The Revolution in Health Care Delivery
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  • Anthony

    The points made in this post are good, but Professor Mead seems to be avoiding the bigger issue. He constantly talks about the ability of nurse practitioners and physician assistants to reduce health costs. And while this is obviously an accurate observation, no mention is made of the fact that major procedures are the main driver of healthcare costs. Are we going to have nurse practitioners performing open heart surgery? Professor Bhagwati, who regrettably no longer writes for The American Interest, had a good idea that, to my knowledge, has not yet been taken up by Professor Mead.

    He thought that patients should be encouraged to get surgeries done in foreign countries such as Thailand, where doctors who have completed a residency in America are available in first class facilities at a significantly lower price than their counterparts here in America. If this idea intrigues you, I suggest watching the 60 minutes episode on healthcare tourism, which is available on youtube. It shows Bumrungrad hospital in Thailand, which looks outstanding. Not only is it much cheaper for patients paying in cash, they actually get a much more luxurious experience than is available in America.

    • Andrew Allison

      Like most people, Prof. Mead (or, perhaps, the flogees) is not thinking clearly about healthcare. Specifically, he not only conflates the delivery of healthcare with the entirely separate problem of how it’s paid for, but tends to tar all providers into the same brush. As you point out, primary care is not the primary (sorry) problem.

      The difficulty with medical tourism is that the patient has to pay the bill in full at the time of service and, if insured, attempt to get reimbursed. Insurance companies could save a lot of money (and put pressure on domestic providers) by agreeing to pay approved foreign hospitals for non-urgent procedures (hips, knees, heart by-pass, etc.).

      A simpler solution might be for insurance companies to publish the amounts which they are actually reimbursing for standard procedures and do away with the entirely fictitious billing by hospitals and specialists. I’ve seen estimates that it’s about 30% of the list price.

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