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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

#161
post #126

Earlier quoted context omitted.

It is not out of taste. Caste System(Jati System) though weakened still alive and kicking in India. (Dalits) Lowest caste layer in India is still subjugated to things like Cow vigilantism, Honour killing, Social boycott, Caste clashes and discrimination in various/all forms of life. It is interesting to note that Dalits are almost always on the receiving end of these issues. Giving example of the Prime Minister/Presi…

Ignorant question: in India, how can a stranger know your caste? These days I assume there is some mobility, so is it possible to say move to Mumbai, dress the part, and rebrand yourself as a higher caste? I’m in US, race is the thing here and it’s fairly identifiable.

Well there are many ways, most of the Hindu surnames are representatives of their castes- for example Sharma means High Caste Pundit, (Agarwal, Agerwal, Agrawala, Agarwala, Aggarwal, Agrawal)-> all mean a Bania(Trader) Caste etc etc.

You can check out a wikipedia page which can be used to map it - https://en.wikipedia.org/wiki/Category:Indian_family_names

Apart from that, you are required to submit your caste certificate in school in for Board Registration, which is loosely handled, hence process is not anonymous, so now your schoolmates know your caste. In my College, there were many ways to know the caste of the person- like Fee structure is different for SC/STs and Others. The whole list used to be published publicly, and everyone had to refer to it during semester registration. Now everyone who notices your name knows you an SC/ST. There was huge resentment in the General/OBC community regarding the Fee Structure, as they just see that his mate is paying almost 1/10th the fee. I usually didn't reveal my caste to anyone, and my surname is a bit ambiguous so sometime my peers/friends used to rant about it as well.

Now after college, I have lived in around 3 major cities- Mumbai, Delhi and Bangalore. Usually no-one asks about your caste here, but it does happens sometime. People belonging to Higher caste have no issues in revealing it, though people in my/lower communities usually hesitate and do not want to reveal it.

Moving to other city and rebranding yourself as an higher caste might work, but if caught, there can be social severe repercussion. Caste hierarchy is actually flexible and dependent on the social position of the caste in that specific area. So you would also find cases, where X is a higher than Y in some places.

Arranged Marriages in India are most mostly caste based as well.

People also associate caste with IQs as people of lower caste using reservation didn't had to score much in their entrance exams, hence usually I avoid the topic all together if possible. There are other traits as well that people assume.

Now not everyone would discriminate against you, its almost like not every white guy is racist in US, but you would very much like to just avoid interacting with the ones who are. But I would still say an inherent Bias is still present.

In short, answer to your question- yes rebranding yourself is possible, though its not very simple. There is even a term for it in sociology named Sanskritisation. There is also Brahminisation, which is when a group adopts social traits of Brahmins who sit at the top of the caste system.

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

#162
post #61

This article is really informative, and makes me feel proud to be an Indian. Medical care really is one of those things that no person should have to beg or borrow for, in a civil society. We're still not there yet as a country, but the signs are positive. FWIW, I'm relatively well off and have medical insurance, but the cost is absolutely negligible compared to what I hear is prevalent in the US - about $10 / month.…

I lived in India for about 5 years and worked in the healthcare space with all the hospitals you mention. So here's my take:- India has amazing "private" hospitals if you compare the doctors and the equipment they use. India also has the worst "private" hospitals if you compare the hospital support staff specially nurses. Most of them (not all) nurses have no passion and the profession itself is not given the kind of…

"India also has the worst "private" hospitals if you compare the hospital support staff specially nurses. Most of them (not all) nurses have no passion and the profession itself is not given the kind of importance that it is given in the US."

This is because Nurses don't get paid well, avg pay will be around Rs 15,000/month which is simply not enough in metro cities. Majority of the profits of private hospitals goes towards Doctors and hospital administration. Nurses pay have been stagnant for so long. Nurses don't even get extra pay or shift allowance for working nights. Many of the skilled ones, migrate to western countries rather than stay and work in India. Nurses do get paid well in govt hospitals, but govt hospitals are so few as compared to privately run hospitals.

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

#163
post #126

Earlier quoted context omitted.

It is not out of taste. Caste System(Jati System) though weakened still alive and kicking in India. (Dalits) Lowest caste layer in India is still subjugated to things like Cow vigilantism, Honour killing, Social boycott, Caste clashes and discrimination in various/all forms of life. It is interesting to note that Dalits are almost always on the receiving end of these issues. Giving example of the Prime Minister/Presi…

> I became an Software Engineer and now live in a major city, thanks to the affirmative actions adopted by India... You mean from reservations in school / university admissions? Or does that even extend to private employment? Is there widespread resentment? I'm really curious about the parallels (or not) between racism in the US and caste in India, esp. affirmative action. The US never really went all-in on AA like I…

Yes, there are registrations in university admissions, which is the one I used. It does not extend to private employment. Regarding the resentment part, yes, people have resentments against reservations, though now even higher caste groups have started demanding reservation - this means the community will call for strike, stop trains, buses to get the attention of the government. OBC reservations in India were started in 1980 after a similar country wide strikes.

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

#164
post #26

Earlier quoted context omitted.

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.

Yes but I always contribute the max to get the most tax reduction. I like paying taxes less than I like paying doctors.

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

#165
post #61

This article is really informative, and makes me feel proud to be an Indian. Medical care really is one of those things that no person should have to beg or borrow for, in a civil society. We're still not there yet as a country, but the signs are positive. FWIW, I'm relatively well off and have medical insurance, but the cost is absolutely negligible compared to what I hear is prevalent in the US - about $10 / month.…

I lived in India for about 5 years and worked in the healthcare space with all the hospitals you mention. So here's my take:- India has amazing "private" hospitals if you compare the doctors and the equipment they use. India also has the worst "private" hospitals if you compare the hospital support staff specially nurses. Most of them (not all) nurses have no passion and the profession itself is not given the kind of…

Even some "public" hospitals are really good. e.g. Tata hospital in Mumbai, They have had equipments and cancer treatments, which are even considered state of art in US. Like DOTATATE scan and lutetium therapy has been available to so many people in India for more than 5+ years now. Only 2 hospitals in Mumbai have it Jaslok and TATA. And TATA charges are so low , its a blessing for all the people who have been able to get treatment. Experience both healthcare system. India is cheaper which means every one can get access to cheap medicines and medical treatment. US obviously will fare better.

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

#166
post #88
post #74

Earlier quoted context omitted.

I am not saying you should not be proud of Indian progress, but I suspect the experiences of a businessman in a big city in India are vastly different to a low caste woman with TB in rural India. A friend of mine is a nurse who did social work in rural India. What she told me about the local hospitals was horrifying, not just the condition of the hospital and how patients with infectious diseases were sleeping on the…

Experiences in India will vary dramatically based on which state you live in. If you are rural Kerla, a state with 50M people in South India, you are likely to get some of the best quality healthcare are very affordable rates. It’s hard to generalise anything about India which is incredibly huge and diverse.

Kerala is but one state out of many. Kerala is probably the only state in India with a public safety net. How many states names can you pull to exemplify your argument besides Kerala?

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

#167
post #48

Earlier quoted context omitted.

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 ho…

Or the effect could be that Lenox Hill Radiology discovers it's getting a ton of MRI patients, has utilization above 85%, and can now afford to get another machine. A group doing a thing well getting more business is typically not a bad thing. Yes, if it's a loss leader then bad things can happen - but that doesn't seem to be the case here.

"Personal Responsibility" is just "making the market actually be a market". Markets are great - but situations where the person paying isn't the person choosing or receiving the benefit tend to be horrible in some dimension.

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

#168

Earlier quoted context omitted.

The use of the word "low caste" is in quite mean considering "poor" would be more appropriate. Just as Black or Native American would be a poor substitute for poor american. Or Roma/Eskimo/Greenlander/Sami for Europe Especially considering that the current prime minister and president of India are from so called backward communities. India has come a long way in social development and using the "caste card" is quite…

I'm very confused by your comment, and I hope you can clarify. I'm familiar with the colonial/European origin of the "cast system", but having been to India a few times and studied/read a bit, saying that the word has no proper native equivalent (to be blunt) seems both irrelevant and kind of disingenuous. Regardless of the word's origin or colonial reasons, it seems clear that caste-related issues are very visible a…

If one has Anglo-Saxon family names like Smith, Farmer, Clark or the Germanic equivalent like Meyer, Schumacher etc, it is often the profession handed down father to son. In India this is termed the JATTI, and is considered the nearest equivalent of the caste.

If India was the only country where "caste" is a phenomenon, at least we should have a native name for it. People often claim Varna to be the equivalent, but you almost never hear the word "Varna" being used.

The reason is "William Jones", who synthesized the Indian caste system by selectively digging deep into the scriptures.

Caste today is essentially an economic mobility problem and should have a quick death. But by constantly casting it as a social problem people make sure it is kept alive.

The main beneficiaries are 1. Politicians 2. Evangelists 3. Otherwise wealthy Indians who have managed to carve out a quota from the reservation system meant to benefit the backward communities. 4. Used as a stick by the west 5. Naxal and sociologists

Modi unlike Obama isn't a one show man. Nor is he just the face of the party. He has won again and again, and continues to have huge public support. Goes to prove ones caste isn't important to the public.

Caste is also extremely regional, the names are meaningless outside. In the state that I come from TN, the vast majority of the people have gotten rid of the their family names for the last 2-3 generations for the sake of social equality, yet have a 70% reservation.

Understandably JATTI (rather than caste) is significant among the poor because it is their primary social security. So fishermen, metal workers, farmers, weavers etc form a strong community within their profession.

Like a lab rat that has been deliberately infected and the conditions made worse so it can be studied. The "caste system" that should have a natural death, continues to live on thanks to our heros.

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

#169

Earlier quoted context omitted.

I lived in India for about 5 years and worked in the healthcare space with all the hospitals you mention. So here's my take:- India has amazing "private" hospitals if you compare the doctors and the equipment they use. India also has the worst "private" hospitals if you compare the hospital support staff specially nurses. Most of them (not all) nurses have no passion and the profession itself is not given the kind of…

"India also has the worst "private" hospitals if you compare the hospital support staff specially nurses. Most of them (not all) nurses have no passion and the profession itself is not given the kind of importance that it is given in the US." This is because Nurses don't get paid well, avg pay will be around Rs 15,000/month which is simply not enough in metro cities. Majority of the profits of private hospitals goes…

I agree, the pay for nurses is a pity.

I try to impress on the hospital management during my interactions with them that nurses in some ways are the most important staff in a hospital. They interact with the patient the most and they have the most knowledge of the situation than even the doctor in some situations. Hospitals in the west seem to get this but in India they don't. Most of the focus is on the doctors and equipment. Hopefully this should change in the future.

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