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Heart Surgery in India for $1,583 Costs $106,385 in U.S.

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Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#81

Post by Gatsky »

bayesianhorse wrote: post #28
seanmcdirmid wrote: post #13

Earlier quoted context omitted.

> A doctor trained in India is no less qualified than a doctor trained in the US. In general? http://blogs.worldbank.org/developmenttalk/shocking-facts-ab... > It’s also pretty staggering that hiring qualified staff doesn’t appear to increase this probability. Das and colleagues suggest that part of the issue might be the variation in the quality of instruction in Indian medical training institutions. So there may be…

I read about this clinic somewhere else, and there it was said this clinic actually outperforms western clinics in terms of complications, which seems to be achieved through staggering case numbers per doctor.

It's completely meaningless to compare mortality rates. It's also not clear that if a patient had a CABG in India, went home and dropped dead within 30 days, that this data would actually be captured rigorously.

Anyway, you're drawing the wrong conclusion - it's astounding how close the US mortality rate is to the Indian, which attests to how good the US system is at operating successfully on more complex, elderly patients. Of course, you could argue that the US has optimised the wrong thing, at great expense...

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#82

Post by DanBC »

People have mentioned the cost of MRI scans in the US.

How much would it cost to buy a bunch of scanners (full body, and bucket-type for arms and legs) and employ technicians to do the scanning and offer this as a service to hospitals?

You could have technicians working on shifts to have out-of-hours scanning.

The scans are provided in electronic format to the patient and to the doctors specified by the patient. The centre encrypts all the scans and stores them for X years to cover regulation and litigation.

There's a big capital investment cost, but you're not doing any actual medicine there (no interpretation of scans, for example) and so litigation risk is reduced. You can concentrate on churning people through the machines, you don't have to give way to emergency cases that need immediate scans.

And the price of a scan can be listed up front.

Is this a stupid idea? (Or is it already being done?)

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#83

Post by DanBC »

Gatsky wrote: post #81
bayesianhorse wrote: post #28

Earlier quoted context omitted.

I read about this clinic somewhere else, and there it was said this clinic actually outperforms western clinics in terms of complications, which seems to be achieved through staggering case numbers per doctor.

It's completely meaningless to compare mortality rates. It's also not clear that if a patient had a CABG in India, went home and dropped dead within 30 days, that this data would actually be captured rigorously. Anyway, you're drawing the wrong conclusion - it's astounding how close the US mortality rate is to the Indian, which attests to how good the US system is at operating successfully on more complex, elderly pa…

> Anyway, you're drawing the wrong conclusion - it's astounding how close the US mortality rate is to the Indian, which attests to how good the US system is at operating successfully on more complex, elderly patients. Of course, you could argue that the US has optimised the wrong thing, at great expense...

Is that connected to the extra funding that older people get?

What happens if we compare mortality in people under 65?

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#84

Post by yuhong »

noonespecial wrote: post #41
dantheman wrote: post #30

Earlier quoted context omitted.

A huge problem in the US is all sorts of really really bad laws. For instance to open a new hospital you have to get permission from other hospitals in the area.

That's the opportunity. Eventually regulatory capture and corruption will become so great in the US that it really does become impossible to actually provide the care. Nothing will make it through the wall of parasites. The opportunity is in helping Americans get real healthcare outside their borders. Take a glance Uber's way. You'll know you've got it right when there's serious talk about making it illegal to travel…

impossible?

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#85

Post by andrewparker »

DigitalSea wrote: post #9

The first supposed fact thrown around in the medical costs argument like this is, "Well in India their cost of living is lower, so they charge considerably less, yadda yadda..." but it's obvious the price difference goes way beyond any cost of living gap. That's over $100,000 in price difference, while it is true the cost of living (salary, prices of every day items) in India is considerably less than that of the US,…

>> A doctor trained in India is no less qualified than a doctor trained in the US.

This might be objectively true (which you could reasonably determine through some combination of standardize testing and surgery complications/outcomes), but if you ask 100 people on the street in US whether they would prefer to see a US MD or an Indian MD for their heart surgery, I bet 97 or higher would prefer the US MD. The tiny remainder would probably show no preference.

Their is a brand power of a US medical education, which is especially strong for US patients.

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#86

Post by kokey »

acchow wrote: post #56
kamaal wrote: post #42

Earlier quoted context omitted.

>>You don't see this kind of innovation in the American health system because it has been engineered with greed in mind right from the start. As an Indian, I can tell you people here think the same about our health care system. The Doctor in discussion here, Dr Devi Shetty is a sort of a local hero here in Bangalore. And who knows in some years he might as well be a national hero. Its basically because he seems to br…

> You just feel its cheaper as $1 = 60 rupees. There you get a straight 60x value of your money. That is what it is at the end of the day. I find the vast majority of people are tripped up by currency conversion, but I'm surprised to find this on HN. In Japan $1 = 100 yen, but certainly I don't feel I have 100x in buying power. A bowl of ramen will cost me $8 in SF; an equivalent bowl will cost me 800 JPY in tokyo. L…

I'm surprised that how many otherwise smart people gets tripped up by this. The only time you can deduce something from the exchange rate is if you compare the difference between the two rates over a longer period of time. Then it can roughly tell you things about difference in direction of inflation between the two countries, and the effect on wages and imports/exports. If the difference between the exchange rate between two countries doesn't change for a long time the prices of goods in both countries end up being roughly the same.

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#87

Post by kokey »

tenfingers wrote: post #73

I'd like to point out that the price difference is most likely to do with the marked conditions of the health care in general, and has nothing to do with the quality of the operation itself. There is a big problem with health care in most countries that I've been living into for extended periods of time (France, Italy and to a lesser extent Germany). Anything sorrounding "medical" and/or "health care" has a 10x-100x…

What you describe sounds a lot like the problems the developed when supplying to government in general, whether it be IT, military, transport, etc. That said to me the US system sounds like it's so rigged that it has developed many of the same problems you encounter with government inflicted monopolies.

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#88

Post by anu_gupta »

patio11 wrote: post #50

Somewhere there is a forum of doctors saying "Pfft, the US firm wants $100k for the patient records system and the Indian firm wants $1,000. Those greedy bastards! They live in a toxic industry which acts as parasites on us noble public servants saving lives every day. It serves them right to deal with international competition finally. Let's go with the Indian bidder. What could possibly go wrong."

Not sure what you're trying to say here. You seem to be trying to defend the cost of a $100,000 operation by making a snarky comparison with outsourcing an IT project.

Is that actually what you meant?

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#89

Post by jfoster »

DigitalSea wrote: post #9

The first supposed fact thrown around in the medical costs argument like this is, "Well in India their cost of living is lower, so they charge considerably less, yadda yadda..." but it's obvious the price difference goes way beyond any cost of living gap. That's over $100,000 in price difference, while it is true the cost of living (salary, prices of every day items) in India is considerably less than that of the US,…

I can't defend the US cost entirely. It certainly seems exorbitant. That said, I think there are some things baked into the US cost that most patients probably want. A certain degree of post-operative care that maximizes comfort under the circumstances, for example. Possibly also factors that affect the success of the surgery. Heart surgery isn't necessarily over once they close you up. It's great that surgery is being made so much more accessible, of course, but these procedures are probably not comparable.

Re: Heart Surgery in India for $1,583 Costs $106,385 in U.S.

#90

Post by toble »

tenfingers wrote: post #73

I'd like to point out that the price difference is most likely to do with the marked conditions of the health care in general, and has nothing to do with the quality of the operation itself. There is a big problem with health care in most countries that I've been living into for extended periods of time (France, Italy and to a lesser extent Germany). Anything sorrounding "medical" and/or "health care" has a 10x-100x…

Medical equipment has to meet more rigorous standards. This reminds me of the news story where breast implants were being sold with low grade silicone in Europe:

http://www.bbc.co.uk/news/health-16391522

I realise that suppliers are probably taking advantage due to limited competition, but at the same time, I hope the regulation helps to protect us from sub-standard products.

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