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Zyndryl

Politics Makes For Strange Bedfellows:

The AMA has been very, very good at protecting its interests for over a century -- mainly by erecting tough credentialing & exam barriers for foreign doctors. They won't take kindly to this competition at all.

The Trial Lawyers will freak out even more. Try suing a hospital in India or Thailand like you can here. Good luck with that.

So, I predict that before they throw in the towel, we'll see a lot of frenetic lobbying activity for protectionist legislation of the worse sort by both groups -- culminating in the two sworn enemies allying with each other when they get truly desperate.

You read it here first!

Global Doctor Options

There probably will be lobbying, and a lot of fear, uncertainty and doubt, about the outsourcing of medical tourism. But having experienced overseas medical treatment, I've seen the future. And having seen the cost of Western medical treatment, the future is pretty clear.

The first segment that is already taking advantage of high quality overseas hospitals is the underinsured. They can't get the affordable (or in some cases timely) access to medical care they need at home (whether IVF or hip replacements), so they go overseas. It will be the stories of these pace setters that determine how fast the industry will grow.

Most research seems to show that initial feedback is very positive and that the Futurist predictions are spot on.

brokerdavelhr

GK,
I didn't see this mentioned in the article anywhere, but did you ever write about the high taxes that doctors offices pay to stay open? Did you mention the insurance that skyrocketed due to frivolous lawsuits?
I suggest you read the following:
http://www.ethicalhealthpartnerships.org/doctorfees.html
So yes, our hospitals do charge a lot more. Yes outsourcing a major operation could cost you less. But you get what you pay for.
You want to know why doctors visits in the US are at such a high premium compared to Taiwan, China etc.? Because their insurance charges are a lot lower, their malpractice suits are almost non-existent (in most cases), and the MUCH LOWER cost of living and operational expenses.
People want to blame the hospitals for this huge conspiracy of trying to make more money. Given the above facts, can you blame them?
Moving on.
You cited ‘"Jagdish Bhagwati, an economist at Columbia University, thinks that the offshoring of, for instance, customer service and claims-processing could save America alone $70 billion-75 billion a year."’
What he means to say, is that it would initially save the consumer market 70-75 billion a year. The consumer using this option will most likely have no health insurance. So this money will go straight into a foreign economy. This helps the US out how?

"By Deloitte’s reckoning, medical travel will represent $162 billion in lost spending on health care in America by 2012. "
Once again, how does this help the US economy? The 162 billion is not saved by the consumer at all. It is simply injected into the foreign economy.

"A bit of rivalry from top foreign facilities may introduce transparency and price competition into an inefficient system riddled with oligopolies and perverse incentives. "
Once again, the healthcare system we already have is already in enough trouble as it is. There is a very good chance that if this goes through with the success you envision it, it would be destroyed in it’s entirety.

And last but not least- If someone cannot afford an annual premium of $3,600/yr. in health insurance (spread out over 12, $300 payments), what on earth makes you think that they could afford a $1,500 plane ticket, and a 10K surgery in cash anyway? They cannot. I want to know who the 1mil + patients are comprised of that have already done this. I will bet my bottom dollar they could have afforded a good insurance plan here in the US.

I am not arguing with you by the way. Just saying what I see so to speak. You say that the US system is one of the biggest&worst sectors of the US economy. The only reason I can agree, is that America has become a victim of her own lawsuit-loving, and protest-shouting throngs. Now that everyone else is paying the price, it kinda sucks huh?

Zyndryl

Replying to what brokerdavelhr said:

"What he means to say, is that it would initially save the consumer market 70-75 billion a year. The consumer using this option will most likely have no health insurance. So this money will go straight into a foreign economy. This helps the US out how?"

Because we get real goods and services for essentially worthless pieces of green paper, that's how. That is a lot of crap we bought at Wal-Mart and we are richer for it. It's a pretty good deal if you ask me.

And if the foreigners start to demand real goods and services from us in return/instead of those worthless pieces of green paper, then unemployment rises for them while grows for us. They are acutely aware of this even if the average American is not.

The essentially worthless pieces of paper are actually worth more outside the US -- nations can buy oil and rice and steel with it from each other, not to mention use it for investment opportunities here in the US or to pay the 'made for usury' trap they might be in with the IMF.

Hence why the Chinese have a $1.8 TRILLION money pot of dollars from their exports they aren't exactly sending back to us -- except to buy US Treasury notes or real estate, factories and other investments.

"If someone cannot afford an annual premium of $3,600/yr. in health insurance (spread out over 12, $300 payments), what on earth makes you think that they could afford a $1,500 plane ticket, and a 10K surgery in cash anyway?"

You are speaking of the uninsured, yes? GK was speaking of the already insured and -- especially -- the UNDERinsured as being the vanguards for this new transition.

But even then, I can lay out for you a future scenario involving medical tourism that would definitely apply to the uninsured: Hospitals have to take people in and treat them regardless of ability to pay right now. So, pretty soon you'll see in the media reports of hospitals finding it cheaper to just provide the minimal treatment necessary to stabilize them enough for the flight (again, at the hospital's expense) to Mexico for them to be treated there. The delta between how much the hospital would have to fork over to treat the uninsured here vs 'there' is that great in many cases, I am sure.

"I will bet my bottom dollar they could have afforded a good insurance plan here in the US."

Yeah...and it will get even more affordable as hugely expensive in-patient treatments are handled outside the US -- via those very same domestic insurance plans you mention.

Insurance for care and provision for care are two different things, albeit closely linked because one pays for the other.

"The only reason I can agree, is that America has become a victim of her own lawsuit-loving, and protest-shouting throngs. Now that everyone else is paying the price, it kinda sucks huh?"

Which was why I predicted that the Trial Lawyers will go nuclear over this trend even more than the providers will. See, as soon as this starts to bite, medical malpractice reforms will start to pick up and have serious teeth as an outcome. Just look at how the public has become steamed at the Dem's continuing 'no drill, let everyone ride mass transit and bikes' suck-up to the enviros over $4+ gas. When hospitals start to close left and right and doctors finally throw in the towel en mass, things will change on this front as well. Nothing is static -- not anymore thanks to the medical offshoring competition being unleashed.

The ambulance chasers are going to watch their entire business model literally get offshored along with the patients. The lawsuit madness will be solved one way or another, starting now and it is way over due.

GK

Zyndryl is absolutely correct on all points.

brokerdave,

Today, you can buy something at Wal-Mart for $10, that in the 1980s used to cost $20 (despite inflation since that time). Thus, Chinese manufacturing has caused US consumer purchasing power to increase.

The same goes for healthcare, where a big chunk of the costs are insurance, lawsuits, and bureaucrats. Outside of Oil, almost all the remaining inflation in the US economy over the last decade is from healthcare.

Market forces find a way. US trial lawyers like John Edwards are responsible for making healthcare costs stratospheric. They sue anyone who opposes them, and have enough money and power to lobby against tort reform. Thus, there is only one remaining way around them, which is exactly what is happening. No amount of lobbying can prevent a patient from voluntarily going somewhere for a procedure.

Also remember that US insurance companies are the ones encouraging people to get major procedures overseas. It is the insurance company that saves $90,000 (even after plane ticket and vacation package) by sending someone to India for a bypass surgery that would be $100,000 in the US. The other group going are the somewhat wealthier uninsured, who can either spend $15,000 in India, or otherwise die because they can't afford $120,000 in the US.

brokerdavelhr

GK & Zyndryl,
Thank you both for your insightful replies. There are more questions that I have now (sorry, but I do not relish being ignorant of anything).
1- When money is freed up by the savings gained by a foreign procedure, what is to say that the consumer will use it for a 'durable' good? The reason I ask, is that most people who have extra money (including myself at times) buy goods that will last for no more then a few years. How are such goods more valuable then ‘worthless pieces of green paper?’ They give us the goods that are far from their best, and in return, they receive a green piece of paper that will actually help them? We buy low to mid grade product, they receive money to better leverage their position (on top of what is injected via medical procedures). Once again, how does this help us? I would agree that foreign trade is a good thing. However to make it profitable at all, doesn’t the trade have to a least be a little profitable? I mean if the process works as stated, and people do go to Wal-Mart to spend money, a good portion is still going to foreign labor, and shipping. Now this can be a good thing too when taken in perspective with the goods received, but when the goods are geared for short term entertainment (which is usually the case) how can we sit back and say that this is a good thing?
2- Tort lawyers make cases in a typical fashion. They find a handful of legitimate cases, add a few hundred fakes, and a case is born. Sometimes this can be a good thing as it shuts down businesses with very poor practices. However it also leads to things like the modern screw up of a health care system we have now. Like everything else, it is a lack of common sense on the judges side (who all to often inject their own opinion) who allowed precedence to be set by allowing tort cases to happen in mass. So the question here is- will it ever truly stop?
3- One simple fact remains (and the future may cure this as well, but for now, it is what it is), and that is we all die eventually. People get sick, hurt, damaged, lose their sanity, or something of that nature. Now turn the clock back a hundred years. Back then, a bum knee or old wound would be only a complaint, and the individual would have moved on to a different stage in life. Nowadays, everyone feels that they have a right to feel good all the time. While I would agree that life would be easier that way, I must say that it comes with it’s own problems as well. To level the playing field, viruses and the like mutate as well. We find a cure for disease xxx, and suddenly disease xxy evolves into being. Any doctor will tell you that the mutated form is usually much worse then the original. Did you know that there is a strain of common cold that will kill you in a few weeks time when it has finished incubating without medical treatment? This is not an isolated issues either. People say that life finds a way, heck, your singularity concept is based on that concept. If it were just people, then that would be a 100% true. But there are many forms of life and other natural phenomena. And not all are healthy for humans. You see as life finds a way, so does death. So the next question is- will people ever realize this to a point where they will no longer sue doctors wrongfully for malpractice? Will they ever manage to conquer their own greed?

Zyndryl

brokerdavelhr-

I can probably answer this one:

"... people do go to Wal-Mart to spend money, a good portion is still going to foreign labor, and shipping. Now this can be a good thing too when taken in perspective with the goods received, but when the goods are geared for short term entertainment (which is usually the case) how can we sit back and say that this is a good thing?"

I can answer with another question? "What difference does it make if the purchase came from China or not?" We still make those sorts of purchases. Everyone in a modern economy does. And, I can see no advantage over goods produced domestically unless and until those goods become as competitively priced as the Chinese versions -- assuming all things being equal, like quality involved.

And guess what? The day is coming...within our lifetimes I believe...where goods produced here WILL be competitive in both price and quality compared to foreign goods and probably by a wide margin at that, too. Industrial molecular 'nanofacturing' is going to be such a disruption to the world trading order that medical outsourcing will be just a drop in the bucket by comparison.

Zyndryl

"It is the maxim of every prudent master of a family, never to attempt to make at home what it will cost him more to make than to buy. ... If a foreign country can supply us with a commodity cheaper than we ourselves can make it, better buy it of them," -- Adam Smith, The Wealth of Nations

x-ray fluorescence

Hi,
Nice post.The AMA has been very, very good at protecting its interests for over a century -- mainly by erecting tough credentialing & exam barriers for foreign doctors. They won't take kindly to this competition at all.

GK

x-ray,

But they cannot prevent an American from going to Thailand or India for a 'vacation'.

The AMA is also powerless to stop trial lawyers from destroying the practices of thousands of doctors, so it does appear that the AMA is so omnipotent.

Account Deleted

This is a vry good article related medical tourism
www.indiameditours.com

IVF Clinic India

Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

surrogacy

Great Post.....

I found your site on stumbleupon and read a few of your other posts. Keep up the good work. I just added your RSS feed to my Google News Reader. Looking forward to reading more from you down the road!

Thanks for sharing....

Savethemales

Count me in as a soon to be medical tourist. I am getting stem cells to improve my hearing, something not available in America for another 10 years. Even when stem cell technology comes to America, the cost will be several times higher.

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