Usually you have to pay more to get things that are better. In today’s healthcare marketplace that is not necessarily true.
In the normal free marketplace, businesses compete on price and on quality. To get higher quality you can expect to pay more. But in the healthcare marketplace doctors and hospitals do not compete on price – and rarely compete on quality.
That’s because healthcare in this country is mostly paid for by third–party payers; insurance companies or the government. Since patients pay only their co-pays or deductibles, they have little reason to be concerned about the actual price of the treatments they receive.
John C. Goodman, economist writing for Forbes, says this means doctors and hospitals don’t compete on price or quality. The public has little reason to be concerned because the third-party payers are picking up the tab. Most people have no idea how expensive their doctor or hospital may be and rarely if ever compare prices.
All that may be changing in the near future, however. With the growth of Health Savings Accounts (HSAs), millions of Americans have increased incentive to watch their healthcare dollars. These accounts give patients more control and interest in how their healthcare dollars are spent.
Healthcare providers in other countries are taking notice. Many countries like India and Thailand have been attracting American consumers for years with lower-cost healthcare for elective procedures like total hip replacement and cardiac by-pass surgery. But now there is an alternative that is much closer to home.
Grand Cayman Island has long been known for its friendly banking laws as well as its pristine waters that attract SCUBA divers and snorkelers in great numbers. But now there is another reason to consider travel to this island getaway – healthcare.
Goodman says Health City Cayman Islands (HCCI) is open for business and targeting the American healthcare consumer. Dr. Devi Shetty, a heart surgeon who owns 32 hospitals in India is a major investor. They have package deals that arrange airline transportation, ground transportation, and hotels with your elective medical treatment. All costs are disclosed up-front and are typically one-third of U.S. prices for the same treatments.
What about the quality? Goodman says when doctors and hospitals offer fixed package rates they usually provide lower prices and higher quality. In the United States, hospitals make money on their mistakes. When infections keep patients in the hospital longer than expected, the hospital makes even more money. But when you have package pricing, the longer length-of-stay comes out of the profit of the hospital – therefore they have much greater incentive to prevent infections and other complications.
This incentive, however, does not apply to doctors, especially surgeons, who do not profit from their mistakes. Surgery is billed as a fixed price and requires a 90-day post-operative period when additional professional fees are not allowed. When complications arise, the surgeon must take whatever steps are necessary to treat the problem and cannot bill for the additional work required.
HCCI is proud of their outcomes data and quotes them.
- Out of 290 orthopedic procedures, only 2 have required readmission.
- Out of 107 cardiac surgeries, there has been only one readmission.
- Out of more than 1,000 total surgeries there have been four mortalities – and all four came through the emergency room rather than elective surgery.
- Out of 1,500 in-patients, there have been only 6 infections and one bed sore.
To be sure, these are small numbers of surgeries and patients to draw any significant conclusions. But Goodman quotes U.S. readmission rates of nearly 20 percent and approximately 75,000 deaths a year in U.S. hospital acquired infections. He also attributes HCCI’s low infection rates to the frequent exchange of air in their operating rooms. But as an orthopedic surgeon, I can attest to the same air-exchange technology in all of the operating rooms where I routinely do surgery.
Perhaps the greatest reason to travel to HCCI is for expensive medical therapy. The treatment of Hepatitis C in the U.S. with Sovaldi costs about $1000 a pill. A full course of treatment costs $84,000 for three months. The same treatment at HCCI costs about one-third of this price. Expensive cancer treatments may cost as little as 20 to 30 percent of the U.S. prices.
Why can’t hospitals do the same thing here in America? The answer is simple. ObamaCare disallows it. ObamaCare prevents the construction of any new physician-owned hospital. (For more information on this subject see my earlier post Hospitals Disdain Competition.)