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Rapid Responses: Rapid Responses published:
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Universal Cover for America?
- Hank Kearney (28 November 2006)
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Universal Insurance in the U.S. is Impossible
- Boris Odynocki (2 December 2006)
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Medical tourism of India can be a boon for uninsured Americans.
- Soubhagya R. Nayak, Ashwin Krishnamurthy, Latha V. Prabhu (2 December 2006)
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Hank Kearney, CEO PHM International, US 32958
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Dr. Uwe E Reinhardt writes in “Uninsured Americans and the new Democratic Congress: Is universal coverage now more likely?” "...America's national conversations on the topic - a conversation that resembles nothing so much as the rambling of a drunken lover at a bar - big talk, little action. In health care it has become "the American way." Be still my heart! While Dr. Reinhardt cites Altman's Law as the main reason for lack of change in financing America's healthcare mess, I do believe his other issue is at the heart of the matter. America and Americans simply do not have any sense of "health solidarity" and this does stem from the belief that poverty is “the product of free choice rather than lineage and bad luck.” While Americans don’t have a concept of health solidarity, many in the healthcare clinical and financing professions will claim the right of “emergency care” for all Americans. Unfortunately, this manifestation of "guaranteed access to healthcare," e.g. being wheeled into the emergency room with end stage bone cancer, isn't a very effective way of providing healthcare. The challenge for American healthcare reform isn’t necessarily developing a sense of solidarity or political expedience, but rather economics. The current health care financing scheme (or lack of) in the US is increasingly putting us at a disadvantage in the global economy. We're just too inefficient. Not too expensive, just too inefficient. Couch the conversation in economic and competitive terms and watch American politics at work. Competing interests: None declared |
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Boris Odynocki, Associate Professor Southern University, New Orleans, 70122
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Professor Reinhardt is right when he claims that comprehensive insurance for all in the United States is impossible at present, even though Democrats will dominate the next Congress. He errs, however, when he attributes this failure to an American belief that those who are uninsured should blame themselves for their misfortune. (See Reinhardt, Uninsured Americans and the New Democratic Congress, BMJ.) After all, substantial proportion of uninsured, or underinsured Americans, are the middleclass and are not viewed by themselves or others as poor. The true reason for lack of National Health Insurance in the U.S. is the paculiar American system of financing national elections. The system allows the major actors in the health care industry - the American Medical Association, the American Hospital Association, the Health Insurance Association of America, and most recently - the coalition of pharmaceutical companies to control government policy towards financing and delivery of health care through substantial monetary contributions to election campaigns of favored political candidates. Thus, these actors reward those politicians who are against universal health insurance with substantial contributions, and punish politicians who favor universal insurance by denying them these contributions. In additon, they dominate the airwaves in any debate about financing and consumtion of health care. No one else in the United States has such an abundance of resources which can be thrown immidiately into media advertising to defeat any national health insurance plan that violates the interests of these actors. Propaganda about "socialized medicine" and long waiting time in the U.K and Canada fall on receptive minds of mostly poorly educated Americans.These associations not only control Congress but also dominate public debates about national health policies. Recent mergers of media conglomarates and decline in outlets for public debates makes the job of these pressure groups easier. Competing interests: None declared |
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Soubhagya R. Nayak, Anatomist Kasturba Medical College, Bejai, Mangalore-575004, India., Ashwin Krishnamurthy, Latha V. Prabhu
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Dear Sir, We want to point out here; the lack of health insurance in America should not be a matter of concern. As a medical tourist in another country, you can save as much as 80% of hospital cost. Because now your, dollars are actually going to the surgeons, anesthesiologists and other hospital workers who are attending to you during your surgical procedure. Whereas in the United States, your money is going to the insurance company and then the insurance company money is being used to pay paper shufflers. Countries where medical tourism is being actively promoted include Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical tourism. According to a study by McKinsey and the Confederation of Indian Industry, medical tourism in India could become a $1 billion business by 2012. The key “selling points” of the medical tourism industry are its “cost effectiveness” and its combination with the attractions of tourism. Price advantage is, of course, a major selling point. The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. Open-heart surgery could cost up to $70,000 in Britain and up to $150,000 in the US; in India’s best hospitals it could cost between $3,000 and $10,000. Knee surgery (on both knees) costs 350,000 rupees ($7,700) in India; in Britain this costs £10,000 ($16,950), more than twice as much. Dental, eye and cosmetic surgeries in Western countries cost three to four times as much as in India. The recent growth of medical tourism in India can be boon for those who don’t have health insurance in America. Then the health insurance system of America should be changed if the American government is serious about the health care system in the country and in our point of view it can be achieved by low cost and good health care. Dr. Uwe E Reinhardt hope for a universal health insurance will be fruitful when there will be change in the health insurance law. If the present scenario does not change, the developing countries like India can take advantage of the situation. Competing interests: None declared |
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