisdictions [1] and if the insurance representative is in a 2-party consent state, you could be C&D'd/sued. It's a shame, but in our money-fuels-everything society even winning a lawsuit can be costly. [1] http://www.vegre…

Nearly every call to a business starts with a message indicating that the call may be recorded, which sure sounds like permission to me.

Re: My adventures in medical tourism

#109

Post by chimeracoder »

maxerickson wrote: post #101
chimeracoder wrote: post #67

Earlier quoted context omitted.

> Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. The AMA is a common scapegoat, except that the AMA has literally nothing to do with the number of of doctors supply-side. You're probably thinking of the AAMC, which has nothing to do with the AMA, and is responsible for the numb…

Why can't some other entity fund residency programs? What if the Gates Foundation decided it wanted to fund 1 residency position? Is there some structural roadblock in the way of its money?

I am not aware of any legal roadblock to this, though there may be one. (I wouldn't be surprised if there were - there are already plenty of laws restricting providers from taking money for the same kinds of services that Medicare funds, even if Medicare isn't actually funding that service, which is terrible for Medicare patients who want to pay out-of-pocket certain care above the limit for what their plan covers and discover that they literally cannot.)

But besides that, the Gates Foundation has decided that the most effective way to spend its money, dollar-for-dollar, is on efforts like polio eradication and malaria research. You'd have to convince them that this would be the most worthwhile use of their money - and quite frankly, if I were in their shoes, I wouldn't. Even if lowering the costs of healthcare in the US were their explicit goal (it's not), it would be a rather inefficient way to go about it. And eradicating infectious diseases that largely affect the poor is a much bigger win for humanity than an ongoing subsidy[0] for medical care in the developed world.

[0] This would require perpetual funding for it to be effective; as soon as they decided to stop funding residency programs, we'd go back to the status quo.

Re: My adventures in medical tourism

#110

Post by jacquesm »

jkot wrote: post #24
pault wrote: post #21

Earlier quoted context omitted.

You might be surprised at how many Americans think Ireland is part of the UK. Source: I live in a hostel. Edit: for extra fun, ask them what country Amsterdam is in.

I would not be so harsh, my initial comment is a bit misleading. And most Europeans do not know the difference between Washington and Washington D.C. :-)

> And most Europeans do not know the difference between Washington and Washington D.C. :-)

Is that so?

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