Last night, I was given this article on medical outsourcing from a May issue of TIME (linking to a blog becuase the original is now premium content), a rag I flip through occasionally. What struck me was the price differential between the US, and say India is higher by a factor of 10 for nearly every kind of elective surgery (heart bypass, kidneys stones etc). I keep hearing all these boasts about the quality of medical care one can get here in the US but still a $90,000 difference for a bypass surgery with comparable outcomes is just too much. I, definately for one, will be using outsourcing as a idea when I begin consulting in a few months. Maybe my doctor cousins and friends back in India will give some "kickbacks" for doing so. cough cough

Besides, my only visit to a hospital here ( downtown ER after a cooking/ burning accident; this was in the early days of cooking, now I can doze and cook) disabused me of the notion that top quality care is a given across the board here in the US. I think not. Also earlier on Thursday, when I was talking with my boss-prof the subject veered to insurance if you are not working, or if you are retired here in the USA. He said that in order to keep the medical coverage intact for his family, he plans to keep working for ever at the university. Me thinks, at that point, i.e., when I renounce Cubeville with its full medical coverage, I would rather move to Mexico (Baja is lovely, and I can get me a boat a la 'Shawshank Redemption') or Costa Rica (as quite a few gringos already do).

Now I will not get into discussing the few crazy dental stories I know of here. I would like to know what medical folks think of this subject?

I think that there are a ton of reasons to explain this price differential. Some of the more common (and doctor sympathetic ones) are the rising rates of malpractice insurance and also the number of people who go to doctor's without the ability to pay. Both of these are kinda shaky reasons and the second involves one of my medical pet peeves :) I'm sure there are cases when malpractice insurance is abused and doctor's are sued for reasons beyond their control but I've always felt that there are better ways to deal with this than an across the board cut in the amount a patient can sue their doctor for. Many of the people who don't pay for medical care do so because they can't afford the non-insured prices and because they can't afford insurance in the first place. There is a lot of room for public policy to change here but it doesn't seem like the government is really working towards some sort of national insurance system or even making sure that low paying jobs have some sort of health coverage attached. If we assume that doctors, nurses, and other support staff are going to be paid more than their counterparts in India, I think the biggest reason for the price discrepancy can be traced back to big pharmaceuticals (my second medical pet peeve!). Drugs, instruments, and machines used in surgeries are far more expensive than necessary as the pharmaceutical companies try to milk as much money as they can from their expiring patents. Pharma is much more of a profit oriented business than medicine I think, just because there is far less actual patient contact. It removes their humane obligation in producing and providing these drugs at reasonable prices. At the end of day, no medical system is perfect but as far as medical tourism goes, it makes me worry about some sort of internal brain drain. Good doctor's in India are being lured to these boutique hospitals to cater only to rich old Americans while there skills could be used to make the Indian health care system far better than it is. That said, seriously go to Mexico. Cuba has an excellent health care system as well, but that whole political thing is a little iffy :) I've typed far too much, if it doesn't make sense, let me know and I shall pontificate further :)