mm323: Get medicine out of the hands of the payers, stat!

MUDGE’s Musings

The dysfunction of the medical system in the U.S. is a cliché by now.

20% of the population uninsured, forced to use the trauma centers of hospitals as their first-aid clinics.

Doctors chased out of the business due to the impossible costs of malpractice insurance.

And most egregiously, the practice of medicine, until recently under the control of highly educated scientists, i.e., medical doctors whose guiding principle for more than two millennia has been “first, do no harm,” is now constrained by the U.S. health insurance industry whose guiding principle is “maximize return to the stockholders, come what may.”

In search of that return, insurers, who charge fortunes to individuals and their employers for the privilege of providing medical “care” at haggled piecework rates, continue to cheerfully leave millions of Americans uninsured while forcing practitioners to drive medical considerations financially, rather than medically.

So, what’s new? Not much, of course. The presidential candidates of both parties recognize that health insurance remains one of the hot buttons of this electoral season, although nobody has revealed a solution that makes complete medical, as well as financial sense. But all seem to recognize that business as usual, i.e., the business of excessively rewarding the executives and officers and stockholders of health insurers at the expense of un- or under-treated citizens must change.

And Exhibit No. 3,023,670 stands before us for your edification:

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Outsourcing the Patients

More U.S. health insurers are slashing costs by sending policyholders overseas for pricey procedures

by Bruce Einhorn With Catherine Arnst

For years, Americans have been traveling abroad to save money on elective procedures or dental work. David Boucher, 49, doesn’t fit the usual profile for such medical tourists. An assistant vice-president of health-care services at Blue Cross & Blue Shield of South Carolina, he has ample health benefits. But Boucher recently chose to have a colonoscopy at Bumrungrad International Hospital in Bangkok, mainly to make a point about the expanding options available to Blue Cross customers. And his company happily picked up the $640 tab—a bargain by U.S. standards….

Yes, just like manufacturing facilities and call centers, health care is moving offshore. “All of the largest U.S. insurers are starting to educate themselves or are putting [offshore] programs in place,” says Jonathan Edelheit, president of the Medical Tourism Assn., an industry group formed just last year. Companies that self-insure are also bombarding Edelheit’s group with requests for information.

Let us lay out the scenario: you have a coronary blockage that requires bypass surgery. Your insurer tells you that they’ll only cover 20% of the $100K cost if you check into your cardiologist’s hospital, but will cheerfully defray the entire cost, plus travel and hotel expenses for you and your spouse, if you try Plan “O.”

So, you put yourself in the hands of the airlines (perhaps a contributory cause of your condition in the first place!), travel 10,000 miles into the tropics, check into a hospital in a third world nation, say India, or Thailand, or Thirdworldia, the lowest bidder of course, to have this complex and dangerous and life-threatening procedure performed by people whose medical education is purported to be suitable, and, by golly, the total fee is 80% cheaper than that Class 1 facility in your home town.

[Please click the link below for the complete article — but then please come on back!]

Outsourcing the Patients

And something, regrettably goes wrong, a quadruple bypass after all (perhaps you were transfused with HIV-infected blood? A lot of that in Thirdworldia), and your estate wants to sue on malpractice grounds. Oh, but wait, there’s no malpractice law in Thirdworldia, sorry.

And even if you survive, you’re still a 10,000 mile steerage passage from home. Some money saving procedure. What a recovery.

It’s not difficult to get exercised over so many of the artifacts of modern life. You don’t have to even be of the progressive persuasion to be appalled by our five-year-old war in Iraq (ready for kindergarten already, the dear); horrendous oil prices, plummeting housing prices and heaving foreclosure rates and other evidences of the dreadful state of the economy; global warming and pollution and nothing getting done; genocide and dictatorships.

In the light of that agonizing big picture, a few out-sourced medical procedures don’t seem like much.

But oh, it is, if it’s you plugged into that Thirdworldia heart-lung machine (no sir, the electric power here is most reliable, and I know we topped up the fuel tank in our backup generator just last October).

We need to elect a President, a House of Representatives, a Senate, willing to take control of every part of our world back from the extremists of capitalism of all stripes who have cheerfully raped and pillaged our economy, our property values, our children’s and grandchildren’s legacies, and our medical care, while smugly voting themselves 9-figure bonuses.

Get mad, America, and vote!

It’s it for now. Thanks,

–MUDGE

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One Response to mm323: Get medicine out of the hands of the payers, stat!

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