This article on hip replacement costs and the experiences of a medical tourist in Belgium highlights any number of issues. Yet most readers would yawn at the obvious – that we pay in the US multiples more for equal or lower health outcomes. The story describes a patient who was quoted a price of $78,000, NOT including surgeons fees for a hip replacement from a local US hospital. The patient was able to receive the same operation INCLUDING round trip air, for $13,660 at a private hospital in Belgium, including the surgeon’s fee. And the hip joint was made by the same US company that sells the device in the US for more than the cost of the entire procedure in Belgium.
Interest groups and politics (including partisan bickering), lack of courage at confronting and tackling the matter, government indifference, and lack of economic skin in the game by patients mean we all get less for more. Government interference is decried by many, but it seems to work in the case of Belgium and others in Europe and elsewhere that regulate the medical market. The alternatives in settings like the US where healthcare is largely regarded as “free” by those who receive it has resulted in what we in America experience. We patients pay little more than a copay or deductible with the rest covered by private or government insurance. We have no incentive to shop, price compare and demand price transparency. But the cost borne by government and private payers is very real and the billions of dollars in excess GDP means that these funds are not available for other productive uses.
If cars, electronics or food were five times the price in the US than Europe, regardless of the logic, there would be a grey market and a hue and cry by those individuals footing the bills. Where is the outrage at the metrics described in this article? It is inconvenient and in the case of emergent situations, impossible to get on a plane and travel abroad for much cheaper care. And the patient who has no economic driver to do so has little reason to consider it.
In the end, we all pay via lower salaries, higher taxes, or both – fueling a bloated health care system enabled by indifference and ignorance.
Bryan J Treacy MD says
This is a succinct, direct and excellent viewpoint on the US health care system. The public has more “skin in the game” than they realize. Just look at your latest “explanation of benefits” statement from the last time you were at the doctor. Discounted fees contracted with physicians and hospitals place more and more costs on the health care consumer while they are also paying escalating premiums. We would all be better off paying for catastrophic health insurance and negotiating routine visits and tests.
CNN reported that the number of “direct pay” physicians has doubled in the past year from 3% in 2012 to 6% in 2013. I am one of them. These physician’s fees are transparent and in line with a free market health system. I’ve also seen private hospitals discount their fees 65% for patients who are directly paying their bill. The premium savings are significant if out of pocket deductibles are raised so that insurance kicks in at 100% after $5000 or $10,000 per year. The rest can usually be negotiated and can be paid from the premium savings.
See my post on Direct Pay Practices at http://www.womensultimatehealthcare.com