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My adventures in medical tourism

chrisstucchio.com

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Re: My adventures in medical tourism

#121

Post by maxerickson »

chimeracoder wrote: post #109
maxerickson wrote: post #101

Earlier quoted context omitted.

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 an…

I knew labeling the pile of money was risky, I realize it is unlikely to do such a thing. But the point of using a concrete example was that it clearly could afford it, not to speculate about whether it would do it.

Re: My adventures in medical tourism

#122

Post by vonmoltke »

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…

> Increasing the number of residency slots is up to Medicare, because Medicare funds residency programs nationwide.

No, it isn't. Congress limited the number of residency slots Medicare could underwrite, but medical residency is not controlled by Medicare. Additionally, Medicare only pays for about 25% to the total costs incurred by residency programs.

In fact, the law that created Medicare specifically stated it was to subsidize residencies “until the community undertakes to bear such education costs in some other way.” Understandably, no one has stepped up to replace the federal government gravy train. Since the AAMC is predominantly responsible for Graduate Medical Education (the formal name of residency) it is absolutely the appropriate scapegoat for the residency bottleneck (since their only answer is to make the FGGT bigger), as is the AMA for pushing increasingly long residency requirements for medical licensure.

Re: My adventures in medical tourism

#123

Post by gnopgnip »

chimeracoder wrote: post #29
tahoeskibum wrote: post #17

One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80. In everything else e.g. car repairs, the cash price is always lower than insurance covered price. Any ideas why this is so?

> In everything else e.g. car repairs, the cash price is always lower than insurance covered price For starters, insurance smooths risk. It is not there to save you money. By definition, insurance will always cost more than than paying out-of-pocket in the long run [0]. Think of insurance as a luxury that mitigates (but does not eliminate!) the worst-case scenario for you. It costs more (a premium[1]) because this lu…

>By definition, insurance will always cost more than than paying out-of-pocket in the long run[0].

This ignores the money saved from group bargaining. It is often not possible to negotiate on price as an individual. A good health insurance company will have more information on pricing than an individual would have and is in a better position to negotiate for the group.

Re: My adventures in medical tourism

#124

Post by Someone1234 »

clamprecht wrote: post #118
Someone1234 wrote: post #105

Earlier quoted context omitted.

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.

What?

Re: My adventures in medical tourism

#125

Post by angersock »

clamprecht wrote: post #96
Spooky23 wrote: post #85

Earlier quoted context omitted.

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.

There are no individual PPO plans for my area (Austin, Texas), so I was stuck with HMO for 2016. This applies to about 330,000 people in Texas who had their individual PPO plans cancelled. So as far as I can tell, it is actually impossible to get "good insurance" (a PPO plan) here, as an individual.

Am in Texas, will attest to this.

Re: My adventures in medical tourism

#126

Post by yummyfajitas »

jacquesm wrote: post #111
pimlottc wrote: post #49

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.

Well, sort of. I would have gone back anyway (I had a girlfriend in Pune, as the pictures sort of hint at, and no reason to be in the US), but my return trip would have been slower and passed through more interesting places.

The OP is absolutely right that it would have been more difficult for me if I knew nothing whatsoever about India. However, I probably could have paid a couple of thousand USD more and OnP (the hospital I stayed at) would handle things for me. I know they have a medical tourism office, albeit catering primarily to gulf residents.

Re: My adventures in medical tourism

#127

Post by ThomPete »

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.

Interestingly I posted this on HN the other day. No love though :) But very relevant.

http://blog.jayparkinsonmd.com/post/134547527433/why-theres-...

Re: My adventures in medical tourism

#128

Post by drumdance »

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.

I don't see how this helps people who are the most fucked: the working poor.

Re: My adventures in medical tourism

#129

Post by Fomite »

mikecsh wrote: post #63
jasonlotito wrote: post #56

Earlier quoted context omitted.

What does this have to do with my experience with Canada's health care system? I'm merely stating the facts of what my family had to go through and experienced with Canada's lack of mental health care support for my children, and the results. Edit: Because you decided to edit your comment. Here are some other numbers for you. -14 days vs 2+ years: US wait time vs Canada wait time to get help for my autistic son. We h…

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…

Keep in mind many of the statistics you posted - healthy lives, health equity, access to care, etc. are extremely important on a population health level (says the Epidemiologist...) but not necessarily for any particular individual, especially one with the money to spend.

Re: My adventures in medical tourism

#130

Post by collyw »

bambax wrote: post #107

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.)

Bizzare being downvoted for suggesting trying a non invasive, cheap procedure before opting for fairly serious surgery. Amazon's reviews give it 4.5 stars.

I assume its something similar to Thomas Hanna's Somantics from the name and Amazon description, which would be something I would recommend people give a try before going under the knife.

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