Heart Surgery in India for Fifteen Cents on the Dollar
Shetty is not a public health official motivated by charity. He’s a heart surgeon turned businessman who has started a chain of 21 medical centers around India. 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. (Bloomberg)
“spurning air-conditioning”
– I feel like comfort is a primary motivation to splurge a little and receive marginally better care, but enormously better service (comfort).
Only if you can afford it. Otherwise you might just want your life saving surgery.
I’m guessing the cost cutting also comes with some risks. Is that a good think in your mind?
Yes. If people want to take the risk they can, otherwise they can pay more money.
True Story.
Not always. That would be cutting costs for the sake of cutting costs, not cutting costs because of innovation and efficiency.
Yeah, you have to weigh it your priorities a bit.
That is incredible. If government policy didn’t coddle the medical industry to such an extreme extent we might have this type of innovation.
How are they coddling them?
Government Funding.
You mean the coddling that prevents physicians from owning their own specialty hospitals and doing this sort of thing here?
By trimming costs with such measures as buying cheaper scrubs and spurning air-conditioning…
I have a great deal of respect for this type of thinking. However, if I’m the one on his operating table, I don’t want his pants falling off while he’s trying to operate on me. Nor do I want his surgical teams sweating uncomfortably while they cut my chest open. In an operating theater it would be hard to have fans due to infection rates. I hope they at least have a chill water system in the OR floor to keep the surgical team comfortable.
By trimming costs… and spurning air-conditioning,
When I toured private hospitals in Costa Rica, the patient rooms all had air conditioning but some of the common areas (e.g. the nurses’ station) did not. The windows were open and the temperature was in the upper 70s.
I still think that spending 20 hours or so on a plane with a condition requiring surgery is a big risk no matter how high the quality of care when you get there.
Heart surgery in America is a major payer for the fixed overhead costs of hospitals.
Either the Indian hospitals have no overhead, which I doubt, or their government pays the overhead costs of hospitals, or Indian labor is so cheap that their overhead is that low.
In a world where more and more products are created with cheap labor, American medicine has been an outlier in terms of little or no offshoring.
This raises our costs, but as Michael Spence and others have noted, health care has created the majority of new high wage jobs in America for the past 20 years.
I have never met a physician who didn’t feel that patients should have a greater say, both literally and financially, in the decisions that affect their healthcare. Giving patients greater responsibility for how money is spent on their behalf (i.e. a form of free market where prices are not universally set by the insurer) would result in less income for providers (including docs). And yet, those who oppose patient responsibility, and who believe in the universality of the third party payment system, are the loudest in their criticism of anyone (including docs) who would dare voice support for an idea that would lower costs and reduce their own paycheck.
The disparity in costs is not entirely due to minor items such as scrubs or air-conditioning. Consider the following:
1. There is a significant discrepancy in the price of equipment/prosthesis/drugs etc between the developing and developed countries. It may be the exact same item by the same manufacturer, but the price is far higher in US. One of the rationales used to justify this practice is that the manufacturers ‘humanely’ provide the developing countries at ‘discounted’ or ‘below cost’ prices and then have to make up for it. IIn all probability, profit is made by the companies in both situations and the pricing needs to be looked into closely.
2. Insurance may actually be driving the costs up. Cost of care and charges are artificially jacked up. Hospitals may charge 3-4 fold of the actual cost, realizing that insurance will reimburse only a portion of what they charge. The fact that insurance companies are profit making concerns, prejudices their objective of covering patient care appropriately. Insurance is easy to obtain when we are healthy. The coverage is easily lost or denied when one actually needs it.