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A Mexican Hospital, an American Surgeon, and a $5k Check
- aaron425 7y agoIt's incredible that medical tourism can allow people to be treated by a Mayo & Brigham and Women's trained physician at a fraction of the cost, and that the physician actually makes more. I suppose much of the expense here is what American facilities normally charge, though I wonder if the stated prices in the article are before any negotiations between the providers and payors.
- teej 7y agoDon’t mistake “more than what the doctor would make from Medicare” as anything close to what they make normally. Medicare pays pennies on the dollar.
- merpnderp 7y agoThe US doesn’t have a free market healthcare system, it has some corrupt charade where aspirin can cost $300 and seeing a doctor in an ER for 2 minutes can cost $3,000.
- MrLeap 7y agoThis is the most absurd escalation I've read regarding the US healthcare system. What a laugh. Since it's this bad, it alludes to vast untapped potential for more cost saving measures that are both funny and embarrassing. A quick google suggests prisoners have to pay 10-100$ copays in some states, but otherwise receive care. I wonder if there's a topology of illnesses where a financially optimal course of action to acquire treatment is to commit some petty crime and receiving treatment in prison? After lost wages, and earnings potential from your now tainted record, and all else. There might be! Here's a business idea that might already exist, vocational-technical elementary / pre-school for trying to lead your own children into and through medschool. Doctors are so expensive you might as well make your own! That one baby saving medicine that just got approved costs like 2 million dollars, right? For anything ~ 200k+ that isn't literally holding your baby hostage from imminent death, it's probably cheaper to get a degree in chemistry and some lab equipment. https://www.vice.com/en_us/article/43pngb/how-to-make-your-own-medicine-four-thieves-vinegar-collective https://www.vice.com/en_us/article/43pngb/how-to-make-your-o... It's crazy, but only in a crazy system can things like this approach rational. Here's another idea. What if patients could rent hospital administration as a service. Put payment for a procedure in escrow, sign all the malpractice waivers and try to attract a doctor like tinder. I'll sign all malpractice waivers if you'll just cut this cancer out of my gut. We can use my living room! It's this or death anyways so fuck it! America WOO
- gambiting 7y agoAmericans need to raze their healthcare system down to the ground. None of the bandaid fixes like getting the government to pay but still having private companies dictating the prices. The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, but it's past the financial absurdity at this point, reading about insurance companies literally deciding whether cancer treatment is "strictly necessary" for weeks without approving it is not a healthcare system, it's hell, it's barbarism.
- rsyring 7y ago> The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, How involved are you with other US government organizations? Do they usually strike you as highly competent and efficient? Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
- rootusrootus 7y agoWe could choose to staff them with competent people instead of deliberately sabotaging it. There are viable alternatives to the GOP strategy.
- b_tterc_p 7y agoIf only someone had thought of that before
- deleted 7y ago[deleted]
- mikeash 7y agoMaybe we could run it similarly to the government-run air traffic control system, which is superb. “Government” doesn’t have to mean “incompetent and inefficient.”
- dsfyu404ed 7y agoSeems like a win for the patient and the insurance company and clearly worth the surgeon's while (or he wouldn't have gone). Personally I'd have no problem signing up for a "everything over $x and we send you to Mexico" plan.
- koolba 7y agoThis is a crazy story. All that’s missing is a connecting flight through Canada on the return to pickup some prescription drugs.
- Scoundreller 7y agoProbably still cheaper in Mexico.
- mlindner 7y ago> Dr. Parisi, who spent less than 24 hours in Cancún, was paid $2,700, or three times what he would have received from Medicare, the largest single payer of hospital costs in the United States. Private insurers often base their reimbursement rates on what Medicare pays. This is what happens when most of the actual health care cost is going to fat administrator paychecks.
- Scoundreller 7y agoIt's 25% in the US on administration. The low end is 12% in public health systems. https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html https://www.nytimes.com/2018/07/16/upshot/costs-health-care-... The more likely answer is: Everyone else is paid less and everything else costs less. The extra costs in the US will be some combination of total nonsense, marginal (you should get some compensation when errors cause you harm) and very real (e.g. Replacing HVAC filters on schedule, having someone go through lab results for the last month's infections and figure out which antibiotics to use the next time when you can't wait for results).
- wil421 7y agoIn 2004 I was in Cancun and met a few people doing this kind of thing. It was for plastic surgery type stuff that wasn’t covered by insurances. Not nose job stuff more disfigurement or getting something unsightly fixed. 15 years later they have a hospital catering to this. It was sketchy back then and I heard of botched jobs with not so great surgeons. Here we are 15 years later where they fly in surgeons and pay the patients. Anyone want to build a system to connect hospitals overseas with insurance companies/patients?
- elliekelly 7y agoIn Florida they have a boat that goes out to international water, drops anchor, and lets everybody gamble for the day.[1] Perhaps we aren't too far off from Norwegian Cruise Knee Surgery and Holland America Hip Replacements. [1] https://victorycasinocruises.com/day-cruise-central-florida/ https://victorycasinocruises.com/day-cruise-central-florida/
- chiph 7y agoAs this grows in awareness and popularity, I can see US healthcare providers lobbying to make it illegal. Which would be tough - what do you do, put heart surgeons on the no-fly list?
- elliekelly 7y agoStates could decide to take away their medical licenses. I would hope politicians would choose to fix their mess of a system rather than punish doctors but perhaps that's overly optimistic of me.
- bro25 7y agoA politican will have a choice: a 50 M bribe from healthcare mafia or being the good guy for a few weeks until his name is forgotten.
- armandososa 7y agoWe have pretty good doctors down here too, why the need to fly one form the USA other than prejudice?
- eipipuz 7y agoAs the article mentions, so you can sue if something goes wrong.
- refurb 7y agoMy mother’s friend did medical tourism and it went horribly wrong. When she got back home, local doctors were like “i’m not dealing with that problem because I didn’t cause it”. The continuity of care is way better if you can keep the same doc once you get home.
- wtdata 7y ago> Dr. Parisi, who spent less than 24 hours in Cancún, was paid $2,700, or three times what he would have received from Medicare This illustrates perfectly the point I (and most everyone on Europe) tries to get to Americans and often they - for some weird reason - refuse to understand: healthcare can be cheaper and better to everyone (yes, this means that universal healthcare can and is cheaper on the taxpayers in most of the EU than for American taxpayers... with ours being universal), if you just understand that the middle man you created by wanting the state out of it, is getting most of the money. It's really so simple to understand...
- monetus 7y agoMedicare for all is incredibly popular when you compare our system as a whole to others. The perception of loss, that people will suffer waiting in line or that their trusted doctor will be unavailable, has been the lynchpin in the campaign advocating for middlemen. Scare tactics are tried and true here in the U.S.
- wtfrmyinitials 7y agoI’m not sure I understand your point. The surgery was done in a private hospital and paid for by a private health insurance company. It certainly points out that care in the U.S. is too expensive, but I’m not sure how it indicates a single payer system is the best course of action. The doctor was also paid 3x the Medicare rate which sounds like a good thing to me. Am I missing something?
- paulsutter 7y agoHe literally said "healthcare can be cheaper and better", and this story definitely proves that.
- theredbox 7y agoHealthcare in Europe IS NOT SIGNIFICANTLY cheaper. It is just someone else footing the bill for you.
- PunchTornado 7y agoSometimes I'm thinking I'd love to work in USA. But reading this stories is very scary. When you have an emergency situation, you shouldn't need to find out if the doctor/hospital is on some network. One commenter on the article complains she was charged 65k.. waw. I'm glad for the nhs.
- codingdave 7y agoHaving had a number of surgeries in my life, I do care that my surgeon is well-trained. But I care even more about the anesthesiologist.
- BadassFractal 7y agoHow does one find any hope in a system like this?
- RhysU 7y agoDespite all the structural crazy, two self-interested parties agreed to a mutually beneficial trade. That is, capitalism finds a way.
- maximente 7y ago> Mr. Stackpole said only a limited number of Americans were willing — even with a financial incentive — to travel abroad, because most perceive the care won’t be as good. this meme that the US has the best and brightest in everything and nobody else holds a candle is both hilarious and depressing. it is now costing people their lives and creating financial ruin, but it seems that US health parasites are still pumping it.
- paulsutter 7y agoWhy are people so surprised? This is a great story and everyone should do it. The US system is gridlocked regulatory capture by scammers scamming scammers. Anything to route around it is a great idea. In Japan I had no insurance, but my shoulder bothered me so I walked in to see my doctor the next morning (no appointment, $100), he scheduled an MRI for the next day ($300), and two days later I paid extra to talk to the radiologist($75) to see the damage up close. By the time I saw the surgeon the next week, I already knew I should do physical therapy instead of surgery. In the US this would have taken many weeks and thousands of dollars. Meanwhile, back in Seattle, a doctor said "take this paper to the emergency desk to get a scan". Bad idea, that cost me $5500 and 8 hours of imprisonment. I couldn't leave after the scan, I waited hours longer for the doctor on duty to give a diagnosis (for a scan?), and of course she billed me separately for that.
- com2kid 7y ago> In the US this would have taken many weeks and thousands of dollars. The many weeks part is not true, the $ part is pretty much random and unknown. Every time I've gotten injured, it has been a next day appointment, or I just walk into urgent care, and an MRI/Xray scheduled a day or two later. The imaging clinic my doctor uses provides a complete price sheet before any services are given, saying exactly: 1. How much the overall bill is 2. How much they will be billing and reimbursed from the health insurance company 3. What the patient's total will be > Meanwhile, back in Seattle, I'm also in Seattle, find a better clinic! (Also ERs are overkill for 99% of things, sucks if you get injured after Urgent Care hours though...)
- paulsutter 7y agoIt wasn't an injury. I was at Swedish for a routine checkup and the doctor handed me a piece of paper and said "take this to the emergency desk, they can get you a scan". I had no intention of being checked into the ER and no idea I was about to be imprisoned for 8 hours. It wasn't a big deal for me to be robbed like that, but for most working people a surprise unnecessary $5500 bill would be a real problem, so it's infuriating.
- epmaybe 7y agoThis is a misleading article. If the patient truly qualified for outpatient total knee replacement (orthopedic surgeon was out of Cancun in less than 24hrs per the article), the cost of this procedure would have been around $11,677 in the US at an ambulatory surgical center. Per the article, the cost of the procedure in Cancun was..."but at Galenia, it is only $12,000". I will definitely give credit where it is due, as the inpatient cost in Mexico would be far cheaper than in the US. Disclaimer: I am a medical student, so please keep my biases in mind. I have no skin in the game, and I totally get that prices in the US are abhorrently high. Please read the following articles to gain a better understanding: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.3.89 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.3.... https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05144 https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05144 Source: https://www.eurekalert.org/pub_releases/2019-03/hfss-nir031319.php https://www.eurekalert.org/pub_releases/2019-03/hfss-nir0313...
- classics2 7y agoYou’re mental if you think you can get a knee replacement for $12k in the us. People who make one trip to the Ed here, with insurance, for something simple like an infection end up with bills over $20k for little more than what ends up being an ultrasound, A lab test and a script for antibiotics.
- Scoundreller 7y ago$15.5k at Surgery Centre Oklahoma for a total knee replacement: https://surgerycenterok.com/ https://surgerycenterok.com/ EDs don’t have competition like outpatient surgical centres do.
- epmaybe 7y agoI don't think he read my comment in full, where I specifically mentioned that it would only cost that much at an ambulatory surgical center, linked to a source, and accepted that it would definitely cost more in a hospital.
- pier25 7y agoI live in Mexico with my Mexican wife. Earlier this year she had a minimally invasive heart valve replacement (instead of opening all the chest they did via a smaller cut on the side). She was walking out of the hospital 4 days after the surgery. We paid about $6500 USD which included everything. The mechanical valve, surgery, hospitalization, etc. Some people pay a lot less than that since the price is according to a socio economic background check the hospital makes.
- Scoundreller 7y agoIn the US, the valve would have cost that.
- noir_lord 7y agoHow long until someone converts a cruise ship to a hospital ship and parks it off the coast. The US healthcare system just gets weirder and weirder, almost everything has been tried except fixing it.