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Ken777
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Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 2:38 pm

Interesting story on CNN about a guy heading to the UK for a simple surgery - at 10% of the cost he was quoted in the US. Including airfare.

This isn't the first time that I have read of medical based travel forced by costs of care here, but found it interesting that this was a guy who went looking for costs around the US before looking overseas.

It's also interesting that some employers are looking for this option to help hold down their costs of providing insurance to employees.

http://www.cnn.com/2010/HEALTH/04/26/cheaper.surgery/index.html?hpt=C1
 
NIKV69
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 2:59 pm

30k? I hate to say it but that BS, how can a rhinoplasty and septoplasty average 6 to 8 thousand and this cost over 30?
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Revelation
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 3:00 pm

It's a pretty natural consequence of the medical and insurance industries having no competition within the US.

I'm sure those groups will be there to emphasize any issues that any "medical tourist" should happen to encounter.

And de-emphasize any similar issues that happen in the US.
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sv7887
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 3:52 pm

Quoting Revelation (Reply 2):
It's a pretty natural consequence of the medical and insurance industries having no competition within the US.

On the plastic surgery side of the business you do see the effects of competition. For example the price of Lasik surgery has fallen considerably over the years.

I recently had some Fraxel (Laser Resurfacing) treatments done to my face to deal with some old acne scarring. I was quoted $750-$1,000 for each treatment, but ironically the hospital where it was invented only charged me $450 per treatment.
 
TheCommodore
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:01 pm

[quote=NIKV69,reply=1]30k? I hate to say it but that BS, how can a rhinoplasty and septoplasty average 6 to 8 thousand and this cost over 30?
[/quote

I don't know ?

You tell us you live there !   
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PPVRA
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:04 pm

Quoting sv7887 (Reply 3):
On the plastic surgery side of the business you do see the effects of competition. For example the price of Lasik surgery has fallen considerably over the years.

Shhhh! Don't give governments any ideas! I have considered it before, but not until a few more years down the line as per recommendation of my doctor. So be quiet or else Government will declare it a right and I will have to shell out multiple times as much!
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
PPVRA
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:07 pm

Quoting NIKV69 (Reply 1):
30k? I hate to say it but that BS, how can a rhinoplasty and septoplasty average 6 to 8 thousand and this cost over 30?

Looks like you may be right, according to these guys anyways. . .

Quote:
Average Cost of Rhinoplasty: $4,493
http://www.plasticsurgeryportal.com/costs.cfm
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
Newark777
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:11 pm

Quoting PPVRA (Reply 6):
Looks like you may be right, according to these guys anyways. . .

It also says in the article that he didn't look outside of Indianapolis. If he was willing to fly to England, why didn't he look outside of his metro area?
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Ken777
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:26 pm

Quoting NIKV69 (Reply 1):
30k? I hate to say it but that BS,

Going back to the article, one hospital did say they quoted the wrong procedure, causing it to be over estimated. But apparently so did every other US hospital he called.

But other hospitals were in the same general price range, with the "cheapest" being $33K+. When you add in all costs associated with a procedure, from doctors, lab & x-ray, pharmacy, operating room, recovery, etc. the bill can add up fast.

That's why, to quote the article,

Quote:
An estimated 878,000 Americans will travel internationally for a medical procedure this year, according to a report from the Deloitte Center for Health Solutions. That number is expected to nearly double by 2012.

Maybe sometime in the near future you'll be able to pick the country where you have a medical procedure based on costs and how desirable it is for a vacation spot. Toss in some cruise lines that will bring you back to the US so you can "recover" during the transit and some parts of US Medical will have some real competition.  
 
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:36 pm

Quoting sv7887 (Reply 3):

On the plastic surgery side of the business you do see the effects of competition. For example the price of Lasik surgery has fallen considerably over the years.

Not as much as you think. In August of 2000 I paid $4,500 for it (got a $500 discount for being a student). Today, my partner will be paying $6000 for his.
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Ken777
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 4:54 pm

Quoting PPVRA (Reply 6):
Looks like you may be right, according to these guys anyways. . .

Those prices listed were just for the surgeon. Now start adding in the other costs and things start adding up really fast.
 
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 6:58 pm

Quoting Ken777 (Reply 10):
Those prices listed were just for the surgeon. Now start adding in the other costs and things start adding up really fast.

These guys:

http://www.yourplasticsurgeryguide.com/rhinoplasty/cost.htm

Still put it at 30-50% of what that guy was quoted, for the more expensive type of the surgery.
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
Ken777
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RE: Yanks Going Overseas For Medical Care

Mon Apr 26, 2010 7:08 pm

Quoting PPVRA (Reply 11):
Still put it at 30-50% of what that guy was quoted, for the more expensive type of the surgery.

The guy was having surgery for polyps that were basically blocking his airway, and going to an ENT, not a plastic surgeon.

And then there are three interesting points from the CNN article:

Quote:
When Fitteron's team investigated the cost of the procedure Godfrey Davies underwent, for example, they found that on the high end, the price should have been no more than about $17,850 in his state.
Quote:
"We inadvertently provided an incorrect quote for the consumer," a hospital spokesman wrote in an e-mail. "The actual procedure price was less than half of what we initially quoted."
Quote:
Fitteron says self-pay patients are "getting really aggressively overcharged," as hospitals are trying to subsidize for money lost on things such as Medicare and Medicaid reimbursements.
 
Pyrex
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 5:39 am

And are we going to talk about the people that travel to the U.S. because they cannot get their procedures done anywhere else (or better yet, have those procedures made available to them at cheaper rates subsidized by U.S. patients) as well or not?
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jcs17
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 6:02 am

I'm gonna go with.... BFD and this is a bad attempt at trying to garner support for you little cause, Ken.

The Premier of Newfoundland went to Florida for a heart procedure. Why? Oh, that's right, he could get the surgery done very quickly and he'd get it done with a new-age, expensive procedures that Canadian doctors aren't authorized to provide. My buddy from the 'Peg had kidney stones. How long would the wait be in Winnipeg to get the laser? Six weeks. He had enough of missing classes and his grandmother gave him a few grand. How long did he wait after the bank transfer and the laser? One day. Why are Buffalo, Detroit, and Seattle hospitals populated with a lot of Canadians? That's right. They can pay out of pocket and they don't want to wait for treatment.

It's a loser cause, chief. More people come to the US for treatment than leave the US for treatment.
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 7:00 am

Quoting JCS17 (Reply 14):
The Premier of Newfoundland went to Florida for a heart procedure. Why? Oh, that's right, he could get the surgery done very quickly and he'd get it done with a new-age, expensive procedures that Canadian doctors aren't authorized to provide. My buddy from the 'Peg had kidney stones. How long would the wait be in Winnipeg to get the laser? Six weeks. He had enough of missing classes and his grandmother gave him a few grand. How long did he wait after the bank transfer and the laser? One day. Why are Buffalo, Detroit, and Seattle hospitals populated with a lot of Canadians? That's right. They can pay out of pocket and they don't want to wait for treatment.

Can you support that claim? Because I know a bunch of doctors in those three areas and I haven't heard this from them.
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Arrow
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 1:48 pm

Quoting DocLightning (Reply 15):
Can you support that claim? Because I know a bunch of doctors in those three areas and I haven't heard this from them.

He can't support it because it isn't true. (Premier) Williams headed south on his own volition and has taken much much heat for it. The procedure he needed was readily available in a number of Canadian cities, and Toronto has a globally recognized cardiac care centre that is as good as, if not better than, anything you'll find in the US. They often treat Americans. Yes, Canadians head south for one reason or another. And Americans head north for one reason or another.

This is just more anecdotal BS designed to make Americans think our system is inferior. I'm one very sick dude, and I haven't ever waited for any diagnostic test, or treatment -- not ever. I could document it all, but for those non-believers, it would be a waste of my time. They'd just find another anecdote that suits their prejudice. Funny how those anecdotes that go the other way (e.g. screw-ups in the US system) don't get as much traction.
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Newark777
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 1:50 pm

Quoting DocLightning (Reply 15):
Can you support that claim? Because I know a bunch of doctors in those three areas and I haven't heard this from them.

""It was never an option offered to him to have this procedure done in this province," said Ms. Dunderdale, refusing to answer whether the procedure could be done elsewhere in Canada."


http://www.nationalpost.com/news/story.html?id=2510700
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StuckInCA
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 2:09 pm

Quoting Pyrex (Reply 13):
And are we going to talk about the people that travel to the U.S. because they cannot get their procedures done anywhere else (or better yet, have those procedures made available to them at cheaper rates subsidized by U.S. patients) as well or not?

Uh. This is brought up in every thread where healthcare is a topic. The OP was just providing an example of the opposite... a growing trend.
 
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 3:20 pm

Quoting newark777 (Reply 17):
""It was never an option offered to him to have this procedure done in this province," said Ms. Dunderdale, refusing to answer whether the procedure could be done elsewhere in Canada."

No, not anecdotal evidence. Numbers. Anecdotal evidence means nothing in medicine.
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Ken777
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 3:27 pm

Quoting JCS17 (Reply 14):
BFD and this is a bad attempt at trying to garner support for you little cause, Ken.

Actually it was another article that I found interesting. I've posted articles on various topics that caught my eye - many times avoiding the temptation of commenting strongly in the OP.

Quoting JCS17 (Reply 14):
It's a loser cause, chief. More people come to the US for treatment than leave the US for treatment.

You missed one of the important parts of the article, Dude. Insurance companies are looking at traveling for treatment as a way of cutting costs. An "emerging situation", as it were, and not related to HCR. My bet is that even in 2015, when HCR is supposed to be pretty fully implemented (less takeaways from the Conservatives) this trend will still be with us, and at a much higher rate than today.

Quoting JCS17 (Reply 14):
He had enough of missing classes and his grandmother gave him a few grand.

BINGO! Your friend has discovered that a wad of cash can get you treatment quickly. Bet that wad would have worked in other countries as well - it just could have been about half the size.
 
doug_or
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RE: Yanks Going Overseas For Medical Care

Tue Apr 27, 2010 3:51 pm

I know people that have gone to Argentina for major dental work. My brother (who was unemployed/uninsured but had my flight benefits at the time) almost did the same.
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OA260
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RE: Yanks Going Overseas For Medical Care

Wed Apr 28, 2010 12:06 am

Europeans have gone to Cuba and Hungary for dental and other things.
 
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seb146
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RE: Yanks Going Overseas For Medical Care

Wed Apr 28, 2010 12:14 am

Quoting JCS17 (Reply 14):
Why are Buffalo, Detroit, and Seattle hospitals populated with a lot of Canadians? That's right. They can pay out of pocket and they don't want to wait for treatment.

And why are hospitals in Thailand, England and India populated with Americans? Because their health insurance will not cover the procedure in the States and the procedure will cost less in another country, anyway.
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Pyrex
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RE: Yanks Going Overseas For Medical Care

Thu Apr 29, 2010 6:03 am

Quoting seb146 (Reply 23):
And why are hospitals in Thailand, England and India populated with Americans? Because their health insurance will not cover the procedure in the States and the procedure will cost less in another country, anyway.

If we're going there hospitals in Portugal are full of Brits because the waiting lists on theirs are too long... and it is actually their NHS that sends them.
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JJJ
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RE: Yanks Going Overseas For Medical Care

Thu Apr 29, 2010 7:33 am

Quoting DocLightning (Reply 9):
Not as much as you think. In August of 2000 I paid $4,500 for it (got a $500 discount for being a student). Today, my partner will be paying $6000 for his.

Well, come to Spain then. Lasik generally costs under 1.000 euro per eye.

http://www.quiron.es/pfw_files/cma/d...stacados/cuponlasercorporativo.pdf

That's 770 euro per eye, on a prestigious private hospital chain. 2.000$ total.
 
bhill
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RE: Yanks Going Overseas For Medical Care

Thu Apr 29, 2010 7:37 pm

DocLighting, I know for certain there are more MRI scanners in the Bellingham/Seattle area than all of BC.
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Arrow
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RE: Yanks Going Overseas For Medical Care

Thu Apr 29, 2010 11:32 pm

Quoting bhill (Reply 26):
DocLighting, I know for certain there are more MRI scanners in the Bellingham/Seattle area than all of BC.

That's a little misleading -- "all of BC' probably doesn't match Seattle/Bellingham in population. And I've seen a lot of doctors comment that these high tech tools -- particularly MRIs -- are over used. Same with CT scans; in fact there's a move now to rely more on an ultrasound, and use the CT scanner only when you can't get the answer any other way. Those things spew a lot of radiation (I've had a lot of them, so I'm a little over-sensitized to the abuse issue).

Having the most toys doesn't necessarily make for better health outcomes.
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 7:19 am

Quoting bhill (Reply 26):
DocLighting, I know for certain there are more MRI scanners in the Bellingham/Seattle area than all of BC.

Lovely. Because number of MRI scanners is an indicator of quality of care?

It's not. MRI is a big, expensive test and Canadian doctors know how to use it appropriately. US doctors use it because they're largely ill-trained and because liability forces us to use it for idiotic things like migraines that really don't merit neuroimaging.

The reason we have so many MRI scanners in this country is because doctors overuse them, not because we need them.
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sean1234
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 7:40 am

I recently had a blood test of my cholesterol and liver enzymes the cost was $1,700. In the past I have undergone UV treatments at a Dermatology office, where they were billing $270 for a three minute treatment, it what was for all intensive purposes a glorified tanning machine. I did this 3x week for several months at a time. How about increasing the supply of doctors by bringing in qualified physicians from oversees? It would lower the cost of care immensely, but the AMA would never allow it.

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

It is hard for me to stomach dermatologists making 300K + in 2003 dollars for what they do.
 
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757MDE
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 8:10 am

I've seen my fair share of US people and Europeans going to Colombia just to get medical care, there's even hospitals that offer "packages" that include picking the person in the Airport and even touristic tours with his/her family.
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 6:53 pm

Quoting Sean1234 (Reply 29):
I recently had a blood test of my cholesterol and liver enzymes the cost was $1,700. In the past I have undergone UV treatments at a Dermatology office, where they were billing $270 for a three minute treatment, it what was for all intensive purposes a glorified tanning machine. I did this 3x week for several months at a time. How about increasing the supply of doctors by bringing in qualified physicians from oversees? It would lower the cost of care immensely, but the AMA would never allow it.

First of all, you do not want to lower physicians' salaries any more than you want to lower pilots' salaries. There are a number of lines of evidence that lowering physicians' salaries just makes us work less and it's true. Seems backward, but I'm not going to work harder if you cut my pay. Also, given that medical school isn't free, most of us have a lot of loans to pay off. Since we get paid very little in residency, we're usually in our very late 20's or early 30's at the youngest when we start making real salary. Remember, you are trusting us with your lives, just like a pilot. You want us to be happy in our work and to actually care. Yeah, you can sue me if I screw up, but winning a suit doesn't un-injure you.

The other reason the salary is so high is because the risk is also high. A single slip-up and my career is over. It's hazard pay.

...except my salary isn't that high. Disregard the "Ambulatory" specialty. There is no such thing and I have no idea what they're talking about. Other than urgent care FP's (and that isn't a specialty, either), Pediatricians like me are the lowest-paid of all the specialties. I'm not complaining because my salary is quite generous, but I'm not raking in 500K a year. That said, pediatricians are also the happiest doctors in all of medicine with a whopping 89% career retention rate. It's obviously because we choose our specialty because we love kids more than we love money.

Second, there is no need to start shipping doctors from overseas. Currently, 30% of med school applicants get accepted nationally. The process of med school admission is a circus to put getting into Harvard/Stanford undergrad to shame. In 1995-6 when I applied to colleges, I applied to 12 schools, most of which were among the most prestigious in the country (Harvard, Stanford, Princeton, Yale, Cornell, Brown, Williams, Northwestern, U. of Michigan, etc.). I got into ten of them.

Four years later, I applied to twenty-two medical schools with a 3.7 GPA from Stanford and top scores on my standardized testing, good references, and good extracurriculars/research. I got into two and even those were off the waiting list. It's completely absurd that the process is that competitive and then we hear about a doctor shortage.

There are a ton of bright, young people who want to be physicians. The AMA isn't blocking them, but the med schools and the government are. We need more spots for medical students. And trying to replace doctors with NP's and PA's isn't the answer. They simply don't have the training that we do.

As for a dermatologist making 300+K, most of them do that by offering fee-for-service cosmetic procedures. That's how they make so much money. If they're actually doing real medicine and less elective stuff, they get paid a lot less.
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FlyPNS1
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 7:31 pm

Quoting DocLightning (Reply 31):
There are a ton of bright, young people who want to be physicians. The AMA isn't blocking them, but the med schools and the government are. We need more spots for medical students.

I agree, but that requires building new medical schools and/or expanding existing ones. This is a costly process that no one seems to want to invest in.

Quoting DocLightning (Reply 31):
And trying to replace doctors with NP's and PA's isn't the answer. They simply don't have the training that we do.

I disagree on this one. Much of the basics of primary care can EASILY be done by a PA or NP. For instance, I had a sinus infection/bronchitis about two years ago. I went to a MinuteClinic (inside a CVS) and was treated by an NP. She easily diagnosed the problem and prescribed the appropriate meds. It was quick and effective and there was no reason to waste an MD's time with something like this. Even without insurance, the total bill would have been $65. I had insurance, so I paid a co-pay of $20...plus $5 for the meds.

Another example, I had a work physical that was required for my job. Most of the physical was done by nurses/technicians anyway (hearing test, vision test, x-rays, lung capacity, TB, etc) and finally I saw the doctor. It was pretty obvious how bored he was doing this exam and what a waste of time it was for him. Nothing that he did during the exam was complicated and could have easily been done by a NP/PA. I'm sorry, you simply don't need an MD to tell someone to turn their head and cough.

Doctors are highly educated (and expensive) and their skills should be put to use treating complex problems (chronic illness/surgery/serious disease). It is a waste of time and money to have doctors providing basic care just to protect the prestige of being a doctor.
 
Boeing744
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 8:48 pm

In my opinion, Canada's system is not perfect, but if you are sick, you get treated. If you are really sick, you get treated FAST. Things like emergency surgeries are done extremely quickly, contrary to what Fox News might have you believe. A friend of mine got appendicitis and went into the hospital at about 1AM in the night... By 3AM she was already under the knife. The same goes for urgent and semi-urgent diagnostic testing such as ultrasounds. As for non-emergencies, I have never waited longer 75 minutes to get into see a doctor in a walk-in clinic in either BC or Ontario. If you book an appointment with a doctor you can usually get in quite quickly also.

The one area which is really lacking is in emergency treatment of more minor problems in the hospital. I recently had to wait with a friend for 9 hours in the ER to get seen by a doctor for a broken wrist. This was admittedly unacceptable. The issue was that they only had one (!!!) ER doctor working in the Ottawa General Hospital (big hospital in a major city). This was definitely unacceptable... However, this same friend recently went into an appointment to re-xray the arm where he was told the fracture was not improving and that he needed surgery. The surgery is in two days from now (so he only waited about one week for a non-urgent thing). It should be noted that he is getting the surgery back where he lives in BC so I don't know how long he would have waited in Ontario.

Quoting FlyPNS1 (Reply 32):
I disagree on this one. Much of the basics of primary care can EASILY be done by a PA or NP. For instance, I had a sinus infection/bronchitis about two years ago. I went to a MinuteClinic (inside a CVS) and was treated by an NP. She easily diagnosed the problem and prescribed the appropriate meds. It was quick and effective and there was no reason to waste an MD's time with something like this. Even without insurance, the total bill would have been $65. I had insurance, so I paid a co-pay of $20...plus $5 for the meds.

Another example, I had a work physical that was required for my job. Most of the physical was done by nurses/technicians anyway (hearing test, vision test, x-rays, lung capacity, TB, etc) and finally I saw the doctor. It was pretty obvious how bored he was doing this exam and what a waste of time it was for him. Nothing that he did during the exam was complicated and could have easily been done by a NP/PA. I'm sorry, you simply don't need an MD to tell someone to turn their head and cough.

Doctors are highly educated (and expensive) and their skills should be put to use treating complex problems (chronic illness/surgery/serious disease). It is a waste of time and money to have doctors providing basic care just to protect the prestige of being a doctor.

Agreed. Excellent post.
 
dxing
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 11:10 pm

Quoting Ken777 (Reply 8):
Maybe sometime in the near future you'll be able to pick the country where you have a medical procedure based on costs and how desirable it is for a vacation spot. Toss in some cruise lines that will bring you back to the US so you can "recover" during the transit and some parts of US Medical will have some real competition.

Nope, the new health care law eliminates being able to buy insurance outside of the United States unless it conforms to the minimum standard that the HHS will anounce. You will still be able to travel to another country for care but it will all be out of pocket.

Quoting DocLightning (Reply 19):
No, not anecdotal evidence. Numbers. Anecdotal evidence means nothing in medicine.

This article was not so much about medicine, he could have had the procdure done in Indy, as much as it is about finance. He was looking for the best money deal, not the best doctors. In the lead paragraph he is a self described bargain hunter.

When Godfrey Davies learned he needed surgery to remove polyps blocking his nasal airways, the self-described bargain shopper set out on a mission to find an affordable surgeon. He quickly learned a good deal is hard to find

Quoting DocLightning (Reply 28):
and because liability forces us to use it for idiotic things like migraines that really don't merit neuroimaging.

You can't say stuff like that else Ken goes off the deep end. Doctors don't practice defensive medicine, he knows that.

Interesting article.....


Fitteron says self-pay patients are "getting really aggressively overcharged," as hospitals are trying to subsidize for money lost on things such as Medicare and Medicaid reimbursements.

Go figure...of course Obamacare will solve all this.
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Fri Apr 30, 2010 11:20 pm

Quoting FlyPNS1 (Reply 32):

I disagree on this one. Much of the basics of primary care can EASILY be done by a PA or NP. For instance, I had a sinus infection/bronchitis about two years ago. I went to a MinuteClinic (inside a CVS) and was treated by an NP. She easily diagnosed the problem and prescribed the appropriate meds.

Did she? Did you get a Z-pack? I hope not. If you did, you did not get appropriate meds.

In fact, the point of basic primary care is that usually it's easy stuff that a trained monkey can do. And on that rare occasion it's not. And if you don't know what hints to look for that say "why is this child not like all other children?" then you will miss the fact that it's acute lymphoblastic leukemia or a strange metabolic or immunologic disorder.

My experience as an MD working alongside NP's is that they need more training than what they get. The idea that it took me seven years of post-graduate training to get where I am, while someone else can condense enough of it into two years to be of any clinical use absolutely stuns me.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
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FlyPNS1
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 12:16 am

Quoting DocLightning (Reply 35):
Did you get a Z-pack? I hope not. If you did, you did not get appropriate meds.

No, I did not get a Z-pack.

Quoting DocLightning (Reply 35):
The idea that it took me seven years of post-graduate training to get where I am, while someone else can condense enough of it into two years to be of any clinical use absolutely stuns me.

It stuns you because you've become indoctrinated to believe that you need all that training to provide primary care. Even though there is a broad swath of literature/studies that doesn't support you.

And if you as a doctor really want universal access to health care, you will have to support using PA/NP for primary care. They are one of the only ways of making care more affordable, particularly for those that simply do not have the income to pay your salary. Doctor's deserve a high income given the demands of their job/educational requirements, however that high income (along with a lot of other health care costs) just doesn't economically mesh with primary care.
 
dxing
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 3:45 am

Quoting DocLightning (Reply 35):
My experience as an MD working alongside NP's is that they need more training than what they get. The idea that it took me seven years of post-graduate training to get where I am, while someone else can condense enough of it into two years to be of any clinical use absolutely stuns me.

Wow, flashbacks of....

http://www.youtube.com/watch?v=LqeC3BPYTmE

Nothing like a little narcassistic rant to end the day.
Warm winds blowing, heating blue skies, a road that goes forever, I'm going to Texas!
 
Newark777
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 4:43 am

Quoting dxing (Reply 37):

Wow, flashbacks of....

http://www.youtube.com/watch?v=LqeC3BPYTmE

Nothing like a little narcassistic rant to end the day.

Haha, that fits perfectly.
Why grab a Heine when you can grab a Busch?
 
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 4:55 am

Quoting FlyPNS1 (Reply 36):

And if you as a doctor really want universal access to health care, you will have to support using PA/NP for primary care.

I have no problem with physician extenders, but they are being used as physician replacers and they aren't trained for that. Make their training longer than two years. And enforce the bit about physician supervision. There is a lot of art to what we do and you cannot learn it in two years. You can't even learn it in four.

They don't have NP's in most other countries, nor do they have PA's. They have enough doctors. We need more MD's here and we need medical schools to stop treating primary care as if it's easy (it isn't; you need to know a hell of a lot more than a specialist does) and as if it's where the dimwits go.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
Ken777
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 4:53 pm

Quoting DocLightning (Reply 31):
We need more spots for medical students. And trying to replace doctors with NP's and PA's isn't the answer. They simply don't have the training that we do.

I will agree with the need for more spots for med students. We could double the number of students and still have a shortage.

But I also believe that we can develop a more effective educational program for medical professionals. A good example was the era my wife trained in. In those days (the 60s) a physical therapy student (her course went straight from high school to the physio school, which was in the med school. Med students went straight from high schoos to med school. That put some pressure on the high schools to actually educate the students, but a physical therapist graduated in 3 years and a med student graduated in 6 years. And the professional quality of the education was as good as anything we see today.

Oh, it also costed students (and/or their parents) a fraction of the costs faced today.

So maybe it's time to cut the BS out of the college years in order to deliver trained doctors at less cost. Maybe it's time to at subsidizing the costs of medical educations for doctors who work in underserved areas.

Quoting FlyPNS1 (Reply 32):
I agree, but that requires building new medical schools and/or expanding existing ones. This is a costly process that no one seems to want to invest in.

It's as good a place to spend "stimulus money" as you can find.

Quoting FlyPNS1 (Reply 32):
I'm sorry, you simply don't need an MD to tell someone to turn their head and cough.

Actually you might be wise to have a doc checking you out in areas like that.

Quoting dxing (Reply 34):
Nope, the new health care law eliminates being able to buy insurance outside of the United States unless it conforms to the minimum standard that the HHS will anounce. You will still be able to travel to another country for care but it will all be out of pocket.

US Health Insurance Companies are moving towards providing out of country treatment where it saves money. They are even paying travel expenses to get you to go cheaper. And they are discussing this option with employers. Add it all up and you get an emerging trend.

Quoting dxing (Reply 34):
He was looking for the best money deal, not the best doctors. In the lead paragraph he is a self described bargain hunter.

And read about his inability to pay the full blown US costs. He didn't have the money to get treatment in the US, so he utilized his bargain hunter skills to find a good place where he could afford treatment.

Quoting DocLightning (Reply 35):
Did you get a Z-pack? I hope not. If you did, you did not get appropriate meds.

I've never been given a Z-pack either. My problems start when the heat on my autopap humidifier is not high enough. Sinus problems first, then sore throat, then chest infection. I can tell when it's giong to hit and I get to the doc's ASAP. Most of the time it means seeing the NP. I have no problems with that because she treats me the same way as the doctor does. Best part of the NP is that she's really good about handing out samples, saves a bit of money.

Quoting DocLightning (Reply 35):
then you will miss the fact that it's acute lymphoblastic leukemia

My wife's PCP admitted that she probably would have missed my wife's case (adult ALL) if she had gone to her office and not the ER. The blood test that presented the blasts is standard in the ER (but outstanding lab people did make a difference) and is not standard in the doc's office.

Quoting FlyPNS1 (Reply 36):
Doctor's deserve a high income given the demands of their job/educational requirements, however that high income (along with a lot of other health care costs) just doesn't economically mesh with primary care.

It can, especially if we have avenues that aren't the most expensive in the world. From education onward this country is pretty expensive for those wanting to work in the medical field. Looking at options might be the first step.

Quoting DocLightning (Reply 39):
And enforce the bit about physician supervision.

I'll agree with that one.
 
PPVRA
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 5:45 pm

Quoting Ken777 (Reply 40):
US Health Insurance Companies are moving towards providing out of country treatment where it saves money. They are even paying travel expenses to get you to go cheaper. And they are discussing this option with employers. Add it all up and you get an emerging trend.

I have a bad feeling you want to ban this type of thing?
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 6:11 pm

Quoting Ken777 (Reply 40):

But I also believe that we can develop a more effective educational program for medical professionals. A good example was the era my wife trained in. In those days (the 60s) a physical therapy student (her course went straight from high school to the physio school, which was in the med school. Med students went straight from high schoos to med school. That put some pressure on the high schools to actually educate the students, but a physical therapist graduated in 3 years and a med student graduated in 6 years. And the professional quality of the education was as good as anything we see today.

They still have that system in much of Europe and they're starting to move away from it. We had that system here where college and medical school were combined into six years. When they found that students weren't coming out well-rounded and that a lot were dropping out, they made those programs 7 years, then 8, at which point there was no point to the programs.

There's a major difference between asking an 18yo to commit to this kind of study for life and asking a 22yo to do it when he's already gotten his B.S. and his pre-med requirements and has an idea of the magnitude of the work to come.

I was offered a slot at U of Michigan's "Inteflex" program, in which I would be guaranteed college and med school in 8 years and declined because "What if I don't want to be a doctor in four years?"

You want well-rounded physicians with an education in at least one field other than medicine. Mine is biology (which is related to, but not the same as medicine). Others were English majors. Others were Art History. Others were Chemical Engineering. Many students choose to go to medical school after having been out of college for some time. Others, like me, take a break between the stress of pre-med and the stress of med school (in my case, that "break" was my M.S., also in molecular biology).

I don't think that the process of medical school can be reasonably shortened while providing the necessary education. It might be possible to shave a year off by eliminating some vacation time and shortening residency by 6 months, but I'm not so keen on that idea.
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"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
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Ken777
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 7:32 pm

Quoting PPVRA (Reply 41):
I have a bad feeling you want to ban this type of thing?

Actually I like the idea. It relieves cost pressure on patients (to some degree) and I would especially be interested in how effective various countries/cities would be in developing "packages".

Quoting DocLightning (Reply 42):
There's a major difference between asking an 18yo to commit to this kind of study for life and asking a 22yo to do it when he's already gotten his B.S. and his pre-med requirements and has an idea of the magnitude of the work to come.

i'll agree that at 18 I was not ready to make a decision on what I wanted to do for the rest of my life. At the same time my wife was very clear on her thinking and decision to be a physio. She got accepted and 3 years later was a physio, working in a children's hospital - her other dream.

Today a PT in Oklahoma has to get a Masters after a BS. The total hours for the PT program is about the same as the equivalent "hours" my wife had for anatomy and physiology alone. Comparing the cost of the two programs puts some heavy questions on the benefits of the current program. To add to these insane costs, soon a PT will need a PhD in order to practice in the state. The result will be higher costs to get trained and licensed, a shift to assistants as the Dr. PT isn't going to work with a stroke patient who might poop on their shoes, and restrictions on what (or how much) treatment insurance will approve because of the increased costs.

For those who are not ready to make long term decisions there can be mature entry programs and these students may well bring a balance in maturity to programs. I do, however, believe that shorter, less expensive programs for those who are firm in their career choice is a logical approach.
 
Continental
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RE: Yanks Going Overseas For Medical Care

Sat May 01, 2010 10:22 pm

Quoting DocLightning (Reply 31):
There are a ton of bright, young people who want to be physicians. The AMA isn't blocking them, but the med schools and the government are. We need more spots for medical students. And trying to replace doctors with NP's and PA's isn't the answer. They simply don't have the training that we do.

When I interviewed at Vanderbilt, they said they were increasing their class size in order to address the physician shortage. How big was the increase? Four, maybe five people! That seems rather pathetic.
 
dxing
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RE: Yanks Going Overseas For Medical Care

Sun May 02, 2010 4:26 am

Quoting Ken777 (Reply 40):
Add it all up and you get an emerging trend.

That will be doused by Obamacare as any policy sold in the United States will have to conform to the minimum standards set by the Health Commisioner and HHS. They can still sell a trip based on complete out of pocket expense but very few overseas medical institutions will qualify, or care if they qualify, to be accredited by HHS as an acceptable provider.

Quoting Ken777 (Reply 40):
And read about his inability to pay the full blown US costs.

Based on the wrong quote or the right one? The story does not define that. Nor does that have anything to do with my response.
Warm winds blowing, heating blue skies, a road that goes forever, I'm going to Texas!
 
fridgmus
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RE: Yanks Going Overseas For Medical Care

Mon May 03, 2010 9:03 am

In Jan 08 I was in Bangkok and had arthroscopic knee surgery at Bumrungrad hospital and it catered to foreigners.
My doctor was US-trained. The complete and TOTAL cost to include an MRI of my knee and a two night hospital stay was $5,100.00 USD.

At the time I was working in Iraq for a US company and we had an insurance policy with a company called BUPA, out of the UK and it was only for use outside the US.

How does the cost of my surgery compare to the US?

Thanks,

F
The Lockheed Super Constellation, the REAL Queen of the Skies!
 
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DocLightning
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RE: Yanks Going Overseas For Medical Care

Mon May 03, 2010 4:54 pm

Quoting fridgmus (Reply 46):
How does the cost of my surgery compare to the US?

My achilles tendon repair, which did not involve an overnight stay, was $14,000.
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