No article, I am just writing up a paper about an Indian healthcare organization who is aggressively pursuing medical tourism. Apparently the NHS in the UK is shipping off patients to Belgium for certain procedures and something kind of struck me. What would you think if the US Government contracted with other countries like India to take Medicare patients for certain procedures? IOW if you had Medicare you might have to go to India for a hip replacement or something that costs a ton here but 1/10 there. Now before we get angry thinking this is just outsourcing more US labor, let's do some thinking. From the patient's point of view they're getting basically a free (minus the coinsurance), vacation out of this. Many medical tourism locales are basically resorts with tour guides, activities, great food, etc. From the US point of view we could outsource some of the procedures that are crippling the system and raising everyone's taxes, namely Medicare. This savings could help the US to either lower taxes or increase reimbursement rates for Medicare for other procedures. I don't think this is a "they took our jobs" scenario, hospitals and doctors have plenty of business and with the Boomers retiring as we speak it's about to get worse. Part of the reason costs are so high in the US is the sheer amount of end of life, Medicare services that we are demanding with no one to tell us no, that's it's not an efficient use of resouces to spend $100,000 to extend a life for a week or a month. (Like a Sarah Palin death panel). I cite a famous study for consideration: "It is a myth that more Medicare spending means better health, or longer life expectancy, and yet our Medicare system has been operating based on this myth for a long time," said lead author John E. Wennberg, MD, MPH, Peggy Y. Thomson Professor for Evaluative Clinical Sciences at Dartmouth Medical School. Lead study author John Wennberg of Dartmouth Medical School said, "Some chronically ill and dying Americans are receiving too much care -- more than they and their families actually want or benefit from" (Dow Jones/Chicago Tribune, 4/7). Wennberg added, "Contrary to popular assumptions, it's the volume of services, not the price per service, that accounts for most of the variation in Medicare spending" (New York Times, 4/7). https://dms.dartmouth.edu/news/2002_h1/13feb2002.shtml So I say if you want these expensive surgeries that bloat the system and are inefficient in cost versus benefit, you can have them mut you've got to take a flight to do it. We could also do this for Medicaid, though it may irk some that a single mom got a trip to New Delhi and a resort on their tax dollar. However if the entire cost of the trip and surgery was $5,000 versus $30,000 at a US hospital could we really complain? I appreciate any input as I attempt to solve the US healthcare problems.
outsourcing hurts American jobs? would shipping people to another country to perform some percentage of procedures hurt medical procedure and med device innovation for those procedures over here and effectively ship an entire industry out of our borders? if so, the question is: will the dollars saved outweigh the lost industry in the long run.
As someone who plans on using medical tourism soon I think the one thing that needs to be considered in the analysis is how do travel cost figure in this? Yes procedures are cheaper in many cases but there considering how expensive it is to fly to places like India that might eat up savings in the cost of the procedures. Also due to the timing of this many procedures aren't practical. If you have to take two weeks off work to travel to India to get arthroscopic surgery and stay there for followup that is going to be far more expensive than doing it at home where it can be done as a day procedure and you can come in for followups while still going to work.
It cost 2g for a ticket to india. It cost like 4g for a night at the hospital here. It seems like every indian person here is going to med school and a lot of doctor are indian so I think the quality is the same as well.
Sounds like a good idea actually. There would definitely be a lot of opposition in the US, but I think people could be convinced about the benefits, given the size of our debt and deficit spending not ending anytime soon. Some companies and insurers are already doing something similar by asking the patients to get procedures done in different cities where the cost of care is cheaper. Biggest problem in the US would probably be malpractice protection in foreign countries, but this could easily remedied by having the US government be liable. There would probably be more controversy in India or whatever country we send our patients to. Using a countries healthcare resources on foreigners would not go down well with the local populace, especially in India, where there is a ton of poverty. Theres a huge disparity between public hospitals in India and the private hospitals where all the medical tourism stuff happens, I could see politicians pouncing on this once a flood of Medicare patients start coming in.
"I appreciate any input as I attempt to solve the US healthcare problems" LOL! I thought the US healthcare problems is solved with the passage of OBAMACARE!
I have no doubt for many things that the quality of health care in India is as good as it is in the US for many procedures but that still doesn't always justify the costs of travel and time off from work. As I noted in my example many arthroscopic procedures can be done on an outpatient basis. I can have my knee scoped and be back at work the next day. If I fly to India to do the procedure I have to bear the cost of not only the plane ticket but also the lost time from work to travel to and from India. This is also ignoring emergency procedures and also situations where stress of travel might be too harmful on the patient. Medical tourism might help to lower costs in some cases but I think it is impractical as a serious solution to the US's current medical situation.
That's because you're not very bright and lack a lot the ability necessary to actually understand things.
One of the problems here is that patients that need this type of extend-your-life-for-a-week surgeries can't really risk the flight. In most cases, they are in fairly bad shape and probably can't even leave the hospital, let alone travel half way across the world.
A good point, but I still feel like we could identify several niche procedures that patients desire and could physically travel for. As I mentioned you could use this for Medicaid and younger healthier patients as well. It's not an end all solution, but we need to start thinking outside the box here.
I wouldn't consider it a solution, I just think we could pinpoint some specific procedures that could be done in another country. Fortis the company I am researching has set up a facility in the Cayman Islands for quick jumps from Miami. We need to cut costs, waste, and inefficiency out of the system somehow. No one wants the government telling them they can't have a likely little to no benefit procedure, so let's explore still providing it but doing so in a less expensive venue.
I saw a good segment on 60 minutes about end of life care. It seems part of the problem is that these patients and their families aren't given an alternative other than pulling the plug. The hospital has no real incentive to give them an option since they rack up the dollars for end of life care. There's a big potential to cut medical costs by having end of life nurses and hospice care for terminal patients to leave the hospital and spend whatever time they have left with their families and die with dignity instead of squeezing every ounce of the resources available to the medical system just to keep a shell of a person alive with machines.
About as much as the Bush Energy Bill cut oil prices, and the Iraq War reduced the threat of terrorism and WMD.
I imagine the healthcare lobby would fight this as vigorously as everything else thus far? And I imagine trial lawyers would probably join in, presuming the decrease in medical malpractice liability? And at what point do the tens of millions of Indians with presumably substandard care get miffed about Americans in their hospitals?
