Heart Surgery in India for $1,583 Costs $106,385 in U.S. http://www.bloomberg.com/news/2013-07-28/heart-surgery-in-india-for-1-583-costs-106-385-in-u-s-.html Devi Shetty is obsessed with making heart surgery affordable for millions of Indians. On his office desk are photographs of two of his heroes: Mother Teresa and Mahatma Gandhi. Enlarge image Heart Surgery in India for $1,583 Costs $106,385 in U.S. Open heart surgery is carried out on a baby at the Narayana Hrudayalaya Institute of Cardiac Sciences in Bangalore, India. Photographer: Michael Crabtree/Getty Images Enlarge image Heart Surgery in India for $1,583 Costs $106,385 in U.S. A man washes clothes while a child bathes at a communal water pump in the village of Paltupur, Uttar Pradesh. Cutting medical costs is especially vital in India, where more than two-thirds of the population lives on less than $2 a day and 86 percent of health care is paid out of pocket by individuals. Photographer: Sanjit Das/Bloomberg Shetty is not a public health official motivated by charity. He’s a heart surgeon turned businessman who has started a chain of 21 medical centers around India. By trimming costs with such measures as buying cheaper scrubs and spurning air-conditioning, he has cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,583), half of what it was 20 years ago, and wants to get the price down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the U.S. Centers for Medicare & Medicaid Services. “It shows that costs can be substantially contained,” said Srinath Reddy, president of the Geneva-based World Heart Federation, of Shetty’s approach. “It’s possible to deliver very high quality cardiac care at a relatively low cost.” Medical experts like Reddy are watching closely, eager to see if Shetty’s driven cost-cutting can point the way for hospitals to boost revenue on a wider scale by making life-saving heart operations more accessible to potentially millions of people in India and other developing countries. “The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” Shetty, 60, said in an interview in his office in Bangalore, where he started his chain of hospitals, with the opening of his flagship center, Narayana Hrudayalaya Health City, in 2001. Out-of-Pocket Cutting costs is especially vital in India, where more than two-thirds of the population lives on less than $2 a day and 86 percent of health care is paid out of pocket by individuals. A recent study by the Public Health Foundation of India and the London School of Hygiene & Tropical Medicine found that in India non-communicable ailments such as heart disease are now more common among the poor than the rich. One in four people there die of a heart attack and per-capita health spending is less than $60 a year. Yet the country performs only 100,000 to 120,000 heart surgeries each year, well short of the 2 million Shetty estimates are needed. The mortality rate from coronary artery disease among South Asians is two to three times higher than that of Caucasians, according to a study published in 2008 in the journal Vascular Health and Risk Management. Dietary Patterns “There has been fast urbanization in India that’s brought with it a change in dietary patterns and lifestyle,” said Usha Shrivastava, head of public health at the National Diabetes, Obesity and Cholesterol Foundation. “It’s leading to this huge jump in cardiovascular disease.” The average age for a first heart attack in India, Pakistan and other South Asian nations was 53 years, compared with 58.8 years in countries outside the region, according to a study published in 2007 in the Journal of the American Medical Association. The biggest impediment for heart surgery in India is accessibility. Shetty aims to bridge that by building hospitals outside India’s main cities. He said he plans to add 30,000 beds over the next decade to the 6,000 the hospital chain has currently, and has identified 100 towns with populations of 500,000 to 1 million that have no heart hospital. A 300-bed, pre-fabricated, single-story hospital in the city of Mysore cost $6 million and took six months for construction company Larsen & Toubro Ltd. to build, Shetty said. Only the hospital’s operating theaters and intensive-care units are air-conditioned, to reduce energy costs. Changing Procedures One of the ways in which Shetty is able to keep his prices low is by cutting out unnecessary pre-op testing, he said. Urine samples that were once routine before surgery were eliminated when it was found that only a handful of cases tested positive for harmful bacteria. The chain uses web-based computer software to run logistics, rather than licensing or building expensive new systems for each hospital. When Shetty couldn’t convince a European manufacturer to bring down the price of its disposable surgical gowns and drapes to a level affordable for his hospitals, he convinced a group of young entrepreneurs in Bangalore to make them so he could buy them 60 percent cheaper. In the future, Shetty sees costs coming down further as more Asian electronics companies enter the market for CT scanners, MRIs and catheterization labs -- bringing down prices. As India trains more diploma holders in specialties such as anesthesiology, gynecology, ophthalmology and radiology, Narayana will be able to hire from a larger, less expensive talent pool. One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform. “Global health-care costs are rising rapidly and as countries move toward universal health coverage, they will have to face the challenge of providing health care at a fairly affordable cost,” said the World Heart Federation’s Reddy, a New Delhi-based cardiologist who is also president of the Public Health Foundation of India. To contact the reporter on this story: Ketaki Gokhale in Mumbai at kgokhale@bloomberg.net To contact the editor responsible for this story: Jason Gale at j.gale@bloomberg.net I think it is pretty cool what Dr. Shetty is doing what he is doing. He is helping to a save lot of people. Maybe some of his findings can be used here.
I don't know if it will ever happen here when most people don't even know how much they pay for a procedure.
There are too many hands in the cookie jar for the medical costs to go down. Why is unhealthy food cheaper than healthy food? Why is the Govt worried about problems thousands of miles away , when there are some serious issues on the same street. Etc ...etc ...
this doctor clearly doesn't seek to become a millionaire like most american doctors he seriously wants to save lives which is goal #2 for most american docs after making money
That is bull****. For the amount of work and hours doctors put in, they aren't the ones that profit. Its the hospitals and insurance companies that profit the most off of the healthcare system as is. Its just so misleading how this lie about doctors keeps getting perpetuated. It is extremely difficult to become a doctor if all you care about is money. All the hassle and bs/stress you go through isn't worth it. With the same amount of time you spend in college/med school/ residency (80 hr wks making dirt pay)/fellowship you could focus your efforts on something like business and make more by the time you are established as a physcian. That being said, it is extremely admirable what this man is doing.
Most businesses fail. If you have the intelligence and competitive drive to become a cardiologist I would say that is a better option.
Kudos to Dr. Devi Shetty! This is a noble cause, but something that will never,ever,ever happen here in the U.S.A.! There is simply mountains upon mountains of red tape that won't allow it. Hopefully this doctor doesn't end up with an untimely death as is often the case with people who dare go against the establishment!..... ....... ....... .......
Most people with intelligence and competitive drive still don't make it through the 10+ years of "training" to become a physician. Not to mention that some people with families depending on them literally can't afford to be paid peanuts for working 80+ hours/week for 10+ years with the hope that some day they'll be compensated for what they do. Lastly, I doubt anybody here would go to India to have their heart surgery... did anybody else notice that he cut out air conditioning? People here complain about lack of A/C in their favorite fast food joint, let alone the hospital bed that they'll be spending several days in with limited mobility. Also notice that nowhere did he mention his "compensation" as a method to keep costs down... the hundreds of other inefficiencies that exist are the reason why hospitals such as the Cleveland Clinic look more like an Apple store than an actual hospital.
That's great and all, but I'm not sure the corners they are cutting would be acceptable here. I mean, I like my surgery room to have air conditioning, in Houston, for instance, as I prefer my surgeon not sweat into my open chest cavity. Call me spoiled.
I agree. I've met only 3 doctors in my life who actually were in it to help people and not for the money. The rest did it for the money.
Residents don't get paid "dirt pay." I think doctor salary should be capped at about 250k. That is reasonable.
great to see him helping the poor in India. now for my heart surgery, I probably won't use the low-cost provider from India, but that's just me. And my heart is currently in amazing condition, given the amount of HIIT I do.
Making $40-$50 thousand during one's residency is not dirt and is actually above the median wages of around $38 thousand in this country. I hear so much about the stress etc. but Nurses are in the same stressful situations and everyone in a professional career has stress. The sense of entitlement by physicians who are constantly ranked as the highest paid professions in the country is really disgusting. The truth is that many PhD's and other people spend the four years in addition to college (law school is 3/ business school 2) and are not paid nearly as much as physicians who are then paid during their residency and internships above the median wage in this country and then around 30 their pay skyrockets. The sad part is that their increased wages are not by creating new products, services or anything original but by billing the system and taking compensation beyond the value of the services provided due to a convoluted quasi-governmental socialized system in which people like drones are billed without paying for it and thereby don't force a competitive situation that will bring down prices and quality for all. There are professions that grow the pie in society and those that benefit by taking from the world. This historical notion of physicians as noble has really been eroded by a group of small business owners with a cartel and price controls on a required need of people. They've reinforced the barriers to entry to keep wages of physicians high by limiting foreign medical graduates and by not allowing more medical schools to be built. Its a sad state of affairs when there is a doctor for every 1200 Americans and a lawyer for every 300! Four times as many lawyers as doctors per capita creating an artificial shortage that is subsidizing some a-holes Mercedes payment. I believe in logical thinking and these stereotypes of the past have allowed the public to be taken and subsidize a profession and not rise up and demand a better system.
40-50K working 80 hours a week with a few hundred thousand in student debt is peanuts. This is also after you are 26+ years old getting paid for the first time. Doctors get paid in the long run but it's quite a bit of sacrifice up front.
