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My adventures in medical tourism

chrisstucchio.com

111–120 of 202 posts

Re: My adventures in medical tourism

#111

Nice piece, although it's a bit misleading to call this "medical tourism" as the author was living in India at the time. Not that it discounts his experience but I'm sure his local connections and familiarity made it easier than it would be for the average American coming it from abroad.

It says he went back specifically to have the surgery.

Re: My adventures in medical tourism

#112
post #88
post #23

Earlier quoted context omitted.

Are Indian humans made out of simpler parts, such that it's OK for them to have free market health care whereas it doesn't work for us?

No, it's that they don't care about people not being able to get care, whereas we at least try to care about it.

That ahem sort of racist snark would make a lot more sense if we weren't having this discussion in the context of a system that appears to be providing wildly cheaper service.

My more subtle point is that when we are discussing an existing free-market based medical system, you can not just trot out all the standard arguments about why the US should not go free market, because they are all based on a discussion of a change in how we structure the system. Here we (appear to) have a free-market system, so, one must validate all the slurs actually apply before just flinging them at the existing system.

If free-market health is so guaranteed to be so utterly disastrous, instead of flinging quasi-racist slurs at the Indians, why don't you actually go find the guaranteed-disasters in progress? Ought to be pretty easy if it's even one-tenth as bad as everyone always claims in the US context.

(Though I'll warn you in advance I'm going to account for the situation on the ground; if the doctor's office in a far-flung village with a per-capita income of 50$/year isn't up to US standards, I'm not going to award you many points. India is not a wealthy country. Only the major medical centers are really that interesting. It's also generally invalid to complain about a government not providing services when they simply do not have the wherewithal to be providing them to everybody yet.)

Re: My adventures in medical tourism

#113

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…

As a patient, US healthcare is terrible even if you have health insurance. Patient is at the bottom of totem pole in US healthcare, and just a number for doctors, hospitals and insurance companies and everyone else involved in the system.

Just a couple of anecdotal personal recent experiences with US healthcare.

1. Recently I witnessed the trouble my primary care physician (PCP) had to go through with insurance company to get approval to perform CT scan. I couldn't believe the 30 minutes, my PCP had to spend on the phone with the United Healthcare person. This is the doctor spending time on the phone explaining all the medical reasons for recommending CT scan and not some administrative person in doctor's office.

This is in contrast to a friend's experience whose PCP kept prescribing pain killers and other prescriptions instead of pushing insurance company for further tests for abdominal pain. The friend later was diagnosed with stage 4 cancer when showed up at ER with same symptoms.

2. While researching a local major hospital rated highly for quality of surgery, I came across the reports of quite a few cancer patients complaining about hospital quickly discharging patients after major surgery and restricting pain medication while in hospital. The claims don't make sense as hospital is rated so highly for Quality of Surgery and might be considered anecdotal. Until I found that two of the measuring criteria for Quality of Surgery was how long a patient stayed in hospital after surgery and dosage and duration of pain medication administered after the surgery. Talk about incentive misalignment. There is all the incentive for surgeon and hospital administration to discharge you quickly to maintain and improve Quality of Surgery rating.

Re: My adventures in medical tourism

#114
post #47

Earlier quoted context omitted.

> 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."

So I suppose there's a serious movement to reform their healthcare system to be more like ours? Maybe also in all the other universal healthcare-having countries with advanced economies (so, the entire rest of the OECD states, more or less)?

If you pay attention, yes, in general, there are places both pushing to increase their centralization and places that seek to decrease it.

Nobody is setting out to specifically copy the US system, because the US system is full of accidents of history like "employer-based health coverage". That's not a useful data point in general, though. The real point is that there indeed a lot of motion happening all around the world and it is not all in the direction of increasing central control, nor is it all in the direction of decreasing it.

Re: My adventures in medical tourism

#115
post #71

My wife is a Dentist in Bangalore, India, and it's amazing what I hear. Basically Cost(Flight to india + treatment cost) The more you think about it, the more crazy it seems on multiple levels. Edit, typed .

Ok, how about this for a startup. We buy a cruise ship, hire a load of doctors, plant it in international waters and boat people out for service. Might be some problems for doing certain procedures because of the boat moving but it might work in some cases haha.

That's fairly similar to what the Spanish government does for its fishing fleet. Mercy Ships operate hospital ships, but as a charitable cause.

It's something I've sometimes wondered about before.

Re: My adventures in medical tourism

#116
post #82

Earlier quoted context omitted.

> 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."

Nobody has ever said that US healthcare was cheaper. Not one.

I posted actual numbers. Sorry, but $0 is not more expensive than $36k.

Re: My adventures in medical tourism

#117

My wife is a Dentist in Bangalore, India, and it's amazing what I hear. Basically Cost(Flight to india + treatment cost) The more you think about it, the more crazy it seems on multiple levels. Edit, typed .

I wrote about this last year on my blog. It would be cheaper to fly to Colombia and spend 7 days there while having a mole removed, than to have it removed in Chicago, with an ACA health insurance plan. The round-trip flight to Colombia alone, excluding any actual care or other expenses, was the same price as having an American dermatologist spend 30 seconds taking the initial biopsy.

https://alexcabal.com/today-i-had-a-weeks-vacation-in-colomb...

Re: My adventures in medical tourism

#118

Earlier quoted context omitted.

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.

Still, $60,000? That's more than an average US salary for an entire year.

Re: My adventures in medical tourism

#120
post #63

Earlier quoted context omitted.

Im sorry to hear that you had bad experiences in Canada. However your personal story is effectively one data point and not necessarily representative of a good comparison between healthcare systems. This analysis is a pretty good overall analysis of the quality, efficacy and safety of different healthcare systems. That’s not to say that just because the US is worse overall that it doesn’t perform better in a subset o…

If you have good insurance, I can't imagine the US not being top of the heap. I had an injury that resulted in a spinal fusion and other surgery at 25. Total out of pocket cost for about $250k of care and full recovery was about $500. That included second opinion visits to top doctors in Boston & NYC. If you're on limited network Obamacare with high deductibles and HMO bullshit, good luck.

> If you have good insurance, I can't imagine the US not being top of the heap.

None of my comments assume private insurance unless otherwise stated.

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