My adventures in medical tourism • Hacker News Board

Re: My adventures in medical tourism

#51

Post by jasonlotito » Mon, Dec 14, 2015, 4:56 PM UTC

ashark wrote: post #47

jasonlotito wrote: post #43

Earlier quoted context omitted.

> Health care in the US is just fucked, and everyone knows it. And yet people still move here for the "fucked" health care because it's cheaper, better, and available unlike other countries held in high regard, such as Canada. I am one such person who was lucky enough to be able to do that, and would never return to Canada after the abusive treatment handed out by the health care "professionals."

So I suppose there's a serious movement to reform their healthcare system to be more like ours? Maybe also in all the other universal healthcare-having countries with advanced economies (so, the entire rest of the OECD states, more or less)?

There is a push to reform the way they handle long term care in Canada, but it's not something people think about until it happens to them. Mental health care is generally like that. Do some reading on the lack of autistic services up in Canada and the efforts people are trying to go through to improve the lack of support up there. The services are severely lacking.

I had to deal with it in 2010-11, and it's only gotten worse from people we talk to still dealing with it. Don't blindly think that just because you can get your broken arm fixed for cheap or no cost that it means health care is a solved problem in other countries. Coming to the US, it was 100% cheaper, available now, and better compared to anything Canada remotely offered, even looking at private services.

Re: My adventures in medical tourism

#52

Post by chiph » Mon, Dec 14, 2015, 5:01 PM UTC

Dove wrote: post #34

Cash friendly places are getting more prevalent in the US, but you have to look for them. For example, one of the hospitals in my area publishes this (very sane) price list: http://swedishhospital.com/patient-financial/?page_name=pric... I go to them. :) There are urgent care centers that are the less-crazy version of ERs, and a lot of primary care stuff can be done self pay. While I have access to insurance through…

Be careful when picking an urgent-care center. Some are now for-profit emergency rooms. They can treat a much broader set of maladies & injuries than an urgent-care, but they're priced accordingly.

http://www.kvue.com/story/news/investigations/defenders/2015...

Re: My adventures in medical tourism

#53

Post by mikecsh » Mon, Dec 14, 2015, 5:02 PM UTC

jasonlotito wrote: post #43

clamprecht wrote: post #26

I should mention that Paul Buchheit wants to fund the Uber of medical tourism: https://twitter.com/paultoo/status/566379518261088258 The tweet: "I want to fund the 'Uber' of medical tourism Needs 5 star service, simplicity and safety Let me know if you apply - http://www.ycombinator.com/apply/" It really has to happen. Health care in the US is just fucked, and everyone knows it.

> Health care in the US is just fucked, and everyone knows it. And yet people still move here for the "fucked" health care because it's cheaper, better, and available unlike other countries held in high regard, such as Canada. I am one such person who was lucky enough to be able to do that, and would never return to Canada after the abusive treatment handed out by the health care "professionals."

Have a read of this - the Commonwealth Fund rankings of wealthy country's health care systems, published last July:

http://www.commonwealthfund.org/publications/fund-reports/20...

Just to add some colour:

Quality: U.S. fares best on provision and receipt of preventive and patient-centered care. While there has been some improvement in recent years, lower scores on safe and coordinated care pull the overall U.S. quality score down

Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost

Efficiency: On indicators of efficiency, the U.S. ranks last among the 11 countries

Equity: The U.S. ranks a clear last on measures of equity.

Healthy lives: The U.S. ranks last overall with poor scores on all three indicators

Re: My adventures in medical tourism

#54

Post by luciusism » Mon, Dec 14, 2015, 5:04 PM UTC

vinceguidry wrote: post #42

anilgulecha wrote: post #11

My wife is a Dentist in Bangalore, India, and it's amazing what I hear. Basically Cost(Flight to india + treatment cost) The more you think about it, the more crazy it seems on multiple levels. Edit, typed .

I went to get dental work done in Medellin, Colombia. Two whitening treatments, perhaps a dozen fillings. My Atlanta dentist wanted to do an inlay on one of my teeth. I'd already had two done that year and just couldn't afford to have them keep working on my teeth. When I got to Medellin, my dentist did not want to do the inlay, said it was too invasive and that he would rather fill it. It cost less to fly to Medelli…

Would you be willing to disclose the place you went?

Re: My adventures in medical tourism

#55

Post by hospes » Mon, Dec 14, 2015, 5:04 PM UTC

lbhnact wrote: post #10

solutionyogi wrote: post #2

I am originally from India and came to the US 10 years ago. I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine. Chris's experience is representative of what one can expect from the Indian health care system. If you are a working, middle class person, the free market health care works extremely well.

>I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine You can. Routine, profitable procedures are not hard to arrange in the US. I have personally worked in a clinic where the exact experience described in this post happens every day. >If you are a working, middle class person, the free market health care works extremely well. It's pretty easy in mo…

For vast majority of the procedures and surgeries you cannot get any quote. I tried to get quote for the standard procedure (that they have performed 100s of times) via phone and in person in Dr's office in 4 different hospitals. All of them told me that they do not know the price, since it depends on what my insurance will cover. They said that they need to do evaluation, schedule the procedure, submit paperwork to the insurance company and then I can get the quote, which is crazy, because to schedule the procedure you need to go through pretty expensive evaluation process. Basically just to know the price you may need to spend couple thousand dollars.

This happened to most of the people that I know that needed some kind of quote from the hospital. The clinic you have worked was an exception.

Re: My adventures in medical tourism

#56

Post by jasonlotito » Mon, Dec 14, 2015, 5:05 PM UTC

mikecsh wrote: post #53

jasonlotito wrote: post #43

Earlier quoted context omitted.

> Health care in the US is just fucked, and everyone knows it. And yet people still move here for the "fucked" health care because it's cheaper, better, and available unlike other countries held in high regard, such as Canada. I am one such person who was lucky enough to be able to do that, and would never return to Canada after the abusive treatment handed out by the health care "professionals."

Have a read of this - the Commonwealth Fund rankings of wealthy country's health care systems, published last July: http://www.commonwealthfund.org/publications/fund-reports/20... Just to add some colour: Quality: U.S. fares best on provision and receipt of preventive and patient-centered care. While there has been some improvement in recent years, lower scores on safe and coordinated care pull the overall U.S. quali…

What does this have to do with my experience with Canada's health care system? I'm merely stating the facts of what my family had to go through and experienced with Canada's lack of mental health care support for my children, and the results.

Edit: Because you decided to edit your comment. Here are some other numbers for you.

-14 days vs 2+ years: US wait time vs Canada wait time to get help for my autistic son. We had help before we arrived in the US. We had no help for autism while up in Canada.

$0/yr vs. $36,000/yr: US cost vs Canada cost for autism therapy. The $36k Canadian cost was the soonest we could get it, which was still a wait time of more than a year after the appointment (which had an additional wait time).

Canada did have more doctors complaining that we were trying to do to much for our children though. It has that going for it.

Re: My adventures in medical tourism

#57

Post by hvmonk » Mon, Dec 14, 2015, 5:08 PM UTC

My understanding is doctors in US are trained to scare you about every possible negative outcomes. I find visiting a doctor here is much much more stressful than doing it in India.

For a simple chest pain, doctors here would tell you 145566 possible scenarios that may happen with your body, and wouldn't confirm any unless he sees a lab test. And then, a tide of lab tests would start, which will cripple you financially, and emotionally because all you are thinking is which test would be +ve, which -ve; diving on internet where people usually blog about their -ve experiences. Usually, it could be just a muscular pain, etc, which become so irrelevant as you are undergoing all these lab exams.

I don't want to blame the doctors here as such, because that's how they are trained here. I guess it boils down to this robust "suing infrastructure" here, that if you missed out a rare symptom with a patient, he will sue you and finish your career.

One thing which I couldn't understand is why in a developed country, lab tests are so expensive. An Xray, costs about $100; similar thing costs about Rs 80 (equivalent to $1.25). Shouldn't they be cheaper here, given there are gizmos for everything, and all electronics items are much cheaper here than India. I think these costs are all artificial.

I think a mix of both approaches (insurance + free market) would better.

Re: My adventures in medical tourism

#58

Post by fluxquanta » Mon, Dec 14, 2015, 5:08 PM UTC

jjoonathan wrote: post #30

itg wrote: post #4

Earlier quoted context omitted.

Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. Here's another example: https://www.washingtonpost.com/business/economy/new-machine-... "Anesthesiologists tried to stop Sedasys. They lobbied against it for years, arguing no machine could possibly replicate their skills or handle…

Before we start squabbling over whether the fault lies with the AMA in particular (this topic has come up before) let me propose that instead we discuss the more general and more relevant claim "the USA overtrains its doctors, creating needless scarcity."

>"the USA overtrains its doctors, creating needless scarcity."

What about the increase in physicians assistants and nurse practitioners, who seem to be taking over in the scene of less serious, more routine healthcare?

Re: My adventures in medical tourism

#59

Post by erkkie » Mon, Dec 14, 2015, 5:10 PM UTC

lbhnact wrote: post #14

atom-morgan wrote: post #5

Earlier quoted context omitted.

Exactly. Imagine how much of a hassle car repairs would be if your car insurance company handled an oil change or a tire balance/rotation.

Imagine how much a hassle car repairs would be if cars were a staggeringly complex biological system where parts could not be replaced figuring out what was wrong was difficult and all work had to be done in while it was driving down the road and it was really easy for you to die if a mistake was made and other people had to pay for it.

Cars are more complex than lots of common medicine.

Re: My adventures in medical tourism

#60

Post by chimeracoder » Mon, Dec 14, 2015, 5:11 PM UTC

mattzito wrote: post #28

tahoeskibum wrote: post #17

One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80. In everything else e.g. car repairs, the cash price is always lower than insurance covered price. Any ideas why this is so?

So the doctors have a list price, which is then negotiated down. They set the list price high for the same reason many sophisticated goods are set at a high price (cars, houses, enterprise software, etc.). However most, if not all, doctors will absolutely charge you less if you pay cash, you just have to ask for it and have the conversation.

> They set the list price high for the same reason many sophisticated goods are set at a high price (cars, houses, enterprise software, etc.).

Everything else in your comment is true, but this line is not. Healthcare is expensive, just like cars, houses, and enterprise software, but the reason that healthcare prices are high is very specific to healthcare (there aren't any other industries that have similar models).