[Long] Outsourcing Medicine

[acropolis]

I couldn't decide on a decent intro paragraph for this thread, so I decided to post both of the top contenders. If there is consensus about which one is superior, the other one will disappear (like magic!).

Option #1:
The other day, I was watching important infotainment (I think they were supposed to have footage of Brad and Angelina coming up or something), and one of the intermediary stories went along the following lines: a woman has horrible teeth, and is going to Austria to have them fixed because she can't afford the surgery here (Brad and Angie better be worth it). Anyway, immediate thought: "how stupid is she, it's going to cost thousands just to travel back and forth. How much could she possibly be saving by traveling to ****ing Austria?" Apparently the infotainment producers had perfectly anticipated my thoughts, because the next two numbers they presented completed the story. Operation in Austria: $15,000 (pretty expensive surgery). The same operation in the U.S.A.: $66,000. A sharp blow dealt to my stereotype that all people with bad teeth are stupid.

Now, the only reason this price difference is even relevant is because apparently making this woman not physically repulsive counts as an 'elective surgery', and isn't covered by her insurance. What about all the non-elective surgeries that are covered by insurance, but could be performed for tens of thousands of dollars less overseas?

Option #2:
So I'm watching House the other night (as I am wont to do of late), and in this particular episode, House uses remotely controlled robotic surgical arms to violently dismember a patient. And I, and I'm sure all the other viewers as well, couldn't help but think to myself: "I bet that patient could have saved an absolute bundle if he'd had a Mexican surgeon dismember him remotely from Tijuana or somesuch instead of having an overpriced American surgeon botch the job locally." I mean, if surgery can be performed via robotic arms, then what difference does it make what continent the surgeon is on (outside of cost)?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

We in America already get our prescription drugs from Canada, and Indians already answer our tech support phone calls. Is this such a leap? For extremely expensive surgeries, travel expenses for trips across the globe would inconsequential compared to potential savings. Minor surgeries are now being performed laproscopically, and I could easily imagine the surgeon being off-site (continent) in those cases. Obviously most emergency surgeries would still have to be performed here, but oh well.

The point is that America is spending more per capita on health care than any other country in the (history of the) world. And in exchange for this exorbitant cost, we are one of the least healthy of the industrialized nations.*

One obvious question is the level of competence of the surgeon you would be using instead of an American. And since it seems that every other day I hear about some poor girl who went to Mexico to get her boobs done, and then got back here and eventually they turned black and fell off. So I can't just throw this issue aside; the fact of the matter is that Mexicans just can't be trusted with surgery. I think I would have no problem with an Indian surgeon though, because Indians are good at that kind of shit. So ends the racist tirade portion of this post.

Whenever someone gets a $50K surgery that could have been done for $10K, and lets someone else foot the bill, that someone else is getting screwed. Whether it be a fellow citizen of a country with nationalized health care, or someone else with the same insurance company, that person turns out to be me far too often for me to be happy with the status quo. And I'm guessing that person happens to be all of you quite often as well; while your systems might not be in quite the handbasket en route to Hades as ours, the problem is equally relevant.

Anyone think this will happen? Any obvious problems I'm missing (besides the fact that the enemy of all that is good (the AMA) will let this happen over their cold, dead bodies)?

*Partly because of all the fatties and poor. But also partly because medical care here is, quite simply, shoddy.

[Ste]

i didn't even read option 2

[Dante Hicks]

http://hardware.slashdot.org/article...47258&from=rss

[acropolis]

Originally Posted by Dante Hicks

http://hardware.slashdot.org/article...47258&from=rss

cool.

when do my insurance rates drop?

[Dante Hicks]

Well aren't a reasonable proportion of health care costs made up of long-term care anyway?

Sure, individual surgeries might be reduced in price, but what about the last fifty years of my life where someone has to wipe my arse 5 times a day? We already import people to do that and it still seems to cost quite a lot. Presumably the children of those people won't want to that work which means importing more people and so on. It sounds a very sustainable situation.

[Zar]

My father regularly tells me of customers that have gone abroad to places like India to have surgery that would have otherwise cost them 10x more than in the UK. Even after the travel expenses, hotel and sightseeing they come back having saved a bucketload.

It has come to such a stage that he now informally advises people to consider it as an option. Of course for the most life threatening conditions the doctors in developed countries have no match, but for everything else that costs an exuberant amount of money I don't see why people don't just travel abroad. Of course its very important that you seek out the right doctors in the right areas - you don't want anything to go wrong!

Part of the reason they are so cheap, is of course cheaper labour and the medicine and equipment is cheaper. It's upsetting that we still don't use generics everywhere when and where possible. Western countries and their health care services (nhs for example) have too many tie ups with western pharmaceuticals. Of course this is a tied relationship. If the NHS starts putting generics on their front line list the major pharmaceuticals will cut back on deals and offers etc..

[acropolis]

Originally Posted by Dante Hicks

Well aren't a reasonable proportion of health care costs made up of long-term care anyway?

Sure, individual surgeries might be reduced in price, but what about the last fifty years of my life where someone has to wipe my arse 5 times a day? We already import people to do that and it still seems to cost quite a lot. Presumably the children of those people won't want to that work which means importing more people and so on. It sounds a very sustainable situation.

'unsustainable'?

long-term health care is a huge issue, but also a pretty separate issue. i would break it down as follows:
1. Drugs (are overpiced to ****, and poised to bankrupt western civ)
2. Procedures (are overpriced as ****, and poised to bankrupt western civ)
3. Long-term care (is overpriced as ****, and poised to bankrupt western civ)

this thread was really only intended to address #2, but obviously all three are important.

My previous solution to #3 was a governmental promotion of smoking among the middle aged/elderly population,

but you've given me an idea. Bringing Indians here to take care of our elderly is expensive because you don't save any money on drugs (as zar points out), and labor is always as expensive as the local cost of living. Two-birds-with-one-stone solution?

Send our elderly to India instead. They could live like kings off of dollars per day. And we no longer need an excuse not to visit them.

so now we have a comprehensive set of solutions to the modern world's health care crisis:

1) Get our drugs from Canada, or some third-world nation.
2) HAve Indian surgeons perform procedures remotely, or ship our patients to them
3) Ship all old people off to the third world.

[Dante Hicks]

Originally Posted by acropolis

1. Drugs (are overpiced to ****, and poised to bankrupt western civ)
2. Procedures (are overpriced as ****, and poised to bankrupt western civ)
3. Long-term care (is overpriced as ****, and poised to bankrupt western civ)

Yeah, 1 & 2 seem much easier to solve. I wouldn't say long term care is overpriced (it probably is) - it's just one of those things that's going to cost a lot of money. Our current 'model' involves working for fifty years and then festering for another forty. A lot of those forty year people need almost one on one care. Even if I'm saving 50% of my net income now (an obviously ridiculous notion given the high levels of debt most people are in) then unless I've got some really high growth investments along the line the books are still going to be a bit difficult to balance.

As for sending our old people overseas, we already do this in the UK. In particular people go to South Africa and live like kings. I remember visiting some shop in Cape Town and five people in front of me were all English and all over 60. Hopefully the natives over there can thin out the OAPs a bit.

Overall, in the long long run I wouldn't be surprised if we moved back to a more family orientated model (since ultimately that's the only thing that may work).