Heart transplant can be done for $1,583

I agree that is the question and I think most of us have a good idea of what the answer is.

 

India's Walmart of Heart Surgery Cuts the Cost by 98% - Businessweek <http://www.businessweek.com/article...-of-heart-surgery-cuts-the-cost-by-98-percent>


ndia's Walmart of Heart Surgery Cuts the Cost by 98%
By Ketaki Gokhale on August 01, 2013
http://www.businessweek.com/article...-of-heart-surgery-cuts-the-cost-by-98-percent

Devi Shetty keeps photographs of Mother Teresa and Mahatma Gandhi on his desk, and he’s obsessed with making cardiac surgery affordable for millions of Indians. But these two facts are not connected. Shetty’s a heart surgeon-turned-businessman who founded a chain of 21 medical centers around India. Every bit the capitalist, he has trimmed costs by buying cheaper scrubs and spurning air-conditioning and other efficiencies. That’s helped cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,555)—half of what it was 20 years ago. He wants to get it down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the Centers for Medicare & Medicaid Services.

“It shows that costs can be substantially contained,” says Srinath Reddy, president of the Geneva-based World Heart Federation. “It’s possible to deliver very high-quality cardiac care at a relatively low cost.”

Medical experts like Reddy are watching closely to see if Shetty’s severe cost-cutting can serve as a model for making life-saving heart operations more profitable and more accessible to patients in India and other emerging nations. “The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” says Shetty, who opened his flagship hospital, Narayana Hrudayalaya Health City, in Bangalore in 2001.

Controlling costs is key in India, where more than two-thirds of the populace lives on less than $2 a day and 86 percent of health care is paid by individuals. Per capita health spending is less than $60 a year. A recent study by the Public Health Foundation of India and the London School of Hygiene & Tropical Medicine found that in India noncommunicable ailments such as heart disease are now more common among the poor than the rich. One in four people there die of a heart attack, yet the country performs only 100,000 to 120,000 heart surgeries a year, well short of the 2 million Shetty estimates are needed. “There has been fast urbanization in India that’s brought with it a change in dietary patterns and lifestyle,” says Usha Shrivastava, head of public health at the National Diabetes, Obesity, and Cholesterol Foundation. “It’s leading to this huge jump in cardiovascular disease.”

Shetty plans to add 30,000 beds over the next decade to the 6,000 his hospitals have now, and he has identified 100 towns with populations of 500,000 to 1 million that have no heart hospital.

All of that expansion is dependent on keeping costs low. A 300-bed, prefabricated, single-story hospital in the city of Mysore cost Shetty’s company $6 million and took just six months to build, he says. To reduce energy costs, only the hospital’s operating theaters and intensive-care units are air-conditioned. Shetty also saves by cutting out unnecessary pre-op testing. Urine samples that were once routine before surgery were eliminated when only a handful of cases tested positive for harmful bacteria. And the chain uses Web-based computer software to run logistics, rather than licensing or building expensive new systems for each hospital.

When Shetty couldn’t persuade a European manufacturer to lower the price of its disposable surgical gowns and drapes to an affordable level, he persuaded a group of entrepreneurs in Bangalore to make them—for 60 percent less.

The bottom line: In India, where per capita spending on health care is less than $60 a year, a chain is pioneering low-cost heart surgery.

 

ever heard of the term "health insurance"? In most developed countries its mandatory. I am not sure how the US health care system works but when insured I would assume that when several doctors recommend a bypass surgery then the insurance company is obliged to cover all the expenses, that is what the premiums each month are paid for.

This of course does not change the fact that the health care costs in the U.S. are through the roof. A lot in the U.S. is through the roof because of one common evil: The lobbyist system. National election campaign contributions? That should have never existed. Why does a party need to fund itself through campaign contributions. Stop this ridiculous TV, print, radio ad terrorism. TV stations should in turn fight to get interviews not the other way around. A lot in that regards is badly messed up in the U.S. Why health care corporations can be in bed with bureaucrats and politicians is beyond any logic. Health care reform? The U.S. has never heard of that. And to be honest, the quality of health care in, for example, Germany is several notches higher at a fraction of the cost. It can be done, and it Germany has shown that through reform it does not cost a socialist system to afford such health care system....

 

By the way, quite a number of Brits already fly out to France for medical surgeries for a decade or so (most procedures are less expensive in France than in the U.K.). Insurance companies give an incentive to their customers to undergo surgery in France where it was a lot cheaper. Since then prices have come down in the U.K. through they are still significantly higher than in France.

 

you worry about air quality? How about you start worrying about your snacking and fast food habits and worry whats in such kind of foods then you can worry to expose yourself for a week to Indian air pollution. Ridiculous.

 

you seem to be the only politically charged idiot in this thread and that is PRECISELY the reason why health care reform is a term no American resident has ever heard before. This stupid accusing between left and right and each and every initiative and most importantly, logic, is squeezed and killed in between. I just spill my guts each time I hear some rights accusing lefties and vice versa.

 

first you have to determine whether this person on the right accusing the left even knows the different between right and left. it is more like the ignorant arguing with their fellow ignorants. this thread has been hijacked by one ignorant person claiming to be on the right who is about as clueless as those on the left responding to him.

 

Your response is the precise reason nothing useful comes out of WashingtonDC, Paris, Berlin, ....99% of the times. If you focused on the task at hand and were smart instead of trying to sound smart you would accomplish a lot more and not communicate content of close to zero value. What a perfect example of political uselessness.

 

http://www.nytimes.com/2013/06/02/h...ds-the-world-in-health-expenditures.html?_r=0

MERRICK, N.Y. — Deirdre Yapalater’s recent colonoscopy at a surgical center near her home here on Long Island went smoothly: she was whisked from pre-op to an operating room where a gastroenterologist, assisted by an anesthesiologist and a nurse, performed the routine cancer screening procedure in less than an hour. The test, which found nothing worrisome, racked up what is likely her most expensive medical bill of the year: $6,385.

That is fairly typical: in Keene, N.H., Matt Meyer’s colonoscopy was billed at $7,563.56. Maggie Christ of Chappaqua, N.Y., received $9,142.84 in bills for the procedure. In Durham, N.C., the charges for Curtiss Devereux came to $19,438, which included a polyp removal. While their insurers negotiated down the price, the final tab for each test was more than $3,500.

“Could that be right?” said Ms. Yapalater, stunned by charges on the statement on her dining room table. Although her insurer covered the procedure and she paid nothing, her health care costs still bite: Her premium payments jumped 10 percent last year, and rising co-payments and deductibles are straining the finances of her middle-class family, with its mission-style house in the suburbs and two S.U.V.’s parked outside. “You keep thinking it’s free,” she said. “We call it free, but of course it’s not.”

In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.

Americans pay, on average, about four times as much for a hip replacement as patients in Switzerland or France and more than three times as much for a Caesarean section as those in New Zealand or Britain. The average price for Nasonex, a common nasal spray for allergies, is $108 in the United States compared with $21 in Spain. The costs of hospital stays here are about triple those in other developed countries, even though they last no longer, according to a recent report by the Commonwealth Fund, a foundation that studies health policy.




Matthew Ryan Williams for The New York Times

A poster illustrating diseases of the digestive system at a doctor's office.
.

While the United States medical system is famous for drugs costing hundreds of thousands of dollars and heroic care at the end of life, it turns out that a more significant factor in the nation’s $2.7 trillion annual health care bill may not be the use of extraordinary services, but the high price tag of ordinary ones. “The U.S. just pays providers of health care much more for everything,” said Tom Sackville, chief executive of the health plans federation and a former British health minister.

Colonoscopies offer a compelling case study. They are the most expensive screening test that healthy Americans routinely undergo — and often cost more than childbirth or an appendectomy in most other developed countries. Their numbers have increased manyfold over the last 15 years, with data from the Centers for Disease Control and Prevention suggesting that more than 10 million people get them each year, adding up to more than $10 billion in annual costs.

Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation. They are often prescribed and performed more frequently than medical guidelines recommend.

The high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.

While several cheaper and less invasive tests to screen for colon cancer are recommended as equally effective by the federal government’s expert panel on preventive care — and are commonly used in other countries — colonoscopy has become the go-to procedure in the United States. “We’ve defaulted to by far the most expensive option, without much if any data to support it,” said Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.

In coming months, The New York Times will look at common procedures, drugs and medical encounters to examine how the economic incentives underlying the fragmented health care market in the United States have driven up costs, putting deep economic strains on consumers and the country.

Hospitals, drug companies, device makers, physicians and other providers can benefit by charging inflated prices, favoring the most costly treatment options and curbing competition that could give patients more, and cheaper, choices. And almost every interaction can be an opportunity to send multiple, often opaque bills with long lists of charges: $100 for the ice pack applied for 10 minutes after a physical therapy session, or $30,000 for the artificial joint implanted in surgery.

The United States spends about 18 percent of its gross domestic product on health care, nearly twice as much as most other developed countries. The Congressional Budget Office has said that if medical costs continue to grow unabated, “total spending on health care would eventually account for all of the country’s economic output.” And it identified federal spending on government health programs as a primary cause of long-term budget deficits.

While the rise in health care spending in the United States has slowed in the past four years — to about 4 percent annually from about 8 percent — it is still expected to rise faster than the gross domestic product. Aging baby boomers and tens of millions of patients newly insured under the Affordable Care Act are likely to add to the burden.


Advertisement
.

With health insurance premiums eating up ever more of her flat paycheck, Ms. Yapalater, a customer relations specialist for a small Long Island company, recently decided to forgo physical therapy for an injury sustained during Hurricane Sandy because of high out-of-pocket expenses. She refused a dermatology medication prescribed for her daughter when the pharmacist said the co-payment was $130. “I said, ‘That’s impossible, I have insurance,’ ” Ms. Yapalater recalled. “I called the dermatologist and asked for something cheaper, even if it’s not as good.”

The more than $35,000 annually that Ms. Yapalater and her employer collectively pay in premiums — her share is $15,000 — for her family’s Oxford Freedom Plan would be more than sufficient to cover their medical needs in most other countries. She and her husband, Jeff, 63, a sales and marketing consultant, have three children in their 20s with good jobs. Everyone in the family exercises, and none has had a serious illness.

Like the Yapalaters, many other Americans have habits or traits that arguably could put the nation at the low end of the medical cost spectrum. Patients in the United States make fewer doctors’ visits and have fewer hospital stays than citizens of many other developed countries, according to the Commonwealth Fund report. People in Japan get more CT scans. People in Germany, Switzerland and Britain have more frequent hip replacements. The American population is younger and has fewer smokers than those in most other developed countries. Pushing costs in the other direction, though, is that the United States has relatively high rates of obesity and limited access to routine care for the poor.

A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.

“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”


***
Click on the link for the rest of the article and a map with prices across the US.

 

http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html

American Way of Birth, Costliest in the World

LACONIA, N.H. — Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.

At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”

Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.

When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”

Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician’s time using a machine that had been bought years ago. She ended up paying $655. “I feel like I’m in a used-car lot,” said Ms. Martin, a former art gallery manager who is starting graduate school in the fall.
****

Again go to the link for the rest of the article.