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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.

#241

Earlier quoted context omitted.

They brought me back from the dead, how much is that worth? I'm glad you're well. How much would it be worth if you'd had to sell your house and/or declare bankruptcy, while knowing that similar-quality treatment was available for 1/20th the price in India and elsewhere? Not just being snarky. Since leaving corporate America (and the healthcare plan) to start my own thing, I think about healthcare costs a lot. For st…

The For Sale sign would have been up before I went into the OR with nary a second thought. Worst case, negotiate arrangements for $50/day for the next 10 years. Yes, health care costs a lot. Miracles are expensive.

It's not a miracle. It's impressive, but you're mischaracterising it.

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

#242

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,…

Just to put it here, you can get these price differences between US hospitals as well. http://www.huffingtonpost.com/2013/05/08/hospital-prices-cos... in that Article, there's also a link to the Database of Medical Provider Charge data. https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

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

#243

Earlier quoted context omitted.

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?

patio11 has a long history of making snarky comments about how outsourcing to India should not be a concern to Western IT workers because the quality of Indian IT workers is much lower than that of Western IT workers and clients will ultimately recognize this and hire a Westerner instead. This is presumably something that is quite near and dear to him, as he is an American expat who lives in Gifu, a tiny, rural Japan…

Once again, an attempt to attribute someone's words to simple financial interests or other superficial biases makes a whole thread dumber. Has this kind of argument ever worked on HN, even once? This attempt at psychoanalyzing Patrick is so comically ineffective that it might have been improved with a few intimations that he was also in the best pockets of the NSA.

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

#244

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,…

Hmmm. Why do you think it is that the costs of products and services produced by certain industries, like medical care and higher education, tend to rise much faster than inflation, while costs in other industries, like say, technology, fall over time? Could it have something to do with the fact that the industries where costs are increasing are those most heavily regulated and subsidized by multiple layers of government, while those where costs are falling (and quality is rising) are those that are least regulated and subsidized? Perish the thought! Much easier to just scream "greed!!!" and feel a bit morally superior than to actually try to understand what the problem is.

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

#246

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,…

> 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 U…

The $2 figure quoted for Indian is not the middle 2/3, but the lowest 2/3, so it would have very little to do with the median. Let's go by the figures we actually have (mean):

Per-capita income in India is $1492 Per-capita income in the USA is $49,922

So, it's around 1583/1492 = 1.06 years of work in India. And, 106385/49922 = 2.13 years of work in the USA.

And since the hospital price is actually 95k Indian rupees, exchange-rate fluctuations do not matter.

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

#247

Earlier quoted context omitted.

"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?

Assuming no new disruptions, then yes, economic conditions in the two countries would eventually equalize and prices would differ by at most the shipping cost if one of the two countries happens to have much better natural conditions for producing beer than the other. It's because disruptions are now becoming (have become?) the norm that equilibrium never has time to come close to manifesting itself.

I think it's a little more complicated than that. Culture plays a major factor, especially when it leads to niche markets. If a product has a niche demand in country A, and high demand in country B, then the cost in country A can easily remain much higher than the cost in country B. In addition to shipping cost being higher in that case (which is why that difference is hard to abstract away), you have to consider the opportunity cost of keeping it in inventory, the risk of spoilage if the product is perishable, the risk of depreciation if it's technology, etc.

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

#248

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,…

As long as the majority of americans vote against their own self interest, nothing will change.

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

#249

Earlier quoted context omitted.

It brings the financial incentives inline with what everyone says the goal is. Fee-for-service incentivizes volume, even if it comes with the consequence of worse outcomes; we simply depend on doctor’s morals to not push it too far, with malpractice and licensing handling truly outrageous abuses. Fee-for-outcome explicitly incentivizes better quality control in a much more fine-grained manner. More on point, fee-for-…

I fail to see how fee-for-outcome helps any of this. They would still be free to order the more expensive test, and it would even encourage more testing. If they run the wrong test and miss the diagnosis, then they don't get paid at all...

The doctor/hospital gets a flat fee for the outcome regardless of how they achieve it. Unnecessary procedures and tests come out of their bottom line.
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