The Change Begins.

[bill]

Re: The Change Begins.

Cheap labor, obviously, but there are many other factors.

If you go see a doctor, his or her office is usually in a hospital.
So is the lab that does your blood work. So is the pharmacy that handles your prescription.

In Alexandria, Virginia, I would be driving a mile from the doctor's office to get lab work done, driving another two miles, dropping off a prescription, driving back to the pharmacy, waiting three days for lab results, and revisiting the doctor or a nurse practioner.

In Thailand the above visit - lab work, prescription, etc, - would take 90 minutes. At the end I would go over the lab results with the doctor and would be billed for a single visit. While I was waiting I might go to the bank inside the hospital, and/or buy a sandwhich or some Thai food to take to work the next day.

Thai medical records are all digital. It's obvious the second you walk in that Thai healthcare is much more efficient than in the states. Most larger hospitals have a rep from the major health insurance providers working in an office. This cuts lots of red tape, and saves you, the patient, lots of phone calls and frustration.

Dentists, opthamologists, and specialists are in the same building. I can make appointments online just as I would pick out a seat on a flight. Often I kill two birds with one stone: Get my teeth cleaned and have that pre-cancerous growth on my arm zapped in the same hour.

You forgot the starbucks coffee.;)
http://www.bumrungrad.com/thailand-e...-services.aspx

[rjwjr]

Re: The Change Begins.

Cheap labor, obviously, but there are many other factors.

If you go see a doctor, his or her office is usually in a hospital.
So is the lab that does your blood work. So is the pharmacy that handles your prescription.

In Alexandria, Virginia, I would be driving a mile from the doctor's office to get lab work done, driving another two miles, dropping off a prescription, driving back to the pharmacy, waiting three days for lab results, and revisiting the doctor or a nurse practioner.

In Thailand the above visit - lab work, prescription, etc, - would take 90 minutes. At the end I would go over the lab results with the doctor and would be billed for a single visit. While I was waiting I might go to the bank inside the hospital, and/or buy a sandwhich or some Thai food to take to work the next day.

Thai medical records are all digital. It's obvious the second you walk in that Thai healthcare is much more efficient than in the states. Most larger hospitals have a rep from the major health insurance providers working in an office. This cuts lots of red tape, and saves you, the patient, lots of phone calls and frustration.

Dentists, opthamologists, and specialists are in the same building. I can make appointments online just as I would pick out a seat on a flight. Often I kill two birds with one stone: Get my teeth cleaned and have that pre-cancerous growth on my arm zapped in the same hour.

In addition to neglecting the Starbucks stop, another reason for our higher costs is our legal system and frivolous lawsuits. I have a personal example.

Took my mother to her doctor 2 days ago for general weakness. They draw blood, conduct some other tests, then send her home to await results. The next day I take her to the emergency room for same weakness and new severe headache. They say they will draw blood. I inform them that blood has already been drawn and results may be available. They respond that they must draw their own blood because they can only guarantee that their analysis equipment has been "calibrated", they can't speak for her doctor's or another clinic's equipment. Stupid and costly.

[jk]

Re: The Change Begins.

In addition to neglecting the Starbucks stop, another reason for our higher costs is our legal system and frivolous lawsuits. I have a personal example.

Took my mother to her doctor 2 days ago for general weakness. They draw blood, conduct some other tests, then send her home to await results. The next day I take her to the emergency room for same weakness and new severe headache. They say they will draw blood. I inform them that blood has already been drawn and results may be available. They respond that they must draw their own blood because they can only guarantee that their analysis equipment has been "calibrated", they can't speak for her doctor's or another clinic's equipment. Stupid and costly.

or maybe it's just an excuse - conscious or unstated - to run up their own lab fees. that's where their incentives lead.

[thriftyandboringinohio]

Re: The Change Begins.

or maybe it's just an excuse - conscious or unstated - to run up their own lab fees. that's where their incentives lead.

Precisely.
In Ohio some years ago, we limited damage awards for pain and suffering to $250,000 - tort reform and eliminating frivolous lawsuits. Health insurance and malpractice insurance isn't any cheaper here, and medical costs have not gone down.

[Chomsky]

Re: The Change Begins.

Precisely.
In Ohio some years ago, we limited damage awards for pain and suffering to $250,000 - tort reform and eliminating frivolous lawsuits. Health insurance and malpractice insurance isn't any cheaper here, and medical costs have not gone down.

No surprise. Frivolous lawsuits are only a minor driver of medical costs. Good discussion here:

http://prescriptions.blogs.nytimes.c...th-care-costs/

[WildspitzE]

Re: The Change Begins.

well, i'm glad that the justice department has it's priorities straight...

start with the b.... cs?

http://sportsillustrated.cnn.com/201...l?xid=si_ncaaf

[flintlock]

Re: The Change Begins.

Cheap labor, obviously, but there are many other factors.

If you go see a doctor, his or her office is usually in a hospital.
So is the lab that does your blood work. So is the pharmacy that handles your prescription.

In Alexandria, Virginia, I would be driving a mile from the doctor's office to get lab work done, driving another two miles, dropping off a prescription, driving back to the pharmacy, waiting three days for lab results, and revisiting the doctor or a nurse practioner.

In Thailand the above visit - lab work, prescription, etc, - would take 90 minutes. At the end I would go over the lab results with the doctor and would be billed for a single visit. While I was waiting I might go to the bank inside the hospital, and/or buy a sandwhich or some Thai food to take to work the next day.

Thai medical records are all digital. It's obvious the second you walk in that Thai healthcare is much more efficient than in the states. Most larger hospitals have a rep from the major health insurance providers working in an office. This cuts lots of red tape, and saves you, the patient, lots of phone calls and frustration.

Dentists, opthamologists, and specialists are in the same building. I can make appointments online just as I would pick out a seat on a flight. Often I kill two birds with one stone: Get my teeth cleaned and have that pre-cancerous growth on my arm zapped in the same hour.

I think efficiency is the key word. There seems to be no effort to cure people and then move on. I know in my business, you can fix something quickly or drag it out all day and still look busy. The incentives are not there to get the job done quickly and efficently. It's actually the opposite. As if patients are there to be milked for their insurance funds, not cured.

I disagree with those that say legal costs are not important. I think the shadow of the threat of legal action hangs over every decision made by physicians. It forces them into an over-conservative, over cautious mode. Sometimes its just hard to clearly measure this effect.