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Outsourcing Blues? Have a Heart!(Uninsured American worker in India for heart surgery)
INDIA TIMES NEWS NETWORK ^ | THURSDAY, SEPTEMBER 30, 2004 | CHIDANAND RAJGHATTA

Posted on 09/30/2004 7:19:44 AM PDT by fight_truth_decay

WASHINGTON: India's great outsourcing debate with the United States may have just moved from software to 'heartware.'

Defeated by exorbitant health care costs in the United States, a North Carolina worker flew into New Delhi over the weekend for a heart surgery on the cheap.

Howard Staab was wheeled into the Operation Room at Escorts Heart Institute at 9 a.m. on Monday listening to "Oh Brother, Where Art Thou," with dhanyavaad (Thank You) written on his chest with a purple marker.

He was out in the Recovery Room by 3.30 p.m. with "every best case scenario plan implemented," according to his partner Maggi Grace. A team of doctors led by the well-known cardiologist Dr Naresh Trehan fixed a broken mitral valve in his heart.

The cost of the procedure and after care in India – less than $ 20,000, compared to the $ 200,000 Staab was asked to fork out in the US.

Although 'health tourism' and outsourcing of medical procedures has been on the horizon for some time, this is one of the first instances of an American worker seeking out India for high-end medical treatment.

"This is happening because of the prohibitive cost of health care in the US," Dr Vinay Malhotra, a Seattle cardiologist said in an interview while assessing the milestone event. "I don't see the medical profession here objecting to this, but if this becomes a trend, the insurance companies could well be up in arms."

Howard Staab's health woes began in July this year when doctors discovered a broken heart valve after a routine physical. A 53-year carpenter with an active lifestyle, Staab never had – and could not afford --health insurance. Some 45 million Americans do not have health insurance, which can now run up to $ 500 per month per individual.

When he shopped around post-diagnosis, insurance companies quoted astronomical premiums for policies with limited benefits because it was a pre-existing condition.

"I've always thought that the insurance companies are the real terrorists of our country," Staab said in an interview to a local paper later. "They put terror in everyone's mind. You don't have insurance? You could have a catastrophic accident or illness."

But with no insurance cover, Staab and his partner Grace began exploring other avenues for affordable treatment. Around this time Grace's son Bryan Maxwell, a medical student at Stanford, had returned to the US after spending the summer in India Maxwell and his professor from Stanford, Dr. Sakti Srivastava, connected the couple to Dr Trehan, the New Delhi cardiologist who now has a fabled reputation after returning from New York a decade back to set up practice in India.

When they landed in New Delhi in the early hours of Saturday, they were received at the airport by Dr Trehan's staff who scooted them past hundreds of passengers to get them through customs.

"Everyone is so incredible. No worries. Howard is waited on like royalty," Maggi Grace recorded on the website www.howardsheart.com , which chronicles their Indian healthcare experience.

According to Dr Malhotra, India is a relative newcomer to the healthcare tourism from the U.S. Americans have been trickling into specialized hospitals in Thailand and Singapore even as healthcare costs have been rising fast enough to cause cardiac arrests among the working class and senior citizens here.

A report released by a non-profit outfit Families USA this week said insurance premiums have gone up by 36 per cent in the last four years and are rising three times faster than workers' wages.

"For a blue collar worker earning just above minimum wages, what is the option?" asks Dr Malhotra. "India will become the destination as more and more lay people know about this."


TOPICS: Business/Economy; Crime/Corruption; Culture/Society; Extended News; Government; News/Current Events; Politics/Elections; US: North Carolina
KEYWORDS: drtrehan; healthcare; heartsurgery; howardstaab; india; maggigrace
"It's just an amazing idea. ... He works all the time. And then to have nothing left," Grace said of the idea of paying $200,000 for an operation. "His son said, 'Does this mean I can't go to college?' It shouldn't be that way. Two hundred thousand dollars is a lot for anybody."

Jennifer Morcone, a spokeswoman with the Centers for Disease Control and Prevention, said, "If you travel outside this nation, the same protections that are built into the health-care delivery system here may not apply."

Many people have told Staab he was irresponsible not to have had health insurance in the first place, Grace said. Now, he can't get coverage for his pre-existing condition. But other than wishing that he didn't have heart problems, "he does not have any regrets," she said.

1 posted on 09/30/2004 7:19:44 AM PDT by fight_truth_decay
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To: fight_truth_decay

Let's start by putting a cap on monetary awards and damages for malpractice suits, and ESPECIALLY caps on how attorneys may profit from malpractice suits, so that doctors can actually afford malpractice insurance again - that might bring down the costs to within reason.


2 posted on 09/30/2004 7:23:28 AM PDT by Angry Enough
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To: fight_truth_decay

Just wondering where many Indian heart surgeons get their training?

And where the son of "Grace" is getting the funds for medical school at Stanford?

Try as I may- I just cannot join these people in their anger against US capitalism.


3 posted on 09/30/2004 7:24:38 AM PDT by silverleaf (Fasten your seat belts- it's going to be a BUMPY ride.)
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To: fight_truth_decay

People act like health insurance pays for everything. HA! We pay monthly premiums. We also put money aside in a tax free account for medical/dental expenses. We also pay $20 when we go to the doctor. We pay about 1/2 of our prescription expense. We pay most of it when we get a crown. I got one recently and it was $750 and insurance didn't pay half. When my kids have surgery I have to pay up front for a lot of it and wait for insurance to repay. And insurance pays less and less all the time. I don't go whining to the US Gov to pay our med. expenses. We just budget and pay it ourselves.


4 posted on 09/30/2004 7:27:02 AM PDT by buffyt (You don't create terrorists by fighting back. You defeat the terrorists by fighting back. ~GWBush~)
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To: Angry Enough

Might not part of the problems be caused by the insurance middlemen. They suck BILLIONS out of the healthcare industry every year.


5 posted on 09/30/2004 7:29:24 AM PDT by dljordan
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To: fight_truth_decay
"His son said, 'Does this mean I can't go to college?'

Go study abroad, young man. Much cheaper and possibly better.

Jennifer Morcone, a spokeswoman with the Centers for Disease Control and Prevention, said, "If you travel outside this nation, the same protections that are built into the health-care delivery system here may not apply."

Good joke, using health-care abroad is better than no care at all and India has some real centers of excellence. BTW, other developed nations have longer life expectancy than USA, despite lower prices.

6 posted on 09/30/2004 7:30:42 AM PDT by A. Pole (Madeleine Albright:"We are the indispensable nation. We stand tall. We see further into the future.")
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To: fight_truth_decay

Bangkok hospitals get pretty decent ratings from the U.S. Embassy Thailand. Had a wisdom tooth pulled there for $25.00 by an excellent dentist, in the chair for less than 5 minutes, in and out of the office in 15 minutes. Antibiotics and codeine OTC at the nearby pharmacy for a few bucks.


7 posted on 09/30/2004 7:32:28 AM PDT by angkor
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To: dljordan
Might not part of the problems be caused by the insurance middlemen. They suck BILLIONS out of the healthcare industry every year.

Agreed. Let them be next on the list.

8 posted on 09/30/2004 7:33:28 AM PDT by Angry Enough
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To: fight_truth_decay
"If you travel outside this nation, the same protections that are built into the health-care delivery system here may not apply."

Yeah, John Edwards isn't standing by, watching over the doctor's shoulder and waiting to file suit on your behalf. ;)

9 posted on 09/30/2004 7:33:57 AM PDT by Mr. Jeeves
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To: fight_truth_decay

Hmmm.... I wouldn't need catastrophic health insurance if I just paid out-of-pocket for care from India...


10 posted on 09/30/2004 7:34:43 AM PDT by xm177e2 (Stalinists, Maoists, Ba'athists, Pacifists: Why are they always on the same side?)
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To: Angry Enough

Insurance Middlemen?

Call them what they are -- TRIAL LAWYER SCUMBAGS~!


11 posted on 09/30/2004 7:38:45 AM PDT by steplock
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To: A. Pole
Good joke, using health-care abroad is better than no care at all

I forgot to mention above that the Bangkok dentist was a vastly better experience (faster, more skilled, less painful) than having the other 3 wisdoms removed in the States (2 by a U.S. Navy dentist, one by an expensive "dental surgeon").

I've heard other excellent reports from people who've used Bangkok hospitals ... and of course they have pretty nurses.

12 posted on 09/30/2004 7:38:48 AM PDT by angkor
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To: angkor
I forgot to mention above that the Bangkok dentist was a vastly better experience (faster, more skilled, less painful) than having the other 3 wisdoms removed in the States (2 by a U.S. Navy dentist, one by an expensive "dental surgeon").

There are some excellent dentists in Poland, the savings can pay for the ticket, expenses and more. I did it.

13 posted on 09/30/2004 7:45:40 AM PDT by A. Pole (Madeleine Albright:"We are the indispensable nation. We stand tall. We see further into the future.")
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To: angkor
and of course they have pretty nurses

Ahhhh! Now the truth comes out! ;)

14 posted on 09/30/2004 7:47:56 AM PDT by fight_truth_decay
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To: A. Pole


Where did you get the info on life expectancy?
Last report I read, Indian men had a life expectancy of about 65, lower than American men.


15 posted on 09/30/2004 7:55:30 AM PDT by Ghost of Philip Marlowe (I'm fresh out of tags. I'll pick some up tomorrow.)
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To: silverleaf
I just cannot join these people in their anger against US capitalism

I really do not think they have "anger", I think they did their research and made a choice. Their bio does not make them sound like they have ever lived "high on the hog" and seem pretty self sufficient in providing for their own needs.

But no one can dispute the cost of medical care in this country, no matter what political button one chooses to wear. Politicians talk the talk but.. (The End).

16 posted on 09/30/2004 7:55:47 AM PDT by fight_truth_decay
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To: fight_truth_decay

Nothing new - Europeans are doing this all the time - one of their favorite vacation/surgery destinations is Thailand; next you will see China become a favorite for blood analysis, radiologist readings, - the whole nine yards.


17 posted on 09/30/2004 7:56:52 AM PDT by matchwood
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To: fight_truth_decay
The reason why the procedure was so much less in India is mainly because of India's socialist economy. The government, by subsidizing the health care by confiscated/redistributed funds, flips part of the bill by regulating the costs.

If India found itself faced with 10 million illegal aliens all seeking healthcare in emergency rooms and any other government handout available, this system would break and the cost of heart surgery would quickly rise to what it costs in America -- would probably exceed the cost because of their limited free-market competition doe to excessive regulation. Well, that's just my opinion based on talking to lots of Indian folks I work with (yep, their in-house offshore).
18 posted on 09/30/2004 8:00:38 AM PDT by Ghost of Philip Marlowe (I'm fresh out of tags. I'll pick some up tomorrow.)
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To: fight_truth_decay

Can't afford $50 a month? Health insurance is not expensive, free healthcare plans are though.


19 posted on 09/30/2004 8:00:49 AM PDT by sixmil (Principle over party)
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To: dljordan
That's definitely part of the problem. I think a larger part of the problem consists of:

1. The cost of malpractice insurance since the explosion of frivolous lawsuits (think John Edwards).
2. The cost of medical school.
3. The cost of covering the healthcare provided to people who have no insurance and whom the hospitals MUST treat by federal law (think 10 million illegal aliens). Senator Kyl of Arizona has testified before Congress about the need to seal the borders in order to save the hospitals in Arizona. He said something like 14 of the major hospitals are about bankrupt because of the Federal law to provide medical attention and the open border.
20 posted on 09/30/2004 8:04:27 AM PDT by Ghost of Philip Marlowe (I'm fresh out of tags. I'll pick some up tomorrow.)
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To: Ghost of Philip Marlowe
much less in India is mainly because of India's socialist economy.

That might be one reason, but not the only reason. Thailand, as I mentioned above, has a very high quality, low cost healthcare system. But Thailand isn't socialist, it's a parliamentary monarchy. The cost of living there is much lower across-the-board than in Western countries.

The same would certainly be true in India.

I'd suspect a large part of our U.S. costs are due to litigation and "free health care" to those who shouldn't be getting it.

21 posted on 09/30/2004 8:17:18 AM PDT by angkor
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To: matchwood

Last November I needed an new bridge and my local dentist
quoted $9600. I flew to Budapest, and got it done for
$2000 including airfare, lodging for 10 days, meals and
incidental expenses. Like a mini vacation.


22 posted on 09/30/2004 8:30:07 AM PDT by kkalman
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To: Ghost of Philip Marlowe
Where did you get the info on life expectancy? Last report I read, Indian men had a life expectancy of about 65, lower than American men.

I wrote "developed countries" like Western Europe, Canda, Japan.

23 posted on 09/30/2004 8:31:15 AM PDT by A. Pole (Madeleine Albright:"We are the indispensable nation. We stand tall. We see further into the future.")
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To: Ghost of Philip Marlowe

Err India used to be a socialist democracy till the early 90s-it's well & truly on it's way to becoming a free market one,albeit it at it's own pace.Moreover in India ,most people in India go to private hospitals for major medical treatment,not state facilities.The institute mentioned here(Escorts) is just one of many private institutions.The cost of living & education in India is very low(the main logic behind Outsourcing) when compared to the West so any surgery in India will be far cheaper.A lot Brits,Africans,Rich Arabs & Indians living abroad are now flocking to such institutions for quality healthcare at a fraction of the cost it is overseas.Also more & more private multi-speciality hospitals are opening up (some run by Hindu,Buddhist,Christian Religious groups) ,all of which are offeriing such packages to lure foreign money,which in fact helps the Overall healtcare system in India & both Central & State Governments have steadily relaxed restrictions over the past 25 years to encourage this .


24 posted on 09/30/2004 8:32:53 AM PDT by sukhoi-30mki
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To: kkalman

Holy mackerel - send me the details - I need a new 6 crown bridge costing over $4000 and my insurance only covers $1500 - I'm retired and $2500 doesn't come easy.


25 posted on 09/30/2004 8:35:28 AM PDT by matchwood
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To: fight_truth_decay

"I've always thought that theINSURANCE COMPANIES are the real terrorists of our country," Staab said in an interview to a local paper later. "They put TERROR in everyone's mind. You don't have insurance? You could have a CATASTROPHIC ACCIDENT OR ILLNESS catastrophic accident or illness."


Well DUH!!!

That's WHY you get insurance,Homer.

I don't feel sorry for this guy's plight. If he worked hard as he claims, then he should have been able to buy a miminium insurance plan and not GAMBLE that some where down the line his health would fail or he, as a carpenter, would cut off a finger or two.

Bet this North Carolina whiner has two vehicles, one a big ole gas guzzling truck to pull his bass boat on his vacations. Not to mention a couple of color TVs, cable (or satellite).

He had the income. He just rather the other guy (or duh guvmint) to take care of the "boring" stuff.

Irresponsible.


26 posted on 09/30/2004 8:42:08 AM PDT by RedMonqey (Keep RIGHT or get LEFT behind!!vVery good Very V)
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Comment #27 Removed by Moderator

To: Angry Enough
"Let's start by putting a cap on monetary awards and damages for malpractice suits"

The citizens who sue are not the ones creating the health care liability crisis. That falls on other parties or situations.

First the doctors who in most states REGULATE THEMSELVES. It is virtually impossible to get action against bad doctors or other health care personnel. Often there is not even a board or government agency to complain to. If there is in many states it is for all intents a peer review board set up by doctors. Paid for by them, accountable to them.

If there even is one, call the department of health and say that you want to complain about a doctor. Look in your phone book and see if there even is a # for a state agency to complain to or report a bad doctor to.

Doctors brought this on themselves by thwarting citizens from complaining about bad doctors or slipshod care. The real health crisis is that bad medical personnel continue to practice medicine.
28 posted on 09/30/2004 8:56:25 AM PDT by JSteff
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To: dljordan

Absolutely


29 posted on 09/30/2004 8:57:56 AM PDT by JSteff
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To: JSteff

Professional liability isn't the only issue here. If our cardiovascular surgeons were making $35-40K annually and registered nurses drawing $5.00/hr I'm sure our healthcare cost would drop considerably. In all probability this "carpenter" was making more per year than the surgeon that performed his surgery. Ever wonder why our healthcare system is loaded with indian healthcare professionals...MONEY, Money they can't make in their native country.


30 posted on 09/30/2004 9:17:44 AM PDT by politicalwit (NBC,CBS,ABC=Bermuda Triangle of the News Media)
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To: politicalwit
re: If our cardiovascular surgeons were making $35-40K annually....

The surgeon's bill is only part of the bill--a minor part. It wouldn't matter if the surgeon worked for free. What these big bills are for is the hospital infrastructure. Our hospitals are being hit on all fronts--and the charges are passed to the patient, one way or another. Of course, the option is always there for the hospital to simply give up and close its doors.

31 posted on 09/30/2004 9:52:42 AM PDT by Mamzelle (Pajamamama)
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To: politicalwit

"Professional liability isn't the only issue her"

My wife was almost killed by doctors... mistaken diagnosis. Luckily one MD caught it and said he didn't know how her problem was missed by so many before him.

Professional liability is the MAIN issue here!


32 posted on 09/30/2004 10:55:03 AM PDT by JSteff
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To: fight_truth_decay

Brilliant!


33 posted on 09/30/2004 11:40:38 AM PDT by TaxRelief (The homogeneity of agreement is self-defeating in its monotony)
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To: politicalwit

"If our cardiovascular surgeons were making $35-40K annually and registered nurses drawing $5.00/hr "
I agree that doctor salaries are lower there in general. Though I doubt if you could find a cardiovascular surgeon in India who makes < 35k a year. Remember the operation cost around 10-15k in India. Many cardiac surgeons perform more than 1 operations a day. Just calculate from that what the guy makes in a year (even if the surgeon makes a 1/3rd of the 15k ). I know as a fact that several top surgeons own their pvt choppers in India.
The avg physician in India is paid a lot less compared to his american counterpart but the people who work there in the top pvt hospitals are making a fortune. Thats where most foreign medi-tourists end up anyway.
I have lived in India/US as well as Canada. Here is the comparison between what a root canal costs in 3 countries. (all figures in US$)
In the US I had to pay insurance and it still cost me $1200 (40% copay).
In Canada I had no insurance and I had to pay around $900..
In India they have no concept of medical insurance and I paid $200.
I thought the service was equivalent in all 3 countries since the proceedure is standardized and the equipment is too. Though I thought the US facility was the most "assembly-line" of all three.


34 posted on 10/02/2004 12:22:41 PM PDT by Arjun (Skepticism is good. It keeps you alive.)
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To: buffyt; dljordan; A. Pole; angkor; Ghost of Philip Marlowe

I'm very concerned about our health care system. An acquaintance of ours was telling my husband about a client of his who moved for a short while to Italy. While moving into his apt, he experienced chest pains, and became convinced he needed to seek help. He was hoping to just get back on a plane to the U.S to be treated, but could not fly with his heart condition. It was too extreme. So he headed for the hospital, where he underwent a bipass operation, and stayed in the hospital for over a week. When it came time to pay the bill, he was sick about what he assumed would be an impossible debt. The total came to $2,000, which he charged to his credit card and walked away.

When I heard that true life experience, I was just sick. Our health care system is truly broken. How in the world does it get fixed?


35 posted on 10/03/2004 7:54:57 PM PDT by SnarlinCubBear (This space for rent....call 1.ATE HUNNERT Snarlin)
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To: SnarlinCubBear
Tort reform would be a good start. Malpractice suits are important when they are warranted because they keep doctors on their toes. However, frivolous lawsuits are paid by an insurance company. I don't care if it's McDonald's being sued for hot coffee, their insurance pays the suit. That company gets their money back by raising rates on everyone.

Cutting off medical care to illegal aliens would be another good move.

And eliminating some of the absurd regulations. If you walk into any emergency room and say you feel suicidal, they have to put you up for the night. Thus, many vagrants walk in and say this get a free night in the blue cross motel.

Another part of the problem is the partially socialized medical coverage that we now have (HMOs) thanks to Teddy Kennedy. Because the costs are defrayed over multiple patients, the drop-in cost is now what, $20. This leads to excessive people dropping in for every little sniffle they have. The insurance company pays the rest of the bill. The doctors are having their precious time chewed up, so the supply-and-demand balance is off, driving up costs yet again.

I believe health insurance should be for catastrophe, such as for the bipass surgery you mentioned. If we each paid out of the pocket for the minor problems, the overall cost would come down. One last point, no matter how bad it gets, the answer is NOT to implement a Hillary-care type of socialized medicine. The problems that we see today are the result of partially socialized medicine. If we switch to federal healthcare, the problems will only multiply. Do a google search on how long it takes to get surgery in Canada.
36 posted on 10/03/2004 10:34:56 PM PDT by Ghost of Philip Marlowe (I'm fresh out of tags. I'll pick some up tomorrow.)
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