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

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211–220 of 276 posts

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

#211

Earlier quoted context omitted.

I've had heart surgery, costing very close to that six-figure the article gives. Every dollar was well spent. Tearing my chest open with a car jack, rendering me dead for most practical purposes, replacing body parts with cyborg components meant to last for decades , bringing me back to life, repairing the extensive damage caused, continuous monitoring for anything that could go wrong for a week, and sending me home…

This is exactly what is wrong with health care in a free market. if you had an operation with a 10% chance of failure for $5000, would you take it? What if you could spend twice the money and cut your risk down to 5% if you quadrupled the expense? $20000, even I'd take that option for you, as an objective observer. what if you could cut it down to 4% for $50000? Ok now it's getting a little silly, but it's still your…

choosing that expense you doom the ones who can not afford it.

Do I?

Elsewhere in this thread is a post about a surgeon greatly improving the lives of those who cannot afford it by buying a used laparoscopic tool and creatively applying it. I've had laparoscopic surgery; thanks to the high price I & others pay, the laparoscopic instruments used may have replaced the very same one that Indian doctor is using. Far from "dooming the ones who cannot afford it", the system which regularly replaces top-end tools makes entirely acceptable equipment very affordable to regions which can't pay top-end prices.

Disallow me from paying an extra $50,000 to get that extra 0.75% survival odds, and the surgeon very well may not buy that next-generation laparoscopic tool and, as a consequence, sell the still-perfectly-good used one at low cost ... making it possible for another doctor to increase the survival rate for his patients by 5%.

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

#212

Earlier quoted context omitted.

I think it's probably just racism. I bet you'd see similar outcomes if you let people choose between white doctors and Indian-American doctors, even if the white doctor was the foreign one.

Naw, not true, at least on the east coast indian doctors (with american MDs) are common and are not generally viewed as 'inferior' in any way to caucasian doctors.

In rural america often times the only doctors are Indian or Pakistani.

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

#213
post #133

Probably not going to get seen in this morass of comments, but I went back and reviewed the CMS data that the article cites. The article used the Diagnosis Related Group (DRG) 238 - Major Cardiovascular Procedures without Major Complications. This is the best guess at capturing the costs of "Open Heart Surgery". (CMS only releases data for the top 100 DRG codes). "Open Heart Surgery" is a term for a variety of surgic…

Why does the clinic charge that much to Medicare, if Medicare doesn't pay that much (legally, I presume)? Is it an accounting trick or something?

Well, probably a variety of reasons but certainly one key reason is... if you have to ask for 100K to get 25K, then if you ask for 25K your only going to get 8K?...

All prices are always negotiable, just that the individual consumer is so used to not having bargaining power that they forget this fact.

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

#214
I'm not gonna go on the conspiracy road but the world is functioning on the wrong parameters. Instead of being a united civilization and help each other in order to advance to a higher level, we are fighting each other like lions for supremacy in every domain possible.

Our whole system is based on superficial needs and wants rather than focusing on what we really need as species/civilization.

How can we expect innovation and progress when we can't even cross the damn ocean without selling our souls...we can't even cross our own borders without special rules. Not to mention that racism is high in many countries. We are divided as hell. If an advanced race would watch us right now they would probably laugh hard and leave.

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

#216
post #32
post #12

Earlier quoted context omitted.

I don't know much about the American healthcare system, but wouldn't it be the same incentive when selling any product? If you sell the same quality product for cheaper, you will get more business than your competitors. That's what competition in a free market is, no?

The US healthcare system is nothing close to a free market. Every step along the way is rigged: the schools that grant medical licenses is artificially gated, you require certifications you need political clout to obtain to open a medical facility, you need to have enough money to play ball with insurers so you get paid for operations, you need to comply with thousands of federal regulations surrounding your procedur…

I have thought many times of moving to another country (India being high on my list) just so that I could learn and practice medicine outside of the US Money/Chemical game called "healthcare."

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

#217

Earlier quoted context omitted.

I think it's probably just racism. I bet you'd see similar outcomes if you let people choose between white doctors and Indian-American doctors, even if the white doctor was the foreign one.

Naw, not true, at least on the east coast indian doctors (with american MDs) are common and are not generally viewed as 'inferior' in any way to caucasian doctors.

There are so many Indian doctors that it's almost become a stereotype of Indians. I'm just saying that given a choice, the white doctor gets chosen, rather than the US-educated one.

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

#218
post #42

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,…

>>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…

>>I've never been to US, but I can tell you the Indian health care system is if not less is equally greedy compared to their US counterparts. Its just the same.

Its NOT the same. High costs in the US are essentially a result of policy corruption - a systemic issue with results in the exorbitant prices. Greed amongst doctors is prevalent in India as well as the US - maybe more prevalent in India due to general poverty. But health care in India is more 'free-market' than in the US, which is why it is more efficient.

>>I've never been to US, but I can tell you the Indian health care system is if not less is equally greedy compared to their US counterparts. Its just the same.

I have been to the US and I have spent a huge time in India. I have witnessed the Indian health system in close quarters and have close family members undergone major surgeries. There is greed in India, no doubt about it. But the American system is completely EFFED up - there is no comparison. If you go to the US and spend some time understanding/experiencing the system, you will be thankful for what you have in India.

>>These days if you don't have health insurance you are more or less screwed. Its just like the US. I mean from whatever I've read about US so far its the very same. Nothing changes. 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.

You are completely wrong about this only because you don't know what happens in the US if you dont have insurance. My close family members have undergone major heart surgery at Narayanan Hrudyalaya. They had insurance, but even if the insurance did not cover it, it was not a big deal. I could have easily paid from my own pocket - it cost just over $2K USD - not a big amount for middle class Indians for life threatening surgery. All the prices are transparent - so if you dont want to pay as much you can choose cheaper options (shared post-op bedding etc.) which will reduce prices in half - with very little difference in medical care.

In the US if you dont have insurance for something like this - you will go bankrupt. The only reason you don't know about this is because most of your NRI friends work for bigger tech companies which provide good coverage.

Infact one of the reasons why health care is reasonable in India is because insurance coverage is limited and not mandated by law. The resulting free market delivers the economies quoted in this article.

>>Coming to our system. Forget greed, fraud in the system is so massively high nothing that I write here will explain it.

No it is NOT. There is a tendency in Indians to think that they are completely fucked up. Travel around the world - especially to the US and you will thank your stars - and please dont go with what NRI's say - they have a vested interest.

It is true that there is greed in the system and there is fraud - but there is a relatively freer market. You can 'choose' your doctors/hospitals. If you dont have a good experience with a hospital you can choose to write a review on Mouthshut.com and have them get less business. You can do your research and choose a better doctor/hospital over a worse one. This 'choice' and the enabling free market makes India health care deliver economies at scale which are impossible in the American system.

>>The fees for completing your medical course is astronomically high. Capitation fee often runs in crores, the net fee by the time you finish your MD is so high no doubt most doctors have to practically turn into crooks to get something out of it. Add to this nearly more than a decade of studies sets a perfect stage for these sort of activities to happen.

Assuming that this does turn them into 'crooks', they have an easy way to get their money 'out' - migrate to the US/UK after completing their residency. Some doctors are greedy, some are good. The greedy ones land up outside India as much if not less than inside.

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

#219
post #56
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…

Yen is the equivalent of cents, not dollars, thats why the confusion, yen doesnt have a concept of 100 cents=1 xxx. In Rupees case it is an equivalent of dollars, 100 paisas = 1 Rupee.

So in this case 60x is a reasonable assumption except not including the Purchasing Power Parity.

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

#220
post #106

Earlier quoted context omitted.

I am in Bangalore and don't have medical insurance. Paid Rs 300 fee to General Physician for a consultation another 1500 Rs. for a bunch of tests. In my hometown in Bihar the same thing costs Rs 150+500 with excellent doctors. It's not all rosy but it's not that bad.

The only thing I can tell you is to go and get health insurance ASAP. Both for yourself and your dependents. Get one and be safe, one serious illness can bankrupt you these days(actually it always has). But my point is even a week of hospitalization can be pretty expensive. And don't be under an impression you will be able to travel to Bihar or wherever when the need arises. During cases of emergency those are not pr…

Umm, most policies have caps of Rs500k per year (or is it incident). Am I mistaken? That's laughably low even by Indian standards for a serious illness.

I'm assuming the the HN-India audience can hustle Rs500k. My two cents is that you shouldn't sweat it in India if you don't have health insurance.

However, if you get something like cancer in India, not insurance policy will help: the cost of treatment is just too high. You will go bankrupt.

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