Today’s ( Sunday October 15) NYT Business section has an article called Medical Tourism which means people are taking vacations in places like India,Thailand and other countries where the cost of expensive medical procedures is very low (about 80% lower than the US).The medical centers in India are specifically geared to treat people from Western Nations and have the latest technology,first rate surgeons and support staff.It cited the example of one person who had open heart surgery for about $8000 all inclusive.That means it not merely included all his medical fees, hospital stay but threw in a couple of weeks worth of luxury vacation.The patient said he avoided going into deep debt because he got the procedure done in India.
India, once again, is in the forefront of this wave of medical tourism.With a large number of highly trained and skilled physicians and surgeons and almost unlimited capital to invest in latest medical centers it is moving fast to capture the huge market of people in the US and Europe and Japan who cannot afford the medical care at home.
Along with IT ,India’s dominance of medical services threatens to cut the ground from under a segment of our population that is used to high incomes,and a large segment that provides support to the highly trained physicians and surgeons.This segment has been pretty much unscathed in the outsourcing era but is going to feel the tsunami of outsourcing that is coming as insurance companies and even governmental organizations feel the pressure to reduce costs.
I will say this.As a person who has to obtain insurance for my own family’s needs, I welcome anything that lowers my bills.But over the long terms, this is going to hurt my children’s prospects for work that they love and enjoy doing.
I can say that nearly all of the private hospitals are gearing up for or have geared up for medical tourism. It works too. People either get a good vacation and have a minor bit of surgery done at a very cheap price, or they have major surgery done at cheap prices and when they want it done. All of this takes place in modern, clean facilities with high standards of care. Thailand cannot compete with India but it shows an increasing competition in this field. There is also growing demand. Major dental procedures and various forms of cosmetic surgery are also areas where the standards are very high and costs low.
Just as how many manufacturing workers lost their jobs to cheaper labor abroad, so now the same will happen to an increasing number in western service sectors as this spreads to affect the professional classes no doubt we will see a bigger outcry than there ever was over the loss of traditionally lower class jobs.
It might be useful to break this down a little.
For a start there will be medical needs which could never be out-sourced. If for example, you roll your car and break several bones and rupture your spleen, you are not going to be medivaced to Thailand or Mexico to get treatment. In the same way, long term treatment or palliative care is not going to occur overseas. The procedures are therefore likely to be limited to elective surgeries that are more expensive in the USA than the cost in the other country plus air fare.
There will also be a limit to those who would be in the income band in which they are too poor to afford treatment in the USA but wealthy enough to afford the overseas trip and willing to undertake it. The situation is not unknown elsewhere and indeed it is a specific right under EU law that you can demand treatment in another country if facilities are not available in your home country in an appropriate time. There are situations where this could occur through skills shortages. The UK for example has sufficient cardiac surgeons for virtually immediate operations to be available in many parts of the country. On the other hand things like joint replacements have waiting lists because of shortages of surgeons. Some local areas have arrangements so that their residents can have their operations in France where facilities are available. (Incidentally, as dental care is chargeable as a large co-pay for working adults and there is a big shortage of NHS dentists in the UK, there is a growing trend to have extensive work done in the far cheaper countries of the EU like the Czech Republic. Cheap flights mean that the air fare can be as low as $70-80 and the hotel rooms are also reasonable.)
The amount of overseas treatment will obviously be a balance of relative cost and practicability. Even so the “client base” for doctors in the USA is not going to reduce that significantly but it could affect their incomes. If there develops a “donut hole” in the middle band of people going abroad, they will be left with either the Medicare type cases or those able to afford high price insurance and co-pays.
Now in many countries, especially the UK, the biggest resistance to a national health service came from the doctors themselves who saw their incomes threatened. If the scenario you postulate of their incomes reducing, they will be lobbying for it in the USA.
I agree that some procedures, especially the mergency needs,simply cannot be outsourced.But elective surgeries certainly can be and those are the procedures,like Open heart surgery,cosmetic surgery,eye surgery, ENT, etc. will increasingly be moved overseas.
As far as income of our own physicians and surgeons goes, the tremendous pressures for lowering costs and the availability of first rate physicians in India will exert downward pressures on physician’s fees,aided and abetted, no doubt,by the insurance companies and HMOs.Already many radiologits in this country are seeing the effect of Indian radilogists doing diagnostic work over the internet.Who knows what other diagnostic procedures are going to move too?
There is nothing like having high paying jobs outsourced, a situation that could be completely eliminated by full medical coverage by the government.
“Universal health care” would protect these jobs and, more importantly, protect the citizens of the USA. Not to mention take the economic burden off of corporations and small businesses.
It just makes all-around sense, both socially and economically.