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Friday, September 14, 2007
Bill Steigerwald :: Townhall.com Columnist
How The Swiss Do Health Care
by Bill Steigerwald
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Everyone knows our health-care system, superior as it is in so many ways, is too expensive, too bureaucratic and wasteful.

Basically, we hand over about $2.2 trillion each year to hospitals, insurance companies and government paper-pushers -- and then we let them micromanage our health care like we are helpless babies, not rational consumers.

Everyone also knows by now that Canada’s “free” national health care system -- like its sibling socialistic systems in Britain and France -- is a just another Big Government fraud.

So can any wealthy, modern country get health care right without resorting to socialism? Yes.

You never hear it touted by the media but Switzerland uses market forces, not government rules and red tape, to create a private, affordable, high-quality health-care system for its 7.5 million citizens. And it spends 40 percent less per capita than we do.

Sen. Tom Coburn, an Oklahoma Republican, a fervent fiscal watchdog and a practicing physician, knows all about the Swiss system. Much of his proposed health-care reform bill -- the Universal Health Care and Access Act -- is modeled on it.

Coburn’s plan, a major overhaul that can be found at coburn.senate.gov, is complicated, controversial and in no danger of becoming law anytime soon, if ever.

The bill's key elements include achieving universal health-care access by using tax credits to pay for individual or family insurance, phasing out reliance on employer-based insurance, allowing people to choose their own doctors and health insurance and stressing preventive care.

On Wednesday, Sen. Coburn explained why he likes the Swiss system, which operates sort of like our car insurance: You must buy health insurance but you can choose among many plans from many private companies.

Since every Swiss is covered, Coburn said, there is no cost-shifting -- i.e., no hidden subsidizing of those who don't have insurance at all or don't have enough. Cost-shifting costs Americans about $250 billion a year, Coburn said. Ending it would save a family of four about $4,000 a year.

Another virtue of the Swiss way, Coburn said, is that it has fostered a range of innovative insurance products. For example, there are five-year policies that reward customers with lower and lower rates if they do the preventive things the company asks. A third virtue, he said, is a national high-risk pool that all insurance companies contribute to that essentially protects companies from suffering heavy losses in a given year.

Fixing America's health care won't take more money, said Coburn, who notes we already "pay too much. ... One out of every $3 we’re spending today didn’t go to help anybody get well and doesn’t prevent anybody from getting sick."

"What we need to do is we need to start changing our paradigm to prevention instead of treating chronic disease. That’s what has happened in the Swiss system, and that’s why their costs are not going up."

Switzerland is tiny and doesn't have our social problems. But Coburn says its consumer-driven approach -- which is transparent to consumers in price and quality -- would work here.

Coburn knows markets aren't perfect. But he knows why the Swiss system works so well: "It forces people to shop, it forces people to make decisions. ... The point is, markets work -- if, in fact, we’ll trust them."

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About The Author
Bill Steigerwald, born and raised in Pittsburgh, is a former L.A. Times copy editor and free-lancer who also worked as a docudrama researcher for CBS-TV in Hollywood before becoming a reporter for the Pittsburgh Post-Gazette and a columnist Pittsburgh Tribune-Review. Bill Steigerwald recently retired from daily newspaper journalism..
 
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Communists don't want to help
This article doesn’t explain how the Swiss system treats people who don't have a job and thus don't pay income tax. This is what the Demoncraps are trying to "fix". They wish to ruin the system that 85% of the people are fine under so that 5% who are chronic unemployed and 10% who don't wish to have insurance will get it.

If the lying Demoncraps were serious about helping people with healthcare, the first thing they would do is propose elimination of the 7.5% floor on healthcare deduction on income tax. That would go through congress like fecal matter through a goose with little or no debate.

But that would not be in keeping with their communist nature so it will never happen.

Overstated
When one researches the medical health systems of Canada, the UK, France, Netherlands, Germany and yes......Switzerland, you will see that they are fraught with difficulties, rising costs, strikes among physicians, high premiums with no end in sight and increasing deficits in their many bankrupted health schemes.

Just to get you started, take a look at these excellent sources, no hype, just facts.

http://strategis.ic.gc.ca/epic/site/imr-ri.nsf/en/gr116905e.html

http://www.zurich-relocation.ch/content/health/doctors_dentists.html

http://www.swissnews.ch/backissues/2005/10.05/06-07_Health.pdf

Attempting to compare a diverse society such as the USA which has an illegal alien population almost twice the entire population of Switzerland is patently ridiculous and it's really tiresome to see studies that attempt to put our health system alongside of those of any of the above countries. We have over 300 million people to provide health care for, and the majority of these have insurance. The often touted 47 million who are supposedly uninzured cannot, by law, be denied emergency care and, for that matter, are provided for by the Medicaid and/or Federal Children's Health programs.

That we have nearly 85% of our population in some form of health insurance with the remainder eligible for Medicaid and are also providing illegal aliens with medical care to the tune of more money than the economies of some of the above countries and ALL at a lower net tax rate than any of the above is, to my mind, something to be praised rather than scorned.

At the same time, our physicians are being paid twice to five times those of their counterparts and most physicians in any of the mentioned countries would give their eye teeth to establish a practlce in the USA.

But who cares about the bright side?

Did I forget to say that our GDP is $10000 higher than Switzerland, Canada, France, Germany, Netherlands? Gee, life's really tough.




Never going to happen....
The possibility of America ever having some sort of ever having a uniformed healthcare system is just an absurd Utopian pipedream. You think the big drug companies and greedy HMOs are going to sign on board? Not a chance. Anyhow, the American sheeple seem perfectly content just to twist in the wind when it comes to enriching greedy HMOs and drug companies so why upset the applecart as we continue walking hand in hand to a horrible screaming death?

Comments on Article
This is a good idea:
"For example, there are five-year policies that reward customers with lower and lower rates if they do the preventive things the company asks."

Bill Steigerwald didn't say, but I'd be willing to bet that the Swiss health insurance companies must provide needed services to the chronically ill; and, further, that the chronically ill pay the same rates as everyone else (no cherrypicking only the health ones for their plans). (Chronically ill: diabetes, Parkinson's disease, asthma, etc.)


Health Care
Nobody will ever take health care reform seriously with Michael Moores face on the cover page.

Herr Steigerwald feels, no doubt, ....
.... that he is writing about "health care."

But he is not. For America's health care industry, practitioners and practices are second to none and most certainly need no lessons from Euro-peon neo-Soviet states.

Not even for the manufacturers of the world's best cuckoo-clocks, its second best watch and cheese makers and third most efficient (after Hollywood and Singapore) launderers of the criminally gotten gains of the world's gangsters and/or politicians and/or UN bureaucrats, contractors and/or suppliers and/or looters of international AID and/or drug and gun runners!

What he is writing about is health insurance or as the Euro-peons - including those glommed to our northern border - prefer to not call it - having the state steal other folks' money to pay my grand-ma's doctor bill.


missing from the debate
I always find it interesting that key elements of healthcare are always missing from the debate. The debate is usually about how the country can throw more money at the problem via socialized or private enterprise methods.

-Doctors are part of the problem: Doctors control the supply of doctors to the system and keep the supply constrained so prices stay high. Doctors control the state boards of medicine, and medical colleges. Doctors aggressively fight any attempt by lower level medical professionals from delivering service without a doctor getting a cut of the proceeds. To a large extent this a government enforced monopoly. Doctors are not royalty… they are service providers… make them compete.

I think a competing medical accreditation body to put the AMA in check would go a long way encouraging the supply of lower cost medical services and products.

-The FDA adds a lot of cost to the fielding of new medicine. If the FDA had a mandate to control the cost of getting new medicines approved, then the pharmaceutical companies would not have such a high cost to recipe. Maybe the FDA could have a tiered approval process and consumers could choose if they want to pay for the billion-dollar drug, or the 200 million dollar drug. Maybe the FDA could recognize approvals from other advanced countries… for instance Western Europe. The FDA adds tens of billions in cost to the medical system each year.

-Lawyers and tort law add billions of dollars of cost to the medical system each year. Lawyers and politicians have encouraged consumers to expect medical care that is cheap and perfect… which is a fallacy. If we could limit the number of law suites and level of awards under control, costs would come down.

for pjal
pjal writes: "The often touted 47 million who are supposedly uninzured cannot, by law, be denied emergency care"

What about chronic illness, which is a far bigger driver of costs?

YOU try getting care at the Emergency Room for cancer sometime! Fred Thompson, as you know, was diagnosed with lymphoma. That required frequent tests, visits, etc. to oncologists and other specialists. Just the cost of prescription drugs for chemotherapy to fight Fred's lymphoma could cost him $25,000 a year, for several years. Those who are unemployed are usually the ones without the health insurance and hence they can't pay $25,000 a year out of pocket either.

You can't get THAT kind of long-term care at an Emergency Room--fighting cancer is a battle that goes on for years.

So I ask you: What do you propose someone without health insurance should do if they are diagnosed with Stage III cancer? Just blow their brains out and "decrease the surplus population" as Ebenezer Scrooge said?



no bs artist
"... to enriching greedy HMOs and drug companies ..."

I doubt if these people are any greedier than anyone else. I changed my mind about greed after seeing lots of leftists in academia who were greedy and stingy.

Plus, you could just as well talk about greedy malpractice lawyers, who have driven costs up so much.

WHY ARE AMERICANS ?
My caveat is simple.Why are Americans so unhealthy?I hear of people using more than one medication.Why?Americans must address this fact,if we have any "HOPE" for the future.

Swiss Health Care
How do the Swiss do it?
Heart of Europe-no war since when? How long?
Four languages-German, French, Italian, Romansch
Natural resources: Alps? Snow?
Doesn't every man between 16 and 64 have to have a rifle at home? Aren't all in the reserve?
How many murders per year?
Any student riots?
Any Muslim violence?
Women didn't vote until very recently.
Very high standard of living. High average income?
Any geniuses? How many Nobel prize winners-native born.
But still it seems to be an admirable country to me.
Of course, they did have secret bank accounts for the crooks and tyrants of the world.
Donald W. Bales

The cost of health care in the U.S.
I pay about $10,000.00 a year for health care coverage for my wife and I. I retired at 60 so we are caught in the squeeze between retirement and medicare. In the 5 year period our medical costs were no where near what we paid the insurance company, so we helped bridge the gap for others i suppose. I see far too many Americans who are health obsessed. If you engage in conversation with any group of people over the age of 40 you will hear plenty about doctor visits and pains. THe avg. 80 year old in the U.S. takes 18 different pills every day. Those who dont have insurance wear out the emergency rooms as their prime care provider. We as a nation think we can live forever on modern medical discoveries. We would do well to think more about our spiritual well being and also take care of our bodies with the correct food and a good walk every day. The democrats see health care as a way to get votes, but the problem is very complicated, and the solution will not be easy. We do have the best health care in the world, its just far to expensive..

SteveL
suggests, "What do you propose someone without health insurance should do if they are diagnosed with Stage III cancer? Just blow their brains out[?]"


To many people with terminal illness, it's a viable option. Why spend the family fortune on essentially useless medical care when the ultimate result is death anyway?

Unfortunately, too many people in America demand that the fatal disease run its full and complete course prior to the patient's demise.

Health Care
Greed? Are people greedy who want a service and have someone else pay for it? A comment in the newspaper several months ago about health care sticks in my mind. "I don't want charity, I just want what everyone else has." Greed? Envy? Covetnessness? Jealousy? It's apparently not charity if it comes from the government. What has happened to our moral compass that these comments go virtually unchallenged?

I don't know
about this plan either. Why are we forcing people to have health insurance. The only way I would go for this is if all entitlements are done away with. That will never happen. Furthermore how are you going to enforce forced health care...by growing govt. to a phenominal amount that's how.

Phylo
I usually avoid responding to you or even reading you because your just not that smart. But today I did. First off we don't have a free market currently. Secondly, you are quite the communist Robin Hood stealing from everyone to give to your pet causes whether they agree or not.

Focus in the wrong place
While is has been mentioned, both in the article and in a comment or two, it seems that the majority keeps talking around the most important aspect of HEALTH care. That is a system directed to keeping people healthy in the first place, as opposed to only taking care of people after they have become ill.

Phylo
The market-based health system we had when I was a kid back in the 1950s seemed to work fine. Then, beginning in the 60s, greedy malpractice lawyers ruined it.

The non-market-based school system worked fine back then, too. But since the 60s, it has gotten so screwed up that even inner-city blacks want vouchers.

Face it, in both cases, what was working fine went haywire because liberals and leftists ruined them.

Phylo
Your statement was essentially, that even though socialized healthcare would have problems, it would be much better than what we have now.

It is too bad the facts slap that argument in the face with a wet fish. Those systems are not better. People die on waiting lists for medical procedures constantly in those countries that have the system you desire. There are those in Canada who would like to buy their own medical care outside of the government system. Why, if it is so great?

You accused Republicans of constantly holding up the free market as a solution to everything. There is some truth in what you say. But you are the textbook example of the modern leftist. If something is broken, give it to the government! They can fix it! As always, the truth is somewhere in the middle. Oh, and for the record, you dont have a right to anything, that someone else has to provide for you. That includes healthcare.

johnnyP
Well said!

I would also add that until we get a handle on our illegal alien population that bilks our health care system each year and is responsible for closing hospitals due to bankruptcy is another factor that needs to be addressed.

The scary aspect of the article's proposal is the "preventative care" portion requirement within the mandated insurance coverage. How might that translate into going beyond paying for routine health check-ups (mammograms, etc) to being a nanny-state that further interferes with personal choice and accountability?

Would we soon have government telling us how many hours a day we must exercise, what kinds of food we could purchase/eat (Low-fat, low sodium etc etc) all in the name of "preventative care."

I like the market-based insurance, but it has to go hand in hand with other reforms (see johnnyP's post) and further reduce government mandates and red tape. And, it has to be a CHOICE.

JFP
Wasn't it the Republicans who exclusively passed the 2003 Medicare Prescription Drug Act that prevented Medicare from negotiating drug prices? Free market principles are great until there's an extra buck to be made by your campaign contributers.

Competition in education
There was competition in education. We provided a very basic education to all but, you had to pay for advanced education and it was competitive. You paid more for some "prestige" colleges and less for others. Some had more social activities and others, less.

Also, in the 40's when I went to grade school, many parents sent their kids to schools run by churches that charged a fee. They did so because the schools had more discipline and focused more on morality than did public schools. There was always competition in education and it helps keep education standards higher when parents have a choice.

Same with healthcare, as we can see from Canada where they are considering privatizing some of it again to make it more efficient.

The point isn't whether the Swiss system is "best" for us our not but if it has things in it that when combined with other things for our unique nation, they can be used to help correct the huge problems we have.

A $200,000 heart operation here costs $10,000 in a same quality hospital in India where the mortality rate for the patients is actually as good or slightly better than here. Many Canadians, U.K. citizens fly to India for operations where they don't have to wait and the cost is often less than the cost of insurance for us.
quote:
Medical Tourism Takes Flight
By Kathleen Doheny
snip-------
Woodman estimated that more than 150,000 Americans traveled abroad for health care in 2006. The number is projected to double in 2007, he said.
http://healthfinder.gov/news/newsstory.asp?docID=605846
==============================
The people flying there can often afford health insurance but, have chosen to not have it or are in a nation with long waits for operations.

A Small Beginning
The present system is rife with fraud and greed, therefore there has to be a practical solution to lowering medical costs to a noticeable degree. When 45 minutes in an emergency room costs $12,000.00 (and that does not include the physician charges, lab work, or medications) something is wrong. Of course, a lot of that is the result of paying patients having to cover charges for those who do not pay, but the costs themselves are unconscionable.

For a start, why not offer doctors just starting out after internships, reductions in their student loans, so much for every quarter that they work in neighborhood clinics (which would not take that much to set up.) There could be other incentives offered making the program attractive to a doctor who has $250,000.00+ hanging over his/her head in student loans. Babies with high fevers, bleeding cuts and abrasions, bouts of flu and respiratory problems which can lead to pneumonia, diabetes management, vision coverage for those who need glasses, referrals to dentists who would take certain numbers of patients at “charity” fees, and many other non life threatening medical problems that tie up hospital emergency rooms could be dispatched in half the time at a fraction of the ER costs. Medicines would have to be dispensed also, but I hope drug companies would participate to a certain degree. It would be a wonderful opportunity for doctors to see a wide variety of problems, great practice for incoming EMTs and Physicians Assistants, and there could be recently graduated RNs available for triage. If a pilot program could be instituted in a large city so that it could be evaluated, what have we got to lose?

I know this is overly simplistic and someone will poke big holes in it, but we have to start somewhere. I also realize it only addresses a small slice of the medical cost problem. A journey of 1,000 miles begins with one step. What is your idea?

Old Man not World Savvy
OldMan stated "A $200,000 heart operation here costs $10,000 in a same quality hospital in India where the mortality rate for the patients is actually as good or slightly better than here."

Considering that the average Indian income is about 17,500 rupies (about $433 US) that $10,000 heart operation is far more out of reach to the average cash-paying Indian citizen then a comparable American average american earning $40,000 year. (Thats 2.5 x annual income in US for surgery vs 22 times annual income in India). Relatively speaking then, a heart surgery is 20 times more expensive in India than it is here.

Ron Writes:
"THe avg. 80 year old in the U.S. takes 18 different pills every day. "

Damn those evil drug companies, how dare they take advantage of the elderly like that.:-) Of course, not many people can live to 80 without taking those pills, and no one is forcing the pills down the 80 year old's throat. They are free to save the money and take the consequences.

A simple solution is under our noses
Simply put, with the addition of perhaps ten or fifteen adminsitrative personel in any given county or parish, one could administer EXISTING health care to all citizens of said districts.

The bottom line is that every citizen of said demographic should be allowed to, at extremely reduced rates, buy into the existing health plans provided by any given county. All that would be needed is proof of residence and the ability to purchase said insurance at the same premium as the county employees.

By increasing the number of participants to include the residential population of said county the premiums would go down for all involved thus making it affordable for almost everyone.

The only additional cost would be as I indicated at the outset the additional administrative costs and that would be nominal considering that the processes are already pretty much in place.

But this plan is so simple that any given politician who sees health care as a platform would not abide by it as it takes away the need for their overblown public posturing.

The Health Care Problem
We need to fix the health care issue but we cannot fix it unless we know how it is broken. For the answer, please see http://www.InteliOrg.com/

Cam
Yep your right. and those same Republicans got voted out for their efforts.

Old Man
Your facts are completely bogus.

Ron
Those pills actually save money. A pill is still much less expensive than a procedure and usually more effective.

Free Healthcare
San Francosco is going to give all its residents free healthcare.It is going to be fun watching them try to get the rest of the state or federal government to pay for it.Wait until all those people that have insurance decide that they drop their insurance for the free healthcare.Are they going to tell them they can't do that.Bet they will.

Market-based systems DO work for all
The whole premise of the market is that someone (the "supplier") has something another person wants (the "demander"). In the cases of education and health care, some claim that the market can't provide. This is hooey. Doctors or teachers have what patients and students (or their parents) want. The issue is, how much does the demander want what the supplier offers?

People assume that because someone wants something, it should be available at whatever price the demander chooses, rather than at a price the supplier and the demander can agree on. So, enter Big Brother, who will force the supplier to accept what the demander chooses. This is, of course theft of the supplier's services. Theft make the victim a slave.

To alleviate this little problem, B.B. changes the victim--from the supplier to the taxpayer: he steals the T.P.'s money to pay the supplier so the demander can get what he wants at his price (which constantly falls, btw). It's now the T.P. who is the slave.

Socialism is based on slavery.

Le
==
Please visit http://www.schoolandstate.org

Overlooked
1) A tax-credit based health-care system assumes...taxpayers. IRS tax records show the majority of taxpayers pay only a small portion of the tax bill. With the "earned income" tax credit, a large number of tax filers receive a "refund" larger than the sum of taxes paid. How does the Swiss "tax-credit" funded system accommodate those paying no taxes--let alone all those whose refunds exceed tax payments?

2) Can ANYONE name ANY government program setting standards for organization & efficiency? Look at all the games Congress plays with ear-marks on the annual "Defense" budget (including...subsidies for Beekeeping operations in California???).

What sane individual thinks that similar games & political pay-offs won't be maneuvered into a new $2-4 trillion a year government appropriated program?

3) As long as medical treatment is "free," there will be waste & abuse. As long as doctors & hospitals are forced to practice "defensive" medicine, there will be waste & abuse. As long as the co-pay for a prescription drug is cheaper than over-the-counter remedies, there will be waste & abuse. As long the number of medical schools & students are being limited by regulation, supply will not meet demand.

Until these issues are addressed, health-care costs will elude control. The only true solutions will be a system where access is limited for non-payers, where users are incentivized to economize, where government intervention is both focused & limited, & where the supply of doctors is permitted balance demand.

Can’t you trust happy people?
Most everyone is calling for a Health Care System that costs less and does more, than what we have now. Since everyone wants a change, it is obvious that since everyone would be happy with a low-cost solution, we can expect them to be honest and trustworthy.

We can get rid of all bureaucrats — government, insurance, and in the doctor’s office — that take care of all the paper work these days.

Just let each doctor and medical institution write a check on a government account at the end of each day. There would be no need, therefore no cost, to administrate such a system, thereby cutting the cost for the government operated single-payer health care system by billions of dollars, each year.

Can’t you trust happy people?

San Francisco
Let's see how much health care is going to cost in the AIDs capitol of the country...if other San Francisco residents have to pay for that health care, that is OK with me, but I don't want to be involved...but, then, aren't we already involved? Sure we are, and with Pelosi and her ilk representing that area, you can be sure the Federal Government will be asked to kick in an unusually large amount of "free tax dollars" to make the program work. Ugh!!!!!

I agree, Phylo.
Simply put, the health insurance companies business model is to sell a bad product at a high price. However, this is not indicative of a "free market" as much as it is of a monopoly.

It's not the Swiss that we need to focus upon but "Denmark on the Potomac" and all that is rotten there and in the 50 state legislatures.

Health care insurance has gone from being a luxury, to a benefit, to a necessity (but it is not a "right). Nevertheless, it's still too important to be left for government to administer and Wall Street to regulate. The answer is somewhere in the middle.

Bucko*

*a popular compulsive affectation of some supercilious posters on TH that I thought I'd mimic.

Health Care
Socialism is based on slavery, the assumption that the common man is uncharitable, and the assumption that the government agent is charitable and will handle other people's resources better than those people will.

Justme
Just because more people are enrolled in an insurance program doesn't mean that the premiums will go down. Depending on the overall profile of the "group" the premiums could actually go up.

forced to pay for insurance
The article is correct,I am forced to have auto insurance, however, I must have at a minimum Liability insurance to protect the other guy from loss. I don't have to have insurance to protect myself from loss. If I'm a healthy 25 yr old, why must I be FORCED to buy something I probably (and satisticaly) won't ever need?? If I'm going to be forced to purchase it, might as well let the gov insure everyone and just levi a tax.

Responding to Steve L
Steve L asked;
So I ask you: What do you propose someone without health insurance should do if they are diagnosed with Stage III cancer? Just blow their brains out and "decrease the surplus population" as Ebenezer Scrooge said?
_________________________________________

You choose to ignore the context in which I'd mentioned that Federal Law requires that everyone is entitled to emergency care notwithstanding their ability to pay........that comment is just one component of my critque of the suggestion that the so called 47 million uninsured are going without care.

Had you not been seeking a means to selectively ignore the whole in favor of one strand of the entire fabric, mention was also made of Medicaid and the Children's Health program, between them, they cover over 40 million people.

And if you were nearly as informed as you want the rest of us to believe you are, you'd not ask a question such as you posed without knowing the answer first.

The subject of your hypothetical would be entitled to Medicaid. As it happens, my former wife, now in her late 70's experienced the same condition of which you spoke, she's also a diabetic on dialysis. Before turning 65 her expenses had been taken care of by MediCal (California Medicaid) then she was declared by Social Security to be totally and permanently disabled and qualified under Medicare.

Anyone who is suffering from Stage 3 cancer would receive care, just as she did.

About "blowing her brains out"? That's just nonsense and you must know that, then again, you may not have enough up there to know the difference.


Old Man's facts
Are from leading medical sources on healthcare.

I provided the link for the source.

Also the private hospitals in India don't serve the "poor." Their public hospitals do that. This is nothing new. It has been going on for years.
Quote:
The price savings on cross-border medical care can be dramatic. For example, one commercial medical tourism Web site (www.medicaltourism.com) estimates that a heart bypass in the United States costs $130,000, but just $10,000 in India and $11,000 in Thailand. A hip replacement in the United States would cost $43,000 but just $12,000 in Thailand or Singapore. Hysterectomy costs are about $20,000 here but $3,000 in India.
====================================

Those hospitals and medical facilities specifically cater to "medical tourists" from "high cost or slow service" nations.





More info on healthcare in India
Note: the following is from 3 years ago. So, again, this is nothing new.
quote:
Thursday, October 21, 2004; Page A01

NEW DELHI -- Three months ago, Howard Staab learned that he suffered from a life-threatening heart condition and would have to undergo surgery at a cost of up to $200,000 -- an impossible sum for the 53-year-old carpenter from Durham, N.C., who has no health insurance.

So he outsourced the job to India.

Taking his cue from cost-cutting U.S. businesses, Staab last month flew about 7,500 miles to the Indian capital, where doctors at the Escorts Heart Institute & Research Centre -- a sleek aluminum-colored building across the street from a bicycle rickshaw stand -- replaced his balky heart valve with one harvested from a pig. Total bill: about $10,000, including round trip airfare and a planned side trip to the Taj Mahal.

"The Indian doctors, they did such a fine job here, and took care of us so well," said Staab, a gentle, ponytailed bicycling enthusiast who was accompanied to India by his partner, Maggi Grace. "I would do it again."

Staab is one of a growing number of people known as "medical tourists" who are traveling to India in search of First World health care at Third World prices
http://www.aarogya.com/HealthResources/medicaltourism.asp
===============================

Malpractice insurance here for a heart doctor can run as high as $200,000. In India, it was $4,000 at the time of this article for the same type of doctor (note: They listed the U.S. Dr.'s rate at $100,000 which is only true in "most" of the U.S. but not all where it is much higher due to litigation differences.

I am an RN in the healthcare system
johnnyP
I'm no sure, since you cite nothing, where you get your info about the control MD's have over how many new ones there are. Citations always give much more credence to an arguement.
I agree, the FDA probably does have waaay too much involvenment in the release of new drugs, it's BIG GOVERNMENT.
In my limited experience (>31yrs) I feel tort reform would go a loooong way to fixing this stupid system. In our ER we have to do 3 times the testing necessary to establish stablility (which is mandated by another unfunded government mandate EMTALA) in order to cover our
collective butts.
mrsPaddy
We simply must change our healthcare paradigm from care of the sick to prevention. The way to do that IS let the market work, if you CHOOSE to smoke fine, not a problem but you will pay higher costs. If you CHOOSE to eat an unhealthy diet, so be it but the cost of your health care problems will be born totally by YOU. That is letting the market work.
lexx777
Triage is one of the most important assignments one can have in the ER, having untrained recent grad RN's would be disasterous. They simply do not have the experience/intuition to know when that baby with a fever merely has a cold or has meningitis.

harleyone
Don't disagree with the prevention line. But if we get the government involved to mandate health care, they will mandate more than we bargain for. So, yes, bring on the free market.

As far as AMA, what johnnyP said about them lobbying against other providers (for example Certified Registered Nurse Anesthetists) so that doctors can claim payment for procedures that CRNAs provide (even though CRNAs have to be CERTIFIED, and Doctors do NOT in order to practice) is very true.

You and I are on the same page re Tort Reform!

Also we MUST stop illegal aliens from abusing our system...not only in health care.


harleyone
FDA is way too involved? I'd recommend reading the book Overdo$ed America. It explains how the FDA and the doctors who prescribe drugs are bascially owned lock, stock, and barrel by the pharmaceutical companies. I've read that about 180,000 Americans die each year from legal drugs.
US health care is largely so expensive because people who don't need drugs and procedures get them while manny who need them don't get them.

I would love to see health care costs graduated on the basis of one's weight and smoking status.

None of this matters...It's socialized

health care, and we are not a socialist country.

At least we aren't supposed to be a socialist country.

So our health care could use some help. That doesn't mean that the government needs to be responsible for our health care.


tort reform and fda
make this country's legal system into a "loser pays" system and prohibit ALL lawyers from attaining public office.
Make prescriptions into recommendations--not permission slips from doctors. One should be able to walk into any pharmacy and purchase any drug without a prescription. This would dramatically lower drug costs. Sure there would be some inappriopriate use but so what? It is every adult's responsibility to know what they are putting into their system.
Make any drug available--even those "unapproved" by our fda.
Return the fda to its primary mission--insuring the accurate labeling of ingredients in all drug preparations. (Did you know that the first drug control law was a labeling law mandating the labeling of all drug preparations with an accurate list of ingredients?)

To tj
RE " would be some inappropriate use but so what? It is every adult's responsibility to know what they are putting into their system." Now that's really an interesting idea. In a market-driven economy, advertising would take over---just think of what's on TV now for Viagra etc and multiply it about 8000. Even a well-educated, intelligent, non-senile, organized patient who is willing to spend hours on line and taking notes, is unlikely to know enough pharmacology and biochemistry to select his own drugs---and many patients don't fit into that category. Then of course if "people should be able to walk into any pharmacy and buy any drug without prescription", they could also buy any narcotic with which to get high and any poison with which to murder their spouse. Brilliant, tj. BTW, what an elitist idea that surgery can be done only by board-certified surgeons. This is a free country: we should all be free to do our own brain surgery. Why don't you go first and show us the way?
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