Cardiac Bypass Surgery for Just $1,583

Who knew? Entrepreneurship and competition reduces health care costs quite dramatically as Dr. Devi Shetty has proven in India. Shetty opened and now runs a chain of 21 medical centers in India in which physicians offer complicated medical treatments as little as a 1/50th their cost in the United States. As Bloomberg reports:
By trimming costs with such measures as buying cheaper scrubs and spurning air-conditioning, he has cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,583), half of what it was 20 years ago, and wants to get the price down to $800 within a decade. The same procedure costs $106,385 at Ohio's Cleveland Clinic, according to data from the U.S. Centers for Medicare & Medicaid Services.
"It shows that costs can be substantially contained," said Srinath Reddy, president of the Geneva-based World Heart Federation, of Shetty's approach. "It's possible to deliver very high quality cardiac care at a relatively low cost."
How high quality? The Economist reported:
Narayana Hrudayalaya reports a 1.4% mortality rate within 30 days of coronary artery bypass graft surgery, one of the most common procedures, compared with an average of 1.9% in the United States in 2008, according to data gathered by the Chicago-based Society of Thoracic Surgeons.
Oddly Bloomberg continues:
One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform.
"Global health-care costs are rising rapidly and as countries move toward universal health coverage, they will have to face the challenge of providing health care at a fairly affordable cost," said the World Heart Federation's Reddy, a New Delhi-based cardiologist who is also president of the Public Health Foundation of India.
This observation misses the point that entrepreneurship and competition is how Shetty was able to drive costs down. Government run universal health care is the opposite of that.
Still, the good news is that medical tourism will be a way for Americans to do an end run around ObamaCare.
Addendum: See also my colleague Jim Epstein's sharp Reason TV video that asks, "Can Medical Tourism Save Us From Obamacare?"
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One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform.
HAHAHAHAHAhahahahaha... Oh, wait, they're serious...
Doctor Nick will do it cheaper
His motto is, You've tried the best, now try the rest!
http://en.wikipedia.org/wiki/Nick_Riviera
1-800-DOCTORB
The "B" is for "bargain!"
The key question is whether that 1.4% vs. 1.9% mortality rate (and a host of similar measurements) are accurate.
If so, then we have a nice example of dat famous free-market magic.
It's a better example than pet-care or LASIK. (Neither of which are, y'know, urgent.)
Death panels are still cheaper.
Too bad they are not real.
Too bad you are a mendacious cunt.
Like your factoids.
Everything is rationed, dickweed. Whether the rationing is by markets or government bureaucrats is the question.
You've used up your ration of brain work for the day, may as well go back to cave for now.
Medicare does not ration.
so doctors are not accepting new patients because they don't want to be paid? Please.
God you are a fucking idiot.
"Medicare does not ration."
And yet it has eligibility requirements.
Medicare does not ration.
Sure it does, or at least lays the foundation for it.
Doctors limit their Medicare panels.
Medicare refuses to pay for some procedures.
"lays the foundation"? Perhaps.
"Doctors limit their Medicare panels.
Medicare refuses to pay for some procedures."
Rationing.
You're wrong.
And yet you wont admit it.
Medicare won't pay for procedures that are not pre-approved, idiot.
That is not rationing.
"Rationing is the controlled distribution of scarce resources, goods, or services. Rationing controls the size of the ration, one's allotted portion of the resources being distributed on a particular day or at a particular time"
It's the definition of rationing.
I love that you keep letting me laugh at you.
"Medicare won't pay for procedures that are not pre-approved, idiot."
They also have eligibility requirements.
I LOVE that you're so bad at this.
Still, the good news is that medical tourism will be a way for Americans to do an end run around ObamaCare.
You mean an end run around the private insurer that the ACA requires you hire.
You mean the insurers who follow government diktat and are no more in control of their own destiny than you are of the alleged grey matter between your ears and no more private than the swill you dump here?
Aerna, UHC, and others would say they will control their destiny.
How?
They're required to offer fixed services at a fixed price to anyone that comes along.
Where is their ability to control their destiny?
Forget it, Jake. It's Buttplug Town. Stalin's Buttboy would confuse a breadline with a market.
No they are not.
They set their price as they see fit. The only thing that is fixed are minimum services (no rescission, one check-up, no exclusion, etc).
"They set their price as they see fit. "
Yeah, no they don't.
If you were smarter you'd see why. but as I said, you still don't get it.
You're an idiot. UHC just opted out of the California individual market because they could not compete with their cost structure.
"UHC just opted out of the California individual market because they could not compete with their cost structure."
And they had to get a special dispensation to do so.
So, your own example demonstrates you're wrong.
Pretty standard for you.
No, they don't set their prices as they see fit. They have to ask the various states for permission to raise premiums in that state, OCare has a quasi-utility rate-setting mechanism embedded in it which is just a "As the Secretary shall determine" away from being full-blown ratesetting.
Prove it. It will be your first time. And you are already weaseling with this "quasi" handiwork.
I am talking about the INITIAL premium - they may have some limitation on jacking up rates mid term.
"Prove it."
"I am talking about "
You're not talking about anything.
You're making stupid excuses to a man who essentially runs a hospital.
Stop making a fool of yourself again.
"I am talking about the INITIAL premium - they may have some limitation on jacking up rates mid term."
And by the way, I love this "I shot off my mouth, and am asking for proof, but am admitting here that I was wrong" garbage.
Your reading comprehension is poor, jackass.
Yes, I want proof that the INITIAL premium is set by Obamacare.
RC has been wrong debating me numerous times - I will be the first to admit I am wrong if so.
"Yes, I want proof that the INITIAL premium is set by Obamacare."
Of course you do, the rest of your stupid argument is in tatters, but what you want isn't of any concern to anyone.
"I will be the first to admit I am wrong if so."
You're wrong about medicare rationing, and you still haven't admitted it.
No, you'll be the last to admit it, because everybody else already has.
"Covered California, the state agency implementing the federal Affordable Care Act, is announcing the winning bidders and proposed rates Thursday for its insurance exchange, where as many as 5 million residents are expected to shop for coverage next year.
The state has picked a group of health plans for each of 19 regions across California."
The state picks, but it's a free market you see.
"Bidder" means various vendor supplied pricing, dumbass.
You fucker lose again.
The Buttplug reigns!
And "picked" means ...?
Buttplug gets laughed at again!
And we're still waiting on that admission about you being wrong about medicare.
It's bad enough that after arguing one point, and having it destroyed, that you suddenly insist that you were only arguing "initial" anything, which you're also wrong about.
But then you lie and c,aim you'll admit you're wrong, only to avoid doing so when you have the opportunity.
Says a lot about you.
RC weaseled out on that too - by adding "or it lays the foundation".
He is gone. He knows when he is beaten. You are too stupid to know it.
You didn't answer my question.
I asked you "And "picked" means ...?"
As to RC, he knows you're stupid and a troll, and he made his point, which you have yet to refute.
He's also more charitable and probably busier than I am on my day off.
I don't know why you think lying so often that peole won't engage you means you've made a point or won anything.
You certainly haven't refuted RC, and you even admit he's right and you're wrong right here
"lays the foundation"? Perhaps."
So, if you admit you're wrong, why are you still acting like a smug asshole who won something?
You've admitted you're wrong.
I mean, are you actually so ignorant that you think something SELECTED BY THE STATE BECAUSE OF A LEGAL DECREE is a free market?
I just want to know if you actually understand the definitions of the words you are using before I continue, it appears that you do not.
" He knows when he is beaten. "
real quick, how does you admitting he's right with "lays the foundation"? Perhaps." mean HE'S beaten?
You're wrong, you admit he's right, and HE'S beaten.
Says a lot about you.
I said they "set their own prices" you fucking idiot.
I never said "free market".
"I said they "set their own prices" you fucking idiot."
And I proved you were wrong.
And you still haven't answered my question.
I asked you "And "picked" means ...?"
"I never said "free market"."
I never said you did, learn to read please.
Look at how angry and frazzled you're getting because you're wrong.
"I said they "set their own prices" you fucking idiot."
And THEN because you were proven wrong, you shifted the claim to "INITIAL" prices, in caps, to pretend that was what you meant from the start because you were wrong.
They don't set their own prices. They have to get state approval. Their prices are also effectively capped by the OCare ratios (which have the delightful "unintended consequence" of capping their incentive to control costs). And OCare has some weasel language just begging to be made a hard approval.
As for the nonsense about "initial" premiums, they are the same as the premiums for existing beneficiaries. When you admit that the renewal premiums are controlled, you admit that initial premiums are controlled.
"He is gone. He knows when he is beaten. "
Nope, RC is wrong again. Insurers may raise premiums 10% without approval.
States have long had insurance commissioners anyway. There is nothing much different going on.
Insurers may raise premiums 10% without approval.
Yet you maintain that they can set their own prices.
There is nothing much different going on.
An admission that the current controls on premiums have deep roots is not exactly supportive of your claim that they can set their own prices.
"Nope, RC is wrong again. Insurers may raise premiums 10% without approval."
WELL DONE! You finally admit that you were lying when you claim they are "free to set their own prices".
I want to raise my premiums 11%. According to scrunt, I'm not free to do so, but somehow RC is the one that's wrong.
I mean seriously, what kind of mental defective admits that there are strict price controls while also insisting they're free to set their own prices.
" the ACA requires you hire."
And yet you admit right there that they don't.
The problem with American healthcare is that there's no connection between what a procedure costs and what the patient actually pays. Though I'm sure the Claims-Adjuster-in-Chief is very open to ordering all hospitals across the country to turn off the air conditioners.
No they won't. They need to spend more money to make up their 80% MLR.
Damn, no AC in India?
Depends on which side of the caste you are on.
Well, it's not like AC has been tried in the US, either. (Chained minds, chained markets?)
Maybe they will offer frills like AC as optional extras.
Zeb: They do.
Still, the good news is that medical tourism will be a way for Americans to do an end run around ObamaCare.
No it won't. You'll still be required to pay for the insurance. The insurance will still not be priced according to your risk, or you history of medical expenses, and thus it will not cost you any less if you go to India for a cardiac bypass. You will simply pay an additional $1,583 on top of what you were going to be forced to pay anyway.
The only reason to be a medical tourist will be as a self-sacrificing gesture of altruism to bring down insurance rates for everyone.
The voluntary exchanges do use age and other factors to price policies.
You mean government rationing panels?
No. The insurer exchanges - the central part of the ACA.
If you apply for health insurance through the exchange a private company is bidding on your policy.
Oh my god!
It really doesn't understand how the exchanges work... or what contracts of adhesion are.
It's comical how fundamentally ignorant the law's most ardent defenders are.
You idiot. I didn't say the bidding was real-time. But when suppliers provide a price for a product that constitutes a bid/quote. The quotes will vary and the participant will buy from a private party.
I love that you still don't realize why we're laughing at you.
I really love that you think you do realize it, and keep posting and missing it.
Not up to the amount that the risk actually varies by.
Also, you can't vary pricing for medical history, only tobacco use. A 28 year old with a history of cancer pays the same a a 28 year old with no major illnesses.
True, but "risk" includes age and tobacco use.
Having previously had cancer is probably a bigger risk factor than both of those combined.
Do "other factors" include "I get all my care somewhere else even though I live in the US?"
Nope. You could get all your medical care in India, not spend a dime in the US, and your insurance rates will still be the same as a person your age who had had three cardiac bypasses and colon cancer.
You do realize there is more to medical tourism than just the price of the procedure right?
That and skipping the waiting list. But I'm going to leave that out since we don't know exactly what there will be waiting lists for.
The only reason to be a medical tourist will be as a self-sacrificing gesture of altruism to bring down insurance rates for everyone.
Not at all. People who travel from Canada to OKC to get hip replacements do so out of their own self interest.
Medical tourism will be a huge factor for any who do not wish to wait in line forever or who want treatments not provided by the death rationing panels.
Wonder what it would take to set up a huge medical center just over the border in say, El Paso?
I'll bet you could get the Mexicans to bite off on it.
It would take a couple hundred million dollars, for starters. That's about what a full-on hospital with, say, 300 beds or so, costs these days.
And, you wouldn't want to put it in El Paso, which is still technically part of the US.
Was trying to come up with a border city with a decent airport so you could fly in, rent a car and drive across to Mexico. In this case, Juarez.
No international airfare, no customs...
Or pay the penaltax.
HM: Perhaps not so self-sacrificing it the results are better than government run health care.
But another reason to be a medical tourist is that almost certainly there will be long waiting periods for many procedures and tests and treatments in the US, similar to Canada, and possibly worse.
If there's a safe and cheaper alternative in India (or someplace closer, perhaps?) it would probably be worth it, and perhaps even life saving.
The same sort of thing is happening in Mexico, where American trained doctors offer price discounts much steeper than the price of a plane ticket.
There's actually a chain that caters to the wealthy in Mexico and has become quite the medical tourist attractions. I went to one of their hospitals when I got sick in Mexico. The hospital looks like a hotel--it's the prettiest hospital I've been in.
There are a couple of downsides. Culturally, in other countries, doctors aren't always accustomed to having their diagnoses and treatment choices questioned. Patients mostly just do what they're told.
And the second is that if you want to sue your doctor for some reason, your chances of accomplishing anything with that in the Mexican court system are pretty remote.
...but not being too worried about malpractice suits or the high cost of malpractice insurance is also reflected in the price. And if you can't otherwise afford the procedure you want in the United States, having more options is better--even if you don't choose to use them.
There won't by anything to prevent a low cost medical provider from setting up a high-deductible low-cost compliant insurance policy.
If the most expensive procedure is $2000 then offer a $1000 deductible plan for $40 a month.
Have faith in the market.
"There won't by anything to prevent a low cost medical provider from setting up a high-deductible low-cost compliant insurance policy."
You mean in the United States?
What if you want a low-deductable low-cost compliant insurance policy?
"Have faith in the market."
In what way does ObamaCare resemble a free market?
Yes, the Bronze policies are high-deductible.
"Market", I said.
If by "high" you mean "low" compared to current high-deductible policies.
Hazel, it thinks that when you click on a link to select a government approved and government-priced policy from a menu of choices on a website, that the people supplying the policies listed on the menu were bidding for your business.
I think I'll do to McDonalds today and see what the different burgers are bidding for my lunch-business today... 😀
Correct. Obamacare killed true high-deductible policies.
"Market", I said.
If that's what you call a "market", then I have no faith in it whatsoever.
You're missing a few problems with this approach.
The insurer doesn't set prices, providers do. Since patients don't pay any of their own costs, and even their premiums do not reflect what they tend to spend, they have no reason not to pay whatever the provider asks. Also, insuers are incentivized to spend more because of the MLRs.
What do doctors in the US have to gain by lowering prices? They won't get any more customers, because the customers already don't care what things cost.
"What do doctors in the US have to gain by lowering prices? They won't get any more customers, because the customers already don't care what things cost."
And we're mostly talking about providers here. What incentive do hospitals and providers have to lower prices...
Especially when ObamaCare requires them to spend 85% of the premiums they collect on actual medical care--meaning, they actually have a disincentive to cut costs vis a vis raising premiums...
If when I spend the money, and turn it into an asset or cost against taxes, I get to keep it, but if I cut costs, I have to spend that profit on care? Why would I ever choose to cut costs?
I don't think most progressives understand that the desire for higher profit margins normally drives companies to cut costs. That's why discussing these things with progressives is often like talking to children. And it's one of the reasons why talking about ObamaCare as if it were a market is ridiculous.
"I don't think most progressives understand that the desire for higher profit margins normally drives companies to cut costs. That's why discussing these things with progressives is often like talking to children."
I mean, seriously, this is a big problem.
We're talking about people who are so confused, they think that profit margins actually drive costs up. ...and they're adamant about it!
I said it was like talking to children, but it's more like arguing with creationists.
You can tell them "Consumers set prices" till you are blue in the face, and they still won't get it.
Right, well, progressives are informed by Marxism, which is like the creationism of economics. All profits are extracted from the surplus labor value of the proletariat and are therefore theft anyway, right?
I think they are missing a certain level of cognitive development where you start to understand concepts like risk and incentives. They really don't understand that people change their behavior in response to financial incentives. And they don't get that the employer-employee relationship is an exchange of risk for security.
I'm actually quite serious here. I think that they just are mentally defective. Some people can't grasp certain higher-level concepts which are necessary to understand economics, and those people become progressives.
But this concept is even more basic:
You mean businesses increase their profits by cutting costs?
Who knew?!
Yeah, profits are the difference between revenue and costs!
You say it works in theory, but how do you know it will work in the real world?
Oh, and does this profit motive drives cost cutting theory of yours have anything to do with Ronald Reagan?
I said it was like arguing with creationists, but creationism is pretty harmless compared to the destruction caused by these progressive idiots.
At least the creationists aren't destroying our healthcare system.
"Right, well, progressives are informed by Marxism, which is like the creationism of economics."
Marxism: The creationism of economics.
I'm stealing that.
"I don't think most progressives understand that the desire for higher profit margins normally drives companies to cut costs. That's why discussing these things with progressives is often like talking to children."
Absolutely. And the creationist example is even better because they feel so morally superior about it.
Incidentally, I don't know if the Obama Administration has made it impossible to use foreign health insurance to satisfy the individual mandate yet, but if he hasn't already made that illegal, I'm sure he's already got something in the works to do so.
Obama can't stand it when Americans are free to make choices for themselves.
And that's why his progressive supporters are America's most horrible people.
It would have to conform to all of the requirements of the law, including coverages and pre-existing conditions and community rating. Therefore, no. No foreign insurance company is going to agree to sell to any American with a pre-existing condition.
I think they might!
Why not?
Right now, you can go to that Mexican chain of hospitals and call up and get a price for whatever procedure you want.
You pay when you check out of the hospital like you're in a hotel.
Right now, the "tax" for not having meeting the insurance mandate is relatively low--so low that they're worried that most people are just going to opt out and pay the penalty. So, if they're really going to be successful in forcing healthy people into buying health insurance they don't need, they're going to have to make that "tax" for not complying with the individual mandate much more onerous than it is now. And once they do that?
Star Medica would be crazy not to offer those services--especially when some of their hospitals are cheap flight to Cancun away--or located right on the border across from San Diego.
And once they do that (raise the tax to where it becomes a penalty), Obamacare becomes a mandate and hence unconstitutional.
If the increase the penalty, that would open the way for an as-applied challange. I don't have much confidence that it would be overturned, but Roberts did leave the door open a crack when he said that at some point, a penalty could become coercive.
That's a valid point, you could opt out and pay the penalty and then just go to Mexico and pay out of pocket. It would be much cheaper.
HM: Probably not, but at a 1/50th the cost, they can pay out of pocket.
The cost of the procedure even including travel will probably be lower than the deductible anyway.
What I can see progressives doing is possibly taxing the medical tourists the difference between what they paid in Mexico and what they would have paid in the US. And possibly a fine on top of that because they are "not allowing the system to function."
Yes, they are that controlling and vindictive.
Under Federal Law, foreign nsurance carriers are treated like U.S. insurance companies that are not chartered within a state.
So, a British Insurance company must jump through the same hoops to sell insurance in MA that a California company must.
Most states prohibit sales of insurance in the state if neither the insurer has a place of business there nor the purchaser resides there. IIRC there are a couple of states that require the insurer to have an office in the state to do business there.
Some states like NH will allow a sale if neither the salesman nor the purchaser resides there, so long as the product is approved by the state's insurance commissioner.
It is theoretically possible for you to contact Lloyd's of London and to purchase a health insurance contract from them (although the current Lloyd's is not the reputable firm that its bankrupt predecessor was), and send them your medical bills for reimbursement. But, I think it would be even more expensive than the exchanges, and enforcing disputes in court might prove problematic.
Like I said, when I dealt with these guys...
http://www.starmedica.com/_EN/default.aspx
I'm not talking about sending bills to a foreign insurer; I'm talking about getting care from a foreign provider--who is also selling you compliant insurance.
That's something like the way PPOs work. You're covered--as long as you get care at our hospital. The only questionable thing is how those foreign providers cover ER services locally in the United States.
That's a problem, but when I go to Star Medica's website at the link above (make sure you check the English box) I see they've got a link for insurance company agreements:
http://www.starmedica.com/_EN/.....ments.aspx
Maybe I could sell Americans a hybrid policy, where their emergency care is covered by a domestic company, and everything else is only covered when they go to a Star Medica hospital or doctor. Pick any one you want!
I suspect I could offer cheap insurance that way, but then with the 85% rule, ObamaCare doesn't really reward offering cheap insurance, does it.
One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform.
Hahas, good one.
So where are they really saving costs? Surely AC is surgical robes don't cost $104k per procedure. I suspect that 1) the doctors and nurses are getting paid a lot less, and it's not likely you could cut doctor/nurse pay anywhere close to that much in the US, 2) you have no legal recourse for malpractice, which is all well and good unless the doctor messes up. Maybe they've also saved some money in admin costs, which could be done in the US.
It would be nice if a state or ten could opt out of this ObamaCarousel business and experiment with something I call a "free market" in medical services and health insurance. I know that's crazy radical, but maybe, just maybe, it would work.
The Democratic and Republican parties dominate every state in the Union. They will not be allowing anyone to opt out of being plundered.
opt out of this ObamaCarousel business and experiment with something I call a "free market" in medical services
So you want barbers doing open heart surgery.
THIS IS WHY NOBODY TAKES LIBERTARIANS SERIOUSLY
Don't be absurd. I want Walmart to do open-heart surgery.
Why not? They already have all those scissors sitting in that blue stuff.
Not Walmart, McDonald's; first they destroy your heart with their deadly food, then they transplant a new one.
One stop shopping, FTW!
My closest Walmart has a McDonald's. The two giants could combine to create a joint venture: McWal's Hack Shack.
That's great. It now costs more to fly to India than to have heart surgery when you get there.
I bet they could have special medical tourist flights to India or other countries that include a total package of flight, transportation to airport, procedure and hospital stay.
They already have cosmetic surgery tourism in countries that include a vacation stay afterward.
There are lots of online medical tourism packages that you can choose and take advantage of their cost-effective procedures that will suit your needs.
One of which is PlacidWay.com, I transact with them when I had my CABG surgery in Bangalore India. The hospital that I stayed in has a really good and qualified surgeons. PlacidWay arranges my flight, stay, and accommodation at the Manipal hospital. You can visit this page for more information: http://www.placidway.com/packa.....lore-India