My heart, my choice...

So America has the best health system in the world.

Good for India

..An American goes to India for an operation, India has the best health system in the world.

When it comes to Americans, India and operations.

I couldn't find the price of kidneys...probably about $3.95 /lb

But they do have a good deal on total knee replacement.

Stocking, a 55-year-old uninsured retiree from Spokane, Wash., was shocked to learn it would cost her nearly $35,000 for a total knee replacement.

"I was appalled by what [the hospital and my orthopedic surgeon] wanted to charge me," she said. "It didn't bother me that my surgeon wanted $150 just to walk in the door for an office visit, nor did I have a problem paying $80 apiece for X-rays. But I was offended that he wanted to charge me $5,000 for a one-hour surgical procedure, and that it would cost me $27,500 for a three-day stay in the hospital.

Over the past few years, some U.S. insurance companies ? dismayed at losing income from uninsured BOO HOO

perhaps you should read Earlier this month, the insurance company WellPoint announced a program that will allow employees of a Wisconsin printing company to get coverage for non-emergency surgeries in India. It's a first for WellPoint, but puts the insurer in good company. Over the past few years, some U.S. insurance companies ? dismayed at losing income from uninsured Americans who get cheap surgeries abroad or clients who choose to pay out of pocket for discount foreign surgeries rather than expensive in-network co-pays ? have announced plans to include foreign medical procedures among those covered by health plans.

The Canadians who opt to come to the US at their own expense do so because they believe the Canadian system is not capable of delivering the care that they want either because of waiting lists or availability of resources.

The Americans who go to 3rd world countries (or, in some cases, somewhat more developed countries like India) for medical care rarely, if ever, believe they are getting better care. My impression is that they don't necessarily believe they are getting equivalent care. They go to get cheaper care. What they hope for is good enough care at a better price than they get in the US. It's a bit like somebody who wants a Lexus but settles for a Toyota. That is hardly analogous to the decisions that Canadians coming to the US are making.

As to the really important question - what quality differences are there between the US version and the Indian or Thai or .... version? I don't think there is any hard data. Right now it's caveat emptor. Isn't it a bit ironic that some of the people who most object to free market forces in THIS country seem to be encouraging patients to trust to the relatively less regulated operations in some other country?

... possible surgery overseas? I have a friend whose doctor in the US told him quite clearly that a knee replacement that he needed could be done for 1/5 the price at a particular hospital overseas (I believe in Thailand). The doctor even recommended the hospital by name and address.

Now what does this say about the the free market? Was the doctor making the recommendation medically irresponsible, just looking out for the economic welfare of a patient, or should we be suspicious that the doctor is receiving some sort of commission for his recommendations?

If a patient says "I can't afford that"... does a doctor have a responsibility to find a cheaper, but comparable treatment, or is it up to the patient to find the alternatives themselves?

I cannot imagine recommending a major procedure at an overseas hospital (except possibly Western Europe, Japan or Canada) unless I had considerably more information about that specific hospital than I have about ANY foreign hospital right now. Even in the US I would want some basic information before making a specific recommendation that a particular procedure should be done at a certain hospital.

It may be that the doctors in question have information about those hospitals. Maybe the doctor trained one of them or knows a surgeon there. I don't know. I hope the recommendation was based on more than just a nice sales pitch.

I don't know of any obligation for physicians to find inexpensive alternatives when patients state that they cannot afford something, although many (most?) physicians will try to find less expensive alternatives when it is necessary. Those less expensive alternatives are frequently accompanied by various caveats about what is or is not appropriate and what risks are being incurred. For some things there are no good inexpensive options.

Most Americans don't choose medical outside of America to get better health care.

or lots of money choose and get better health care inside America.

Those without? anyway they can, if they can.

Roger

There is good healthcare in many countries around the world, as I suspect Dr. Bill may attest.

What I know about is my wife's field where the endoscopes are Japanese, the treatment machinery is Japanese or German, and the big names are Belgian and English and Canadian and American and from several other countries. Venitlators are manufactured in various countries in Europe and the US, and specialists in ICU medicine come from many countries. The US made an enormous contribution to Trauma Medicine, partly as a result of the Viet Nam War, and partly as a result of the funding that US companies were willing to make available.

Canada pioneered heart pacemakers in the 1940's (post war), the Hospital for Sick Children in Toronto invented Pablum, and pioneered "Blue Baby" surgery along with New Zealand, and then the United States. I have tried to find a decent link about this specific issue, but it is not available on the internet. The reason I believe that HSC and New Zealand were early in the running is that there are framed medical journal articles that pre-date any of the information I can find regarding American research.

Before Canada adopted universal Health Care, Sick Kids as it is called was run rather like (damn, what's that Hospital that Danny Thomas did so much work for). They accepted everybody. They still get patients from all over the world, and do Siamese twin separations and haemangioma reductions via The Herbie Fund a Canadian charity which enables patients to be brought to Canada with their families to receive treatment.

I did a lot of research when we moved here, before the internet era, to see what sort of system I was getting into both as a potential patient and as an employer, and I found out there was a lot of interesting stuff here. Toronto General Hospital (as it was then) had quite an interesting display, in a very obscure place in the hospital with prototype pacemakers and a whole time line of medical articles.

Rob

And IIRC the Dr. Osler who helped found Johns Hopkins was Canadian

Still, there is some basis for our belief that US healthcare is the best in the world for people who have access to all of the available resources. The problem in the US is hardly a lack of quality. It's a lack of equity. The abysmal national statistics that you are so fond of quoting reflect the overall system, not what is available to well funded or insured patients.

I admit that there are people who use too much 'health' care, and we overuse antibiotics and underuse preventive treatments at all levels in the system, but for people who are ill (as the patient in the OP was) the options the US are generally at least as good as those anywhere.

I don't mean to imply that I regard our system as functional. It has serious problems. Still, when it comes to caring for sick people who have adequate resources the level of care in the US is second to NONE.

That's better than my response to the non sequitur would have been.

It was St. Jude's in Memphis, Tennessee. They are famous for their work with leukemia.

if you have good insurance or wealth.

If you don't, you do without until it's bad enough to put you in the hospital through the emergency room doors.

That is, if you live long enough for them to save you.

Roger

He came to get "no waiting" care"/

Angeline

That's like saying I didn't come get get better gasoline, I just wanted to get it quicker, before my tank ran out.

He got better care.

"His doctors in Canada presented him with two options - a full or partial sternotomy, both of which would've required breaking bones, he said."

He came to America and got the procedure done without breaking bones.
Granted, I am not a Dr., but I would think NOT breaking bones for a procedure is BETTER.

That makes one wonder why he was not given that option.

In any event, as your link states, the surgeon in Miami was recommended as the best choice.

The best choice

Since the Miami doctor is the "best" choice, and all the other doctors he trained (American and Canadian doctors) aren't the best, everyone they operate on aren't getting "the best health care in the world".

OR does having the operation done in Miami (because of the weather/unless it's hurricane season) make it the best?

Why he went to Florida?

IMO...He's a Canadian politician (with some spare change, and a condo in FL.), living in Newfoundland in the dead of winter (even with Climate Change/Global Warming, not a very warm place), and needing an operation.


Medical Holiday?

........... get back to work in a short period of time," the premier said.


Angeline

Shortening the recovery time is better care.