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The World’s Cheapest Hospital Has to Get Even Cheaper

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Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#41

Post by ausbah »

to me what Shetty shows is how the power of smart and thoughtful entrepreneurship can not only thrive profit-wise, but can produce results that benefit for everyone even in such high risk (surgeries), low reward (large chunk of clientele appears to be made of India's lower income population) industry

I don't think one could naively apply his methods to the US healthcare system and get the same results, but what he has done at least demonstrates once again that the healthcare system is likely irrevocably broken

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#42

Post by leetcrew »

ams6110 wrote: post #26
notyourday wrote: post #19

Earlier quoted context omitted.

High Deductible Plan. Takes care of big ass expenses, steep cost in the beginning.

It's a start, but imperfect because most people with a high deductible plan will also have a health savings account (HSA). The HSA may even be required, not sure. The problem with HSAs is that although it's "your" money, it can only be spent on qualified health expenses. So there's a reduced incentive to spend carefully, because you can't use the money for anything else.

if you end up with "too much" money in your HSA, can't you just reduce the amount of money that goes into it? obviously you can't just go buy a car with the money, but to me it seems like there is a strong incentive not to overspend from your HSA if you control how much of your paycheck goes into it.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#43

Post by blang »

rb808 wrote: post #35
rb808 wrote: post #30

$2k for major surgery, nice! Last time I went to ER it was $2k for the doctor's assistant to ask a few questions and put a band aid on.

Actually it wasn't a critically urgent problem but needed doctors attention. If someone wants an idea for an app or website - a way to lookup local ERs by price would be great.

They do this in Maryland[1], I wish it were standard across the US

[1] https://healthcarequality.mhcc.maryland.gov/Article/View/f84...

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#44

Post by atonse »

rhombocombus wrote: post #8
ebg13 wrote: post #3

Earlier quoted context omitted.

> Its ingenious how the highest skilled individuals only step in for the trickiest part of the surgery, but the simpler tasks like getting to a heart are performed by lesser doctors or nurses. Having observed a few major surgeries in the US, this appears to not be a unique practice and doesn't explain the pricing difference.

The difference here is not that we don't do surgeries efficiently, but that we are subject to the effects of regulatory capture, which stops any kind of price competition in its tracks and leads to $300 bags of saline.

Yup and organizations like the AMA that artificially keep the numbers of graduating doctors down to create a shortage and drive up prices.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#45

Post by bakul »

benj111 wrote: post #24

I think they need to qualify 'cheapest' because as a Brit I wouldn't have to pay anything (directly) for any of these things. Now the costs of doing the procedures are probably lower, but I have no idea what they would cost in this country.

In UK you are using NHS, a public service, funded out of your tax dollars. NHS spent over £124.7B in 2017/2018 so your average cost is about £2000/person. Not sure how you can break out costs for heart bypass but I suspect they will be much more than $2K/surgery. Narayana Hospital is private and has been profitable continuously, with $8M profit in 2017. And still their patient mortality rate is lower than the US (1.4% patients die within 30 days after heart bypass, compared to 1.9% in the US).

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#46

Post by Scoundreller »

vadlamak wrote: post #25

One of the bigger problems I observed in the US is a defensive approach against being sued by the patient. The doctor prescribes a battery of tests even though he is more or less sure what the symptom might be. But let's play it safe and not get sued approach to everything! Healthcare professionals carry insurances in millions against being sued. The cost ultimately gets passed on to customers. Accountability is good…

Ordering a test and not acting on the results can create liability too.

Not all tests are binary: you have to correctly interpret the levels.

And no test has 100% sensitivity and specificity.

What is clear, is that the provider can charge for these tests and their interpretation, so it creates income.

The liability talk may be a smokescreen.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#47

Post by jrochkind1 »

He succesfully performed a complicated surgery for $10K that would cost $200K in the US.

And India still can't afford to pay those prices.

The problem is obviously not that THIS guy is not working efficiently. It's that the distribution of wealth under our planetary economic system is deeply unfair.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#48

Post by geofft »

notyourday wrote: post #9
rhombocombus wrote: post #8

Earlier quoted context omitted.

The difference here is not that we don't do surgeries efficiently, but that we are subject to the effects of regulatory capture, which stops any kind of price competition in its tracks and leads to $300 bags of saline.

I most am most likely going to need an ACL surgery in a couple of months so we will see how it goes. So far I found out that pretty much every "X is difficult" is a gospel peddled by lazy. This is my first relatively major incident so I'm running pretty blind -- I'm approaching it as I approach needing to do something in business. Instead of going to the ER ($2,500), I went to a walk in medical center ($120), got see…

> Personal responsibility is "hard" so no wonder those who tend to outsource it get fleeced.

What is the effect on the market when everyone engages in "personal responsibility"? If everyone finds out about Lenox Hill Radiology and goes there instead of to hospitals for MRI, won't the effect be that demand goes up without supply obviously going up, causing increased prices and wait times? What will be the effect on hospitals that were subsidizing their other business by pricing their MRIs higher?

The reason people don't like "personal responsibility" as a general-case solution is not that it's hard, but that it's not a general-case solution. This article is talking about an actual general-case solution.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#49

Post by organsnyder »

gowld wrote: post #36
organsnyder wrote: post #29

Earlier quoted context omitted.

HDPs can also have unintended side effects like patients delaying getting screenings until conditions are much worse (and more expensive to treat).

Why? HDPs aren't required to charge for screenings, any more than HMOd or PPOs are.

Yes, many screenings are covered 100% with no deductible. But if I think I'm having a stroke and call an ambulance, I'm responsible for the cost up to the deductible (I just checked my own HDP coverage to verify this). This wouldn't factor into my decision, but I'm fairly affluent (and my family actually maxes our deductible each year because of various chronic conditions). Someone that is in a different financial decision will absolutely be thinking of the cost of calling an ambulance (or going to the ER). Of course, if someone dies from a stroke rather than being treated and surviving, the result is lower healthcare expenditures (yes, that's morbid; but we also need to think about the incentives built-in to our healthcare system).

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#50

Post by jermaustin1 »

rb808 wrote: post #30

$2k for major surgery, nice! Last time I went to ER it was $2k for the doctor's assistant to ask a few questions and put a band aid on.

My wife fainted at a Shake Shack in NYC on the UWS. The 5 hour hospital stay with medicine, a regular check in from a nurse, and fluids cost less than $500. The The ambulance game is the real racket.
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