a taste of things to come?

[astromeria]

Health care abroad for an American worker:
http://www.csmonitor.com/2006/0816/p03s03-usec.html

If this type of insurance were available to me as an individual, I'd give it a try as long as there's no problem getting urgent care in the US. And they can send me to India for my annual checkup anytime...and how about semi-annual dental visits in Thailand Oh, sorry, got carried away...this is presumably just for major surgery...but...just a short trip to Mexico for my mammo, huh? pretty please?

 

[Marshac]

...and how about semi-annual dental visits in Thailand Oh, sorry, got carried away...

oh wow, that's the worst pun ever!

 

[ladelfina]

Really interesting, but they'd have to make sure to cover you equally well in the event that you're too sick to travel. Kind of an interesting stop-gap, though, and if the focus is on specialized centers, not just on cost-cutting, the results could even be better than one might expect in the US (outcomes tend to depend on the experience the docs and staff have with a particular illness/procedure).

 

[astromeria]

It could be a awfully slippery slope. Start with fine surgical centers in India and Thailand, and when their prices rise, end up in a thatched hut with a witch doctor. OK, so I'm exxagerating...or maybe not. This is brought to you by the fine folks who are underfunding pensions while collecting mega-bonuses, offshoring functions that result in worsening service, squeezing suppliers till they go belly-up. Today they offer the Taj Mahal along with your gall bladder removal...tomorrow, perhaps a walk through seedy backstreets to your unlicensed medical center. And what about a too-short hospital stay followed by a long flight, perhaps in steerage? Instead of just crying babies, kicking toddlers, and snoring sleepers, flyers could have groaning patients. But...if done right...and patients aren't forced into it...I see a place for this, but only if patients share in the savings. I don't thnk my former company lowered its prices to customers when it sent half of engineering to Bangalore.

 

[Delawaredave]

Wow - I knew "globalization" has big boundaries and impacts.

But the idea of shipping people overseas for operations is boggling.

 

[Nords]

Wow - I knew "globalization" has big boundaries and impacts.
But the idea of shipping people overseas for operations is boggling.

Nah, with a broadband connection and a robotic surgery suite your LASIK can be done right here in Dubuque... by Dr. "Bob" in Bangalore.

 

[Alan]

A few years back I heard about a company offering its New York heart patients the chance of going to Guy's Hospital in London for by-pass surgery, flying with a spouse or significant other, staying for 3 nights in a good hotel prior to the operation and flying back a few days afterwards. Guy's Hospital in London has a world-wide reputation for heart surgery and the flight from / to London from New York is a single hop of a few hours.

... but Leicester,NC to New Delhi sounds a lot more stressful

 

[runnerr]

Has anyone on the board had any medical or dental work done overseas?

 

[Alan]

I've had plenty done in England before I came to the USA including a couple of operations. I wouldn't hesitate to go to England for treatment if it saved me money. The problem I had with England was not in the treatment itself, but in the waiting lists.

 

[Billy]

I've had lots of dental work done overseas - both in Mexico and in Thailand.

Of the two, I prefer the quality, care and prices in Thailand.

(see http://retireearlylifestyle.com/favorite_er_links.htm for medical links in the center of the page and http://www.retireearlylifestyle.com/thailand_travel.htm for medical links at 3/4's of the way down.)

-- our recommendations 8)

Akaisha
Author, The Adventurer's Guide to Early Retirement

 

[whitestick]

I had to have a tooth pulled, and some minor dental surgery done in China a few years ago. While they didn't speak perfect English, we did manage to communicate enough to get the job done. Work was done well and I had no problems. Only thing that was a bit disconcerting at first, was when you walked into the dental office, their equipment (chair, spit bowl, etc) appeared to be of the vintage that you saw in the states back in the '60s and '70s. Other then that, thought, the work was excellant. Dentist/surgeon said that he had trained in the US, and had been back in China at that time, for several years.
Oh - had to pay, and collect from insurance when I got back, but the cost was around $125. Not really worth it to file, given the deductible we carry here in the states.

 

[LEX]

I wonder if there might come a time where MD's start being 'downsized' and their expensive US operations close down like so many Silicon valley code meisters have done due to the same low cost international outsourcing.

 

[Billy]

You have a point, Lex...

The medical issue seems to be very complex, with so many factors involved (client's insurance, R&D, malpractice insurance, old habits, people wanting guarantees, etc.)

We did a Health Care Panel Discussion (http://www.retireearlylifestyle.com/hcp_toc.htm) in order to get some answers right from the 'horse's mouth'... Every position seems to have their own interests to defend.

The best way to deal with it, in my opinion, is to become an informed and involved patient. (http://www.retireearlylifestyle.com/hcp_recom_websites.htm)

Even we, as patients have different tolerance levels for risk or for doing something 'out of the box'. Some simply don't want to deal with it at all..

Best,
Akaisha
Author, The Adventurer's Guide to Early Retirement

 

[scrinch]

I had back surgery in Singapore about 10 years ago. Had to remove scar tissue that had built up since disk surgery ten years previous to that. The doctor was Singapore Chinese, educated in Scotland, and seemed very competent. The hospital was clean and modern. The surgery went well and the long-term result has been great. My only complaint was, once the surgery was over and I was recovering in the hospital, I felt like I was treated like an idiot child. Following my first disk surgery in the US I was discharged the next day and given Tylenol/Codeine for pain (which I never needed). Following the surgery in Singapore I was kept in the hospital for a week with 3 days of morphine IV. I felt fine after a day of recovery but neither the doctor nor the nurses would hear anything about it. When I told them I felt fine they just smiled that condescending "we know better than you" smile, looked at my chart, and read to me when I could be released. The worst part of the whole experience was the withdrawal symptoms from the morphine during days 4-5. I liken the experience to flying on Singapore Airlines...you are treated very professionally, but there is never any true interpersonal communication, only a plastic smile.

 

[Scrooge]

Has anyone on the board had any medical or dental work done overseas?

A friend of mine was hospitalized in the Czech Republic a couple of years ago. The doctors seemed competent and eventually the problem was taken care of. However, hospital equipment looked like it had been there since 1950, the food was worse than basic and bribery was rampant.

 

[NYCGuy]

I travel at least once a year to Thailand with my wife to visit her family. So, I schedule all dental work, except for checkups and cleanings, during the trip. My dental clinic in Bangkok falls over backwards to treat me well. My favorite item is the price chart next to the receptionist clearly giving the cost of all their procedures. By contrast I once asked an orthopedist what he would charge me for arthroscopic surgery. He looked at me like I was an idiot and said, "How would I know?" Infuriating.

And, of course, the prices are so much less. For instance, a ceramic implant from my New York dentist is about 1000 of which I would pay $300. Same implant at the Asavanant Dental Clinic in Bangkok was $240 of which I paid $72. A dental x-rays costs about $4. The NY dentist confirmed that the Bangkok implant was done correctly. In BKK the dentists work evenings and weekends. Everyone there including the receptionist speaks English.

Part of my intention in using dental services in Thailand is to begin to get familiar with using health services there in anticipation of an eventual retirement. Unfortunately, my health insurance will not pay for overseas treatment, except for travel emergencies.

I love the idea of presenting US doctors and dentists with competition. You have the same problem of identifying the quality practitioners, but that said, I have so far found high end health services in Bangkok (not what the average Thai has access to) to be at least as good as here in NY.

 

[Rich_by_the_Bay]

I love the idea of presenting US doctors and dentists with competition. You have the same problem of identifying the quality practitioners, but that said, I have so far found high end health services in Bangkok (not what the average Thai has access to) to be at least as good as here in NY.

I must, with some remorse, agree with you, at least in a qualified way.

It really depends on what the condition and situation are. Most of the posts I have read about care in Asian and European countries deal with fairly finite, straight forward procedures and illnesses (though sometimes major in nature). These include dental work, disc surgery, pneumonia, even coronary bypass, etc. It seems plausible to me that well-selected facilities and providers in any well-developed country can be equivalent to care in the USA. Get in, get it done, move on.

Unfortunately, the less dramatic but more likely scenario for serious illness may include care for things like advanced diabetes, kidney failure, heart failure, non-terminal cancer, emphysema, liver disease, and hundreds of others. These involve chronic and regular visits, occasional fancy imaging studies, several subspecialists involved, emotional exhaustion at times. As they progress, they sort of become an uninvited and unwelcomed second career - phone calls, appointments, no-shows, sorting out of options.

Not to say these things can't be provided just as well abroad, but it involves a much tighter level of integration into that society in the likely absence of family and friends, and with accumulating uncovered costs (which can mount up even at lower rates). I suppose you could always come home in such a situation but that's a tough time to be uprooting and reestablishing all those connections.

I've seen patients in all the above circumstances. It usually works out but in my opinion if you have a chronic or complex illness, there's no place like home. Now if we could just fix the system at home...

 

[Billy]

I love the idea of presenting US doctors and dentists with competition.  You have the same problem of identifying the quality practitioners, but that said, I have so far found high end health services in Bangkok (not what the average Thai has access to) to be at least as good as here in NY.

I have to agree with you there... we as patients must start somewhere if we want the system at home to change.

that being said, there are other alternatives to try as well - nutrition, acupuncture, lifestyle changes and so on. Disease and wellness is complicated so I do agree with Rich somewhat also.

To repair the system at home might not happen in my lifetime, however... I can't just wait around, if you know what I mean. It's like pushing an elephant up a hill.  We all have to make decisions, and make the best of what we have...

Getting involved in our own care is the best we can do, I think.

Best,
Akaisha
Author, The Adventurer's Guide to Early Retirement