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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.

#221

Post by cgore »

enraged_camel wrote: post #192
ctdonath wrote: post #181

Earlier quoted context omitted.

You are succumbing to the common fallacy of disassociating cost from quality. Yes, a good successful job can be done much cheaper - but, on the whole, the odds of success & quality degrade fast when less is spent. When it is YOUR life on the line, you may very well be willing to pay significantly more for those diminishing returns; they may be diminishing, but they are in fact greater returns. "Healthcare tourism" by…

>>When it is YOUR life on the line, you may very well be willing to pay significantly more for those diminishing returns; they may be diminishing, but they are in fact greater returns. There is no evidence that this is the case. Note that the vast majority of the cost is due to the massive complexity of the system: every party involved - and there are many - wants their cut, and they don't necessarily contribute to t…

You don't get payed for how smart you are or how hard you worked. You get paid for how big of a problem you fixed for somebody, and how much they are capable of paying you. That's why good doctors and lawyers get paid so well. Dying or going to jail are big problems, and people will spend a lot of their money to avoid them.

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

#222

Post by ankitml »

ctdonath wrote: post #159
danso wrote: post #129

Can't resist posting this anecdote from Atul Gawande's (best known for his New Yorker medical pieces, such as the one about checklists) book, Better: A Surgeon's Notes on Performance...at the end, he describes spending some time in India as a visiting surgeon to see how innovation was possible in comparatively squalid circumstances. The Nanded hospital he describes below serves 1,400 villages, about 2.3 million peopl…

The key: His department was able to obtain some older laparoscopic equipment inexpensively. Thanks to high-cost health care systems elsewhere spending enormous sums on the latest & best equipment on a regular basis, older equipment capable of facilitating very good (albeit not best possible) results becomes inexpensive. In all the sneering at the high cost of healthcare in some areas, the consequential benefits to ot…

How is this the key? All that thinking for years, mulling over the problem is off course rubbish and unimportant

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

#223

Post by ankitml »

sliverstorm wrote: post #206
kamaal wrote: post #202

Earlier quoted context omitted.

Its like saying there was no innovation in the iPhone. I mean email, messaging, games, apps etc they were all there before right? The innovation here is to invent practical methods of treatment(even if its a process), when you are severely strapped for resources, money, equipment and helping hands. And then do it reliably for all the patients you see over and over with a high success rate for a very affordable price.

Its like saying there was no innovation in the iPhone. The iPhone was not innovative for including email and messaging. The iPhone was (to my recollection) primarily innovative in the use of the touchscreen and some innovative UX design. The innovation here is to invent practical methods of treatment But was anything actually invented?

Reducing time of the surgery by modifying a process is indeed an innovation, maybe not so an invention.

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

#224

Post by blktiger »

apalmer wrote: post #207
petilon wrote: post #132

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." Actually, it is not just the healthcare industry. All industries in capitalist societies are engineered with greed in mind, and that's OK. It works very well. The problem in the healthcare industry is not greed, but insurance. When someone else is paying for the care you don't…

I kinda get your point, but your analysis as far as capitalism/greed etc seems more ideological than logically rational. The problem as you state it isn't insurance, its the inelasticity of health insurance. Simply put a significant amount of people will pay as much as they can get their hands on for even a marginally improved outcome if their life is on the line. Conversely very few people will refuse life saving tr…

I think that the insurance companies are the real problem in the US. I pay the insurance company, who pays the doctor, who pays the insurance company. The costs go up in the opposite direction. Seems like a vicious cycle.

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

#225

Post by eigenvector »

endeavour wrote: post #111
kokey wrote: post #86

Earlier quoted context omitted.

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 be…

"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." Simply not true. Compare the cost of a beer in, say, Thailand and Norway. Are you suggesting if the exchange rate were fixed they would reach parity over time?

Compare the cost of anything in Norway, and well, anywhere else. Norway is one of the most expensive countries in the world for foreigners because of it's abnormally high average income.

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

#226

Post by tn13 »

When government enters any equation and starts over-regulating in the name of "poor" the poor must be actually worried. Indian healthcare system is no less greedy than that of United states, I know several examples where Doctors would perform needless surgeries, will recommend expensive surgeries for terminally ill patients (which makes death more painful) and so on.

Indian government is a big believer in state interference into everything but when it comes to healthcare Indian government's approach is different. Instead of telling private hospitals who they should be run, Indian government builds its own hospitals. Thus private hospitals are left on their own with very little government interference. Thus those doctors can experiment while being very open about their experiments.

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

#227

Post by tn13 »

One of the prerequisites for markets to work is that, both the parties should get into a transaction willingly. That premise somehow gets violated when it comes to healthcare. That is why there are too many market inefficiencies which are skewed towards hospitals and insurance companies.

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

#228

Post by jacalata »

vbuterin wrote: post #116
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,…

Another question: why don't Indian doctors just import themselves to the US and earn much higher wages and profits by offering American customers something like the average of the Indian and American price? That's what we should be asking IMO.

Because they would have to get student status and undertake a two year residency, and then take the US medical board exams, and then come over on a H1B and work in a regular hospital (once they'd found one to sponsor them) and then get a greencard so they could work on their own and by then, maybe 10 years after they left India, they would probably be perfectly happy to continue living at the same wages instead of massively cutting their prices.

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

#229

Post by antiterra »

danso wrote: post #129

Can't resist posting this anecdote from Atul Gawande's (best known for his New Yorker medical pieces, such as the one about checklists) book, Better: A Surgeon's Notes on Performance...at the end, he describes spending some time in India as a visiting surgeon to see how innovation was possible in comparatively squalid circumstances. The Nanded hospital he describes below serves 1,400 villages, about 2.3 million peopl…

> But Nanded is in a part of the country where people eat intensely hot chili peppers

Isn't current consensus that chili peppers have nothing to do with causing ulcers, and may actually prevent them?

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

#230

Post by auctiontheory »

mikeash wrote: post #186
acchow wrote: post #56

Earlier quoted context omitted.

> 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…

It's like measuring your penis in millimeters instead of inches to make it longer. Zimbabwe is printing trillion-dollar bills, so everybody there must be rich....

I got to hold one of these Zimbabwean bills the other day. One hundred trillion dollars, IIRC. Pretty cool.
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