Dr. Andy

Reflections on medicine and biology among other things

Friday, April 08, 2005

Outsourcing Medical Care

Foreigners are increasingly travelling to India for first class medical care at bargain prices, at least according to this article.

Europeans and Americans, looking for world-class treatments at prices a fourth or fifth of what they would be at home, are traveling to India. Modern hospitals, skilled doctors and advanced treatments are helping foreigners overcome some of their qualms about getting medical treatments in India.

I can't say I am too surprised, but I doubt this will turn in to any sort of significant trend. First, the cost of travel will likely more than offset the savings for all but big-time operations. However much cheaper an allergist in India is, the cost of flying there is much more than it costs to see me. Plus you presumably need to stick around for a while. You can't just have hip replacement and hop on a plane back to San Francisco the next day.

Second, follow-up is problematic. If you get, say angioplasty, in India who follows you for your heart disease when you get home? For stand-alone surgeries like joint replacement, this is probably okay, but for chronic conditions this sort of outsourcing won't work too well.

Finally, what if something goes wrong? While the individual surgeons in this article are well-trained, do the hospitals have the depth of infectious disease and critical care specialists to take care of infections and other adverse events. Even if they do, if you end up with an infected joint requiring prolonged IV therapy or on a ventilator with a pulmonary embolus, wouldn't you like to be close to home.

One other tidbit from the article about the miracle of socialized medicine:

For some foreigners, like George Marshall, a 73-year-old violin restorer from Yorkshire, England, India's hospitals also offer speedier treatments. Last year, Mr. Marshall said that he started having trouble finishing a round of golf. An angiogram showed two blocked arteries in his heart. With the British National Health Service, Mr. Marshall would have had to wait three weeks to see a specialist, and six more months for coronary bypass surgery. "At 73, I don't have the time to wait," Mr. Marshall said. "Six months could be the rest of my life." Nor could he afford the £20,000 ($38,000) for surgery at a private hospital.

Six months for bypass? And people wonder why Americans aren't in favor of single payer health care.


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