In India, 'no frills' hospitals offer $800 heart surgery • Hacker News Board

Re: In India, 'no frills' hospitals offer $800 heart surgery

#61

Post by nairteashop » Sun, Apr 21, 2013, 8:08 PM UTC

philwelch wrote: post #50

mschuster91 wrote: post #6

Earlier quoted context omitted.

Ambulance chasing lawyers? You mean, there exist lawyers who race behind ambulances just to get a mandate from the injured for suing the hospital for any and all possible malpractice? Edit: No need for downvoting. This behaviour even has a Wikipedia article. I am ashamed living on a planet where such things occur.

It's just an expression. Lawyers don't literally chase ambulances. It's illegal for lawyers to accost people in the emergency room offering their services, and it's probably illegal to literally chase an ambulance as well due to traffic laws. The story has more to do with suing someone for the personal injury that landed the patient in the hospital in the first place, but it's meant to refer to lawyers going out of t…

One of my buddies in LA got involved a multi-car accident. Within minutes he had a lawyer stop by his car and drop off his business card in case he could be "of assistance". So yeah, "ambulance chaser" an expression, but sadly very close to reality in some cases...

Re: In India, 'no frills' hospitals offer $800 heart surgery

#62

Post by OGinparadise » Sun, Apr 21, 2013, 8:12 PM UTC

[deleted] wrote: post #47

[deleted]

You assume that the situation was ideal before these guys came in to "give people hospital infections." Also you have to realize that in many third world countries you have to bribe doctors more than $800 for the "free care" and still have WWII style hospitals.

My point is that maybe the Mayo Clinic offers better care...if you happened to have $150,000 under your mattress, but most people don't. So we have to find the best solution, within our price range.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#63

Post by rgovind » Sun, Apr 21, 2013, 8:25 PM UTC

fakeer wrote: post #24

healthenclave wrote: post #16

Earlier quoted context omitted.

Inflation is increasing the cost of living in India and China. A decent apartment (not luxury) will cost you min. $100K in any Indian city (even C and D tier cities) While not as expensive as Manhattan or London, relative to Indian salaries everything is getting expensive.

Agree. I'm looking for a flat to invest in and I am finding them out of reach, even after taking housing loan and they are running away from me a lot faster than I can catch up, besides, I've already started to pant :( (meaning the salary going to other holes in significant portions)

I have myself bought a home in Hyderabad...And I am convinced that that it is useless. Only if you sell the home, you can make it a worth while investment. That too, in the order of 10% which is probably same as mutual funds...Plz do total cost of ownership before buying.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#64

Post by curiousfiddler » Sun, Apr 21, 2013, 8:28 PM UTC

I'd like to take a shot at answering this: why is a low cost medical treatment effective in India?

1. For the most part, medical education is good in India. In the better hospitals you will find that doctors are generally very smart and knowledgeable. They also happen to be very practical when suggesting treatments and do consider the treatment cost as a factor when suggesting options.

2. The cost of living in India is lower when compared to the developed world.

3. The equipment cost and medicine cost is also lower compared to the developed world.

Also, please understand, India "is not a developed nation". Everyone there "cannot" afford expensive medical treatment. Yet, people who cannot afford expensive treatment "can" suffer from ailments like cancer, heart problems etc. I find it commendable that such people do have a fairly reliable option to save their life, however imperfect it may appear, compared to the system in the developed world. Standards will improve as the country develops, but for now, they offer a good solution.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#65

Post by ams6110 » Sun, Apr 21, 2013, 8:36 PM UTC

[deleted] wrote: post #47

[deleted]

A modern pre-fab hospital could conceivably be less prone to harbor infectious bacteria than the decades-old facilities that are common in the "1st world." And air-handling systems, particularly air-conditioners, have been known to host veritable breeding colonies of pathogens.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#66

Post by noonespecial » Sun, Apr 21, 2013, 8:37 PM UTC

"Essentially we realised that as you do more numbers, your results get better and your cost goes down,"

Tis tempting to just think of this as a "low rent" version of the "real" procedures that are offered at much higher costs in the west, but there really is something to just doing enormous numbers of procedures when it comes to the brutal learning of human medicine. I would not be surprised to start seeing innovations coming out of these facilites that would be impossible in the west.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#67

Post by thebooktocome » Sun, Apr 21, 2013, 8:43 PM UTC

[deleted] wrote: post #57

Dn_Ab wrote: post #55

Earlier quoted context omitted.

Why do you so handily dismiss the article without addressing its content? He is bringing 'expensive' care to people who would otherwise be ignored and making more money to boot. He is doing this by being more efficient, distributed, modular, small and optimizing details right down to architecture and construction. In a world where a large chunk still die from trivial diseases, it is clear current methods do not scale…

[deleted]

So, I looked back at his comments, and couldn't find any others about India. Maybe I didn't go far enough, but...?

Re: In India, 'no frills' hospitals offer $800 heart surgery

#68

Post by ahupp » Sun, Apr 21, 2013, 9:10 PM UTC

microarchitect wrote: post #60

jcnnghm wrote: post #29

Earlier quoted context omitted.

Of course their drugs are cheaper, if drugs companies won't sell to them at huge discounts, India ignores the patents and produces the drugs themselves. Consequently, the US subsidizes their drugs, insofar as they do not contribute to the costs of R&D, including research and clinical trials for working and failed drugs. If every country adopts that policy, which is the direction things are headed because it's the dom…

If every country adopts that policy, which is the direction things are headed because it's the dominant strategy, the rate of medical advancement will be much lower. What's the use of medical advancement that can't help more than 10% of humanity? It's far more important that we move to a world in which all human beings have access to basic sanitation and healthcare than it is to spend billions of dollars attacking st…

> What's the use of medical advancement that can't help more than 10% of humanity?

A drug under patent might be accessible to 10% of the population now, but considering the number of people who will be able to access it in the future the total percentage looks very different. 50 years from now, long after the drug has gone generic, what percentage of the population who lived over that time would have had access? It would be far more than 50%.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#69

Post by jcnnghm » Sun, Apr 21, 2013, 9:11 PM UTC

microarchitect wrote: post #60

jcnnghm wrote: post #29

Earlier quoted context omitted.

Of course their drugs are cheaper, if drugs companies won't sell to them at huge discounts, India ignores the patents and produces the drugs themselves. Consequently, the US subsidizes their drugs, insofar as they do not contribute to the costs of R&D, including research and clinical trials for working and failed drugs. If every country adopts that policy, which is the direction things are headed because it's the dom…

If every country adopts that policy, which is the direction things are headed because it's the dominant strategy, the rate of medical advancement will be much lower. What's the use of medical advancement that can't help more than 10% of humanity? It's far more important that we move to a world in which all human beings have access to basic sanitation and healthcare than it is to spend billions of dollars attacking st…

What's the use of medical advancement that can't help more than 10% of humanity?

When the patent expires everybody benefits. Until then, it's available to everyone, but they must help pay for the drugs development. If nobody pays, the drug isn't developed, and nobody gets any benefit.

It's far more important that we move to a world in which all human beings have access to basic sanitation and healthcare than it is to spend billions of dollars attacking statistically rare diseases producing medicines that will help only a few rich people.

Would you die for that? You expect others to, no? That's kind of totalitarian. At the same time, this argument is fallacious in the sense that it assumes we should address no problem until the lowest level problem is solved for everyone. That's undesirable for a large number of obvious reasons I will not bother enumerating.

Do the "few rich people" that are helped not end up paying for the R&D of the treatment for everyone else in perpetuity?

In fact, I'd go one step further and argue that your statement is actually false in the long term. A world where all humans have access to good healthcare and education would actually be a world in which more people contribute to research and development of new drugs and one in which knowledge would advance faster.

That's a nice thought. Unfortunately, there is a huge advantage to not paying development costs, in that you can externalize them to others and reap the benefits, which is what many countries, including India and the UK, have chosen to do. In India it's ignoring the patent, in the UK it's setting a price ceiling, which effectively shifts the burden to the US since the profit maximizing strategy is still to sell the drug in the UK because marginal revenue exceeds marginal cost. If the US stops paying, the drug never gets produced, or gets produced much later because there is no private incentive to produce.

Re: In India, 'no frills' hospitals offer $800 heart surgery

#70

Post by jcnnghm » Sun, Apr 21, 2013, 9:23 PM UTC

nbouscal wrote: post #52

jcnnghm wrote: post #40

Earlier quoted context omitted.

Once the old substances patent expires, any drug company can produce generics. There is no incentive to ignore patents and produce generics if the patent is expired because other companies will likely be producing generics, assuming there is actually a market for the drug.

> Once the old substances patent expires, any drug company can produce generics. Except for when the company makes a tiny modification to the drug that doesn't change its effectiveness and files for a renewed patent, like in the Novartis suit that India's Supreme Court recently (and rightfully) rejected.

That's not the way patents work. There is not a renewal, but a new patent on the modified substance. The patent on the original substance would still expire. This, of course, raises an interesting question. If the claim is that the tiny modification doesn't change the drugs effectiveness, why not produce the original substance with the expired patent (or purchase a generic from a pharmaceutical that is already doing just that)?

Their actions seem to suggest that they do believe the modification increases the drugs effectiveness, but they don't want to pay for any of the R&D behind that.