Outsourcing Cure Treatments makes Economic Sense

[Faye]

Outsourcing Your Heart

Elective surgery in India? Medical tourism is booming, and U.S. companies trying to contain health-care costs are starting to take notice
By UNMESH KHER
SUBSCRIBE TO TIMEPRINTE-MAILMORE BY AUTHOR
Posted Sunday, May 21, 2006

Whiplash was just the first agony that Kevin Miller, 45, suffered in a car accident last July. The second was sticker shock. The self-employed and uninsured chiropractor from Eunice, La., learned that it would cost $90,000 to get the herniated disk in his neck repaired. So, over the objections of his doctors, he turned to the Internet and made an appointment with Bumrungrad Hospital in Bangkok, the marble-floored mecca of the medical trade that--with its liveried bellhops, fountains and restaurants--resembles a grand hotel more than a clinic. There a U.S.-trained surgeon fixed Miller's injured disk for less than $10,000. "I wouldn't hesitate to come back for another procedure," says Miller, who was recovering last week at the Westin Grande in Bangkok.

With this surgical sojourn, his first trip outside the U.S., Miller joined the swelling ranks of medical tourists. As word has spread about the high-quality care and cut-rate surgery available in such countries as India, Thailand, Singapore and Malaysia, a growing stream of uninsured and underinsured Americans are boarding planes not for the typical face-lift or tummy tuck but for discount hip replacements and sophisticated heart surgeries. Bumrungrad alone, according to CEO Curtis Schroeder, saw its stream of American patients climb to 55,000 last year, a 30% rise. Three-quarters of them flew in from the U.S.; 83% came for noncosmetic treatments. Meanwhile, India's trade in international patients is increasing at the same rate.

That's still a trickle compared with the millions of surgeries performed each year in the $2 trillion U.S. health-care system. But a significant shift is under way. It's one that could put greater competitive pressure on U.S. hospitals as some of their most lucrative patients are siphoned off. Elective surgeries are key moneymakers for hospitals, and even a small drop-off can cut deep into their profits.

What may accelerate the trend is that some pioneering U.S. corporations, swamped by rising health-care costs, are taking a serious look at medical outsourcing. Blue Ridge Paper Products of Canton, N.C., a manufacturing company, may soon offer employees outsourcing as a health-care option. The carrot? The patient would get to pocket some of the firm's substantial savings.

The calculus behind this interest isn't complicated. Many major employers in the U.S. are self-insured, which means they pick up the tab for much of their employees' medical care. That's why three major corporations that collectively cover 240,000 lives asked Dr. Arnold Milstein, national healthcare "thought leader" at the consultancy Mercer Health & Benefits, to assess the best places to outsource elective surgeries. Procedures in Thailand and Malaysia, he found, cost only 20% to 25% as much as comparable ones in the U.S.; top-notch Indian hospitals sell such services at an even steeper discount.

The bottom line: If more private payers sent patients abroad for uncomplicated elective surgeries, the savings could be enormous. "This has the potential of doing to the U.S. health-care system what the Japanese auto industry did to American carmakers," says Princeton University healthcare economist Uwe Reinhardt.

http://www.time.com/time/magazine/ar...196429,00.html

[artsyguy1954]

I can see the logic of this. It would introduce much needed good old fashioned competition into the American healthcare system. And anyone going overseas gets a vacation in an exotic location thrown into the bargain.
Now, if only the same logic would be applied to SCI research and clinical trials.

[glider]

Originally Posted by Faye

Outsourcing Your Heart

Elective surgery in India? Medical tourism is booming, and U.S. companies trying to contain health-care costs are starting to take notice
By UNMESH KHER
SUBSCRIBE TO TIMEPRINTE-MAILMORE BY AUTHOR
Posted Sunday, May 21, 2006

The calculus behind this interest isn't complicated. Many major employers in the U.S. are self-insured, which means they pick up the tab for much of their employees' medical care. That's why three major corporations that collectively cover 240,000 lives asked Dr. Arnold Milstein, national healthcare "thought leader" at the consultancy Mercer Health & Benefits, to assess the best places to outsource elective surgeries. Procedures in Thailand and Malaysia, he found, cost only 20% to 25% as much as comparable ones in the U.S.; top-notch Indian hospitals sell such services at an even steeper discount.

The bottom line: If more private payers sent patients abroad for uncomplicated elective surgeries, the savings could be enormous."This has the potential of doing to the U.S. health-care system what the Japanese auto industry did to American carmakers," says Princeton University healthcare economist Uwe Reinhardt.

http://www.time.com/time/magazine/ar...196429,00.html

Presently and at a growing rate.

Corporations are doing it,.. outsource selective surgery to places like Thailand, India and...
where cost its only 25% as much comparing to the US.


International hospital chains are moving in to Mexico and other western countries to take care of our American injured at a reasonable cost, how sad to see this, but it is time.

Cuba, Colombia, Brazil and Mexico are also investing in the future, they are looking to the future and see a collapsed US health care system.

Dr.McDonald, Dr.Wise and many other excellent scientist are also going over seas to do SCI research, just look up OEG or OEC or spinal cord under the PUBMED.com library and you see al the published and on going research for SCI from other countries, than X2 for the ones that dont publish.

Now, how difficult can it be for us, the SCI injured, to focus our energies and donated money to US based scientist in other countries where things are happening at a faster rate, cheaper, with less restrictions and political b.s.

We need a CC space to keep up with the times.

We need to be able to communicate with these centers over seas, in their language.

[Faye]

Originally Posted by glider

Now, how difficult can it be for us, the SCI injured, to focus our energies and donated money to US based scientist in other countries where things are happening at a faster rate, cheaper, with less restrictions and political b.s.

We need a CC space to keep up with the times.

We need to be able to communicate with these centers over seas, in their language.

That is exactly why I view the establishment of a NIH funded clinical trial network in the US as a very necessary but largely symbolic step towards a cure. So much more can be accomplished overseas with far less money.

And now that large health corporations are going that way, we can have more uniform standards even overseas.

Thinking all things can best be done in the US is an outdated notion, though I feel there is no institute better suited to basic science than the NIH. This is however not true when it comes to actual application of the findings.

We need to look towards the business model to ensure we get the biggest bang for the dollar when it comes to human application of basic science findings.

That business model points to outsourcing as the best way to go to speed things up.

[Wise Young]

Faye,

I strongly disagree with you. If you want to encourage treatment developments overseas, you are very welcome and I strongly encourage you to do so, but please do so without making it more difficult for people who want to establish clinical trials and a clinical trial network in the United States.

We can and should establish clinical trial infrastructure in the United States for the following reasons:

• Clinical trials in the United States would accelerate FDA approval and availability of treatments in the United States.
• Insurance coverage. Insurance coverage not only requires FDA approvalo but will require clinical trials carried out in the United States.
• Clinical trials in the United States will familiarize U.S. doctors with the therapies so that it can be delivered in the United States.
• There is a delay in transfer of treatments and technologies from Europe or Asia to the United States.
• U.S. doctors are more likely to accept therapies that have been tested in clinical trials in the United States.

Not everybody can afford to travel overseas for treatments and some clinical trials eventually have to be done in the United States. The concept that the United States can and should outsource clinical trials of therapies is wrong. We cannot have 250,000 Americans with spinal cord injury going overseas for therapies. Why should we have therapies developed in the United States be tested only overseas?

It is not true that a spinal cord injury clinical trial network in the United States is a "largely symbolic" step towards the cure. I have carried out clinical trials in the United States. The United States does most of the clinical trials in the world. Spinal cord injury clinical trials in the United States can and should be done. In fact, I believe that it must be done in order for people in the United States to benefit from the therapies.

Wise.

[Faye]

Originally Posted by glider

Cuba, Colombia, Brazil and Mexico are also investing in the future, they are looking to the future and see a collapsed US health care system.

You're forgetting Peru

http://sci.rutgers.edu/forum/showpos...0&postcount=20

[Faye]

Originally Posted by Wise Young

Faye,

... I strongly encourage you to do so, but please do so without making it more difficult for people who want to establish clinical trials and a clinical trial network in the United States.......

Business is booming in particular in Tailand.

Here is an inspiring article about ESCR done at John's Hopkins by a Tai student who will be returning to Tailand to continue her work:

Her ongoing experiments involve testing a mix of adult and embryonic stem cells in an effort to generate new cartilage.

"We're trying to find the best biological conditions to increase the survival rate of these cells and to get them to turn into the cells that make up cartilage," she says.


Thanissara is currently on a summer break with her family in Bangkok before she returns to complete the last year of her undergraduate study at the university's Whiting School of Engineering.


She is majoring in chemical and biomolecular engineering and plans to move on to a medical school to study towards an MD and PhD in medicine while continuing her research project.

Studying chemical and biomolecular engineering is the foundation for her plans to continue in the field of tissue engineering says Thanissara, who received the American Institute of Chemical Engineers' Award for Scholastic Achievement 2006.

The award is presented annually to the junior student with the top performance in the field.


Thanissara is studying in the US on a full scholarship provided by the Institute for the Promotion of Teaching Science and Technology.

"Very glad, proud and very surprised," she said as she recalled the feeling when receiving the award on May 8.


Although she has always tried her best in her studies, she said she did not expect to become the best of the batch.

And this is not her first time in the spotlight. As a high-school student in 2001, Thanissara received a gold medal with the highest score in the International Biology Olympiad held in Brussels, Belgium, where she competed against 150 students from 38 countries.


She said she expects to return to her hometown as a research doctor in about seven to ten years, determined to improve her medical knowledge through research such as the project she is working on.

"To become a medical doctor, I might be able to help thousands of people in a lifetime, yet as a research doctor I could help save millions of lives at once with good research," says Thanissara, whose parents and elder brother are all medical doctors. Her younger sister is a medical student.

This is one fine lady we need to recruit for sci research!!

http://www.nationmultimedia.com/2006...s_30005621.php

[Faye]

Originally Posted by Wise Young

Faye,

......The United States does most of the clinical trials in the world.....

Wise.

Yes, but that is subject to change as it is undisputed fact that the clinical value per dollar is actually lowest in the US as compared to other industrialized countries.

Premature mortality rates in the US are a disgrace etc. Medical malpractice as well.

The very best piece I've seen on the wholly inadequate health care system in the US is here:

http://www.newamerica.net/Download_D...ile_2855_1.pdf

I would prefer to have clinical trials take place where conceitedness and big business interests were less of an issue.

At least in those other countries, they will go out of their way to be professional and make a good impression.

[Keith]

I don't care what the cost is.... But I will wait until there is something in the United States proven to repair sci. When it is proven that doctors can come here & do the surgeries.

[glider]

Originally Posted by Wise Young

I strongly disagree with you. If you want to encourage treatment developments overseas, you are very welcome and I strongly encourage you to do so, but please do so without (1) making it more difficult for people who want to establish clinical trials and a clinical trial network in the United States.

(2) We can and should establish clinical trial infrastructure in the United States for the following reasons:
· Clinical trials in the United States would accelerate FDA approval and availability of treatments in the United States.
· (3) Insurance coverage. Insurance coverage not only requires FDA approvalo but will require clinical trials carried out in the United States.
· Clinical trials in the United States (4) will familiarize U.S. doctors with the therapies so that it can be delivered in the United States.
· There is a (5) delay in transfer of treatments and technologies from Europe or Asia to the United States.
· (6) U.S. doctors are more likely to accept therapies that have been tested in clinical trials in the United States.

Not everybody can afford to travel overseas for treatments and some clinical trials eventually have to be done in the United States. The concept that the (7) United States can and should outsource clinical trials of therapies is wrong. We cannot have 250,000 Americans with spinal cord injury going overseas for therapies. (8) Why should we have therapies developed in the United States be tested only overseas?

(9) It is not true that a spinal cord injury clinical trial network in the United States is a "largely symbolic" step towards the cure. I have carried out clinical trials in the United States. The United States does most of the clinical trials in the world. Spinal cord injury clinical trials in the United States can and should be done. In fact, (10) I believe that it must be done in order for people in the United States to benefit from the therapies.

Wise.

With all your do respect, I will like to post my opinion on your post Dr. Wise.

1. It is not more difficult, it is only way-way too expensive, a confused democracy like ours where the greed of corporations and the hidden agendas of the FDA and the Gov. make it, not only more difficult but unreachable.

2. We are, at a very slow tumbling pace. Over 12 years and much money spent with nothing in the US pipeline to show for it, no real base for a network.

3. Insurance is a money making machine, they are already looking for less expensive overseas options, some US insurance companies have already paid for part of Limas procedure in Portugal.

4. US doctors may just have to travel overseas to learn these procedures. Miami Project doctors and scientist traveled to China to investigate what Dr. Huang was doing, he did not want to show how he prepares the embrionic cells for transplantation, (trade secrete) these doctors come back to the US to replicate what they herd (not seen) and publish in their web page a brake –through finding of a combo based on (OEC)adult cells therapy, they are not sure how it works. No wonder they are afraid.

5. Conflicting competitive agendas, skepticism, egos, and the FDA delay this transfer.

6. Their lost and ours. how sad but real.

7. How wrong can it be when ChinaNet will be doing it?

8. It makes economic sense and it may be the other way around “overseas therapies may be tested and implemented in the US.

9.“Largely symbolic” is the way it looks. A network is very unsightly to become efficient in a unhealthy, broken-down, competitive environment.

10. It is a small world and all humanity should benefit from these therapies not just us in the USA.

A cure by 2010, a CC poll, shows that by far, CC members believe in ChinaNet and the NTT project with Dr.McDonald (both over seas) as the best options, all the others fall way behind.