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

bloomberg.com

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

#251

Post by maxharris »

GhotiFish wrote: post #182
ctdonath wrote: post #161

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…

This is exactly what is wrong with health care in a free market.

What free market are you talking about? Medicare effectively controls the prices of medical procedures (since insurance companies reimburse non-Medicare recipients on the basis of tables the government puts out). It also controls the number of doctors (it does this by limiting the number of residency slots - see the Balanced Budget Act of 1997). The FDA regulates everything from the development and testing to packaging and marketing of drugs, medical devices and related products. Due to federal regulations, physicians are not permitted to discuss prices with one another. There are countless regulations that manipulate health insurance. And don't forget the 1943 IRS ruling that permanently established the link between health insurance and your employer.

And this is all stuff that's mostly decades before Obamacare. That just scratches the surface. For example, I didn't even mention HMOs, which were created under Nixon via another set of regulations intended to control costs for things Johnson had done.

A free market in health care? If there's one thing American health care has not had in the last 50 years, it's a free market. Sure, it has been slightly freer than in other countries, but that's not saying much.

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

#252

Post by sien »

petilon wrote: post #132
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,…

"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…

Good point.

It's also worth noting that healthcare costs in most of the developed world, while lower than the US system, continue to increase substantially.

However, what you are saying raises the question of how on earth a system can be constructed where people shop around for health care.

Any ideas?

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

#253

Post by eru »

noonespecial wrote: post #44
joshmn wrote: post #3

As an American. this makes me sad. Just sick to my stomach. It's just greed.

But its not just greed. Greed is also whats driving the Indian entrepreneurs to try to offer the surgeries cheaply and en-mass. Its more than that. Its unfair exploitation, regulatory capture, raw corruption and senseless parasitism. Its greed mutated and run amok. Its what happens when you get greed wet and then feed it after midnight.

Actually, in this case it is not greed in India. The guy running the show is a `real hero'. But the US has plenty of self-less people, too.

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

#254

Post by jonknee »

apalmer wrote: post #213
phaemon wrote: post #193

Earlier quoted context omitted.

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.

Medicare does not negotiate. The hospitals break down bills into CPT codes and get paid the published rate for the period for codes that are accepted (including geographic indexes and what not). It's a mess.

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

#255

Post by eru »

rayiner wrote: post #112

First, adjusted for PPP that is more like $3,000. Second, nearly all personal and professional services cost way more in the U.S. Try hiring a nanny in India versus the U.S. and compare the prices. In any case, whenever you talk about prices, it's important to try and think about it in terms of supply and demand. Why might prices for similar services be lower in India? In both countries, the price for that heart surg…

> Higher supply and lower relative demand = lower prices.

For manufactured goods and services that's not true in the _long run_. Higher demand will eventually bring down prices, and goods in low general demand will not see the innovation that brings down costs.

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

#256

Post by wglb »

w1ntermute wrote: post #114
anu_gupta wrote: post #88

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…

You are way out of line here.

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

#257

Post by kamaal »

dheer01 wrote: post #218
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…

>>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…

>>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.

You could have, sure easily! Besides a person who has traveled to US doesn't fall under middle class category anymore. Sorry you don't. In a country where kids die of hunger and where parts of the country manage to barely eat two rotis a day with salt- traveling and working in the US is a rich man's luxury.

Sorry to be putting it this bluntly, but in India anybody apart from Mukesh Ambani thinks he belongs to the middle class.

Most people(The middle class- People who make around 10/15K rupees a month) can't pay for expensive medical treatments, medication, post-op follow ups etc and that's a fact.

>> 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.

Yeah right. I find it hilarious when techies offer solutions like these to common people who don't even know how to turn on a computer.

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

#258

Post by ceol »

riahi wrote: 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…

It really is such a shame your comment was almost halfway down the page while the top comments continue to be towing the "US healthcare is awful and greedy!" line.

Thanks for combing through that data for us.

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

#259

Post by jimgardener »

teyc wrote: post #19

This is classic disruption at work. There are many procedures e.g. cataract surgery costs have come down but they are such cash cows that the prices were held high. India is doing this because skills can scale if there is a system of training. It wasn't too long ago when I read the Russians invented a factory-line method of doing eye-surgery.

Five years back,my father got both his eyes operated upon for cataract removal at Coimbatore,India as part of some free Eye camp program.This year, my mom had cataract in both eyes surgically corrected in a private hospital in North Kerala.They charged only Rs.9500/- per eye,and the treatment was quite good.Now my Mom has 6/6 vision in both eyes.

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

#260

Post by symr »

kamaal wrote: post #257
dheer01 wrote: post #218

Earlier quoted context omitted.

>>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…

>>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. You could have, sure easily! Besides a person who has traveled to US doesn't fall under middle class category anymore. Sorry you don't. In a country where kids die of hunger and where parts of the country manage to barely eat two rotis a day with salt- traveling and worki…

I agree. A large portion of the population barely makes between 5-15k per month that is not sufficient for 3 meals a day + housing + school education. Forget surgery, they can't afford routine doctor consultation, diagnostic tests and medication. And yes, diagnostic tests are almost always done whether needed or not.
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