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The entire premise of the discussions and debate on Capitol Hill misses the key point on the question of changing the health care system. Legislators have debated four points:

a) How to pay for the package

b) How to reduce its cost

c) Whether or not to have a government-run insurance company

d) What mandate to impose on employers to cover their workers

But none of these points copes with the more basic question of where the extra doctors to cover these now uninsured people are going to come from. You cannot cover the 50 million new people Obama seeks to cover without more doctors and nurses. But the administration and even the Blue Dogs in the House have proposed nothing to add to the supply of medical services even as they plan vastly to increase the demand by covering new people.

By focusing on false issues — or at least tangential ones — the politicians can play the Washington game of compromising on these questions while failing to address the central flaw in the legislation.

The projected Senate “compromise” being discussed in the Senate Finance Committee would eliminate the employer mandate and the public insurance option. But it would still extend coverage dramatically without making provision for more medical personnel. The Blue Dog compromise in the House would replace a public option with co-op insurance companies organized by states and would limit the employer mandate, but would have the same blind spot: too few doctors and nurses to cover the new patients.

Both bills would continue to vest the administration with the power to cut Medicare and the mandate to do so. Congress’ only check on the evisceration of the program would be its ability to veto proposed cuts within a limited period of time, as now applies to military-base closure.

Experience has showed that Congress is just as happy to sit back and let the closings or cuts take place without acting to stop them.

And by failing to provide for more doctors or medical schools or nurses, both bills will force widespread rationing of medical care. And that rationing is going to mean lower-quality medical care for us all, especially for the elderly.

A doctor in Massachusetts — where Romney passed a plan similar to Obama’s, recently told us that she now has to read 60 mammograms a day in the time she used to spend on 45. Less time, she said, means less accuracy in reading the complex data and more mistakes. “It keeps me up at night,” she told us, “that I might make a mistake, I am so rushed.”

And, for the elderly, it means less and less medical care. A Federal Health Board will sit in judgment of medical procedures and protocols and will decide what guidelines all providers must use in giving patients certain types of care or withholding them.

For example, the drug Avastin is widely used in the United States to treat advanced colon cancer. But it costs $50,000 a year. So the Canadian health system will not permit its use. As a result, 41 percent of colon cancer patients in Canada die each year as opposed to 32 percent in the United States. The average eight-month wait for colonoscopies in Canada also contributes to the problem. Colon cancer rates are 25 percent higher north of the border than in the United States, where colonoscopies are readily available.

Neither the House nor the Senate will act on these bills until September. Congressmen and senators will be home during August to test public opinion. It is up to us to give them an earful!

source:  http://www.theusdaily.com/articles/viewopiarticle.jsp?id=2443&type=Opinion

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In the end – if one is to be thorough – a buyer of insurance always has to go to the actual insurance contract. There is no other way. Somewhere down the line the contract had to be vetted by lawyers and accountants and submitted to a government agency which oversees and regulates insurance plans and coverage’s. Nothing will ruin the long weekend or even the month of administrators of any insurance firm than a letter from the “registrar “or regulatory board of any insurance industry. One has to examine that actual document.The firm may be resistant to provide it or hand it over. They may say and respond at great length (usually verbally) that such a document or paper does not exist. It has to. In the end the company will have to forward you to those insurance documents. Glossy marketing brochures and the like are no substitute for such information. Actual legal documents are the only means of determining your insurance coverage. In a pinch or negotiations the insurer will use the data and facts – why not you as well?

The key factor in terms of medical tourism and insurance coverage is that now an increasing amount of insurance companies – group plans, commercial coverage and coverage by employers are now covering overseas treatments as well as surgeries.

Read the small print of your medical insurance coverage and benefits and as well the extent to which the coverage by the medical insurance coverage covers any follow-up treatments required. A key question as well is what happens if mistakes or complications arise – what costs are covered or are not covered. Are out of pocket or additional costs covered. It is not a negative feature of the care provider chosen. Complications can arise at home, or at the best first world medical care intuitions. Why not could they not arise overseas? The major difference here is that you are far away from home – or even far away from other specialized medical care if need be.

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Patients can save as much as 80 percent on procedures done by medical professionals often educated and trained in the United States at hospitals increasingly accredited for meeting U.S.-like standards.

An estimated 150,000 people traveled abroad last year for medical treatment, and the number is expected to double by 2010, said Josef Woodman, author of “Patients Beyond Borders: Everybody’s Guide to Affordable, World-class Medical Tourism.” Nearly half had medically necessary surgeries, such as hip replacements or spinal work, heart surgeries, even cancer treatment.

The book, released in March, tells how patients can save 25 percent to 75 percent on anything from LASIK eye repair to neurosurgery by traveling outside the United States.

Health-industry representatives said U.S. healthcare costs more, in part, because of skyrocketing medical-malpractice insurance and the higher wages and benefits paid to hospital workers.

Costs are high, said Woodman in a telephone interview, “because Americans demand from cradle to grave the most expensive treatment, the most extensive testing.”

He said the American healthcare system is “stuck” because insurance companies are dictating what can and can’t be covered, and consumers are unable to negotiate direct payment to providers.
A longtime surgeon and clinical professor for UC San Francisco’s Fresno-based medical education program, said that while he has been all over the world and knows there is great medical care available, he advises caution.

He said there are also plenty of Third World countries with hospitals and doctors that don’t meet U.S. guidelines and restrictions but offer huge discounts. Hospitals here have to meet certain standards, he said.

Those who choose to go abroad? “I think it is probably dangerous, and you are probably taking a risk with your life. I think you should find a way to get it done at the good hospitals in town,” Parks said.

Woodman has traveled abroad for his own care. He went to Costa Rica for dental work — a root canal, implants and follow-up care — after looking at several other countries. He said he saved about $2,000.

The key to a good experience, he said, is to do your homework, find out about the doctors, try to interview them beforehand, and then ask about success rates and find out about the facility. “If they don’t speak English, then move on.”

Interest in traveling abroad for medical treatment has spawned a new industry: medical tourism. Companies are playing the role of travel agent and medical-care coordinator and linking American patients with overseas hospitals for a fee.

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What is interesting to note is that even the medical insurance industry has now stepped into the act of evaluation , promotion and use of medical tourism both as a cost saving and queue shortening procedure..
Some will say that the basic tactic and reputation of insurance companies is to gladly accept insurance premiums while trying to shirk or avoid payouts.  While this is not true, it is true that as if with any business profitability is key.   Thus any cost savings or reductions are highly powered for any insurance provider or company due to its very powerful effect on the bottom line.  Any cost savings are money earned for the firm.  The one major concern to medical insurance providers who utilize medical tourism in an effort to save costs is prevention of any additional costs – whether it is for additional therapy when the patient returns home and has problems, or even of lawsuits.  For patients themselves it can be a nightmare.  The foreign medical care may be protected first by actual geographic and cost logistics, their legal and / or medical system and the costs of conducting legal actions in the far away foreign country.  As a result the first actions of unhappy or ill treated medical tourists who have been sent for far away medical care by their health care insurance company is to seek redress from their insurance provider.
As a result health care insurance companies have shied away from using medical tourism and medical tourist facilities – at least until the cost structure more than justified it.

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                    To many overseas , or even in Canada , the concept of not being provided with medical care – uninsured or not insured , or not being able to afford medical care may sound unlikely or even preposterous.   Yet it is the sad fact for many in the United States.  On top of that health care costs themselves in the U.S. compared to other places are relatively much higher.   This is said to be the result of many causes – not one in themeselves.    It costs money to run a business – especially in the states.  Doctors not only have to be paid relatively large pay scales compared to the U.K., Europe and Canada and yet their costs are not small .   Doctors have to pay substantial costs for health care insurance due to the plague or almost an industry of lawsuits against them.  It is said that having 2 lawyers in a town increases the total costs of legal services and  total services used immensely .  Imagine a whole industry based on seeking lawsuits against medical practitioners.  Its defensive medical system at its finest.  On top of that add other costs – costs of modern equipment , running a hospital often with unionized staff .  On more point is the cost of administration – both in the medical insurance plans and companies for administration and non payment and collection of bills to doctors.

                    What is interesting is that even though patients and health care consumers in other countries with socialized or public health care believe all in all that their healthcare is “free”  even though they may be subsidizing it greatly with tax dollars either specifically collected for that purpose or from general tax accounts – from say gasoline taxes or income taxes.

                  Even though these citizens may be astounded that someone in America will gladly pay for medical treatment in their countries the actual consumer may see it as a tremendous bargain and value when all costs are counted up.   Its similar to a Canadian citizen making a special trip to farwaway Texas or Florida to purchase a automobile to bring it back to Canada.  Even though the car may be manufactured in Canada under free trade Nafta rules when it is all said and done they may be greatly ahead in the bargain – even when including travel as well as other costs.  To boot they even get a sort of vacation away from home during the cold Canadian winter.   The Canadian car industry may not like it , however you cannot  “have your cake and it too”.  If these local north american industries wish to benefit from the economies of scale that a free larger market provides for , they cannot pick and choose what rules and procedures they wish to follow and which they don’t.  The only people in the equation who may be perplexed may well be the customs officers at the Canadian border who when finding that even when the rules are followed , they cannot stop the process.  It is all perfectly legal and proper.  If the customs agent was not suave enough to use those same rules – and even contacts to obtain a similar bargain that is their issue and not one of the thorough and determined modern consumer.

<p><a href=’http://www.pressreleasepoint.com/nip-and-tuck-solutions-take-price-medical-tourism-down-under’>Nip and Tuck Solutions take the price of Medical Tourism Down …</a> – This is the age of affordable international travel and with it has come the rise of medical tourism and healthcare. Nip and Tuck Solutions Australia has seen a dramatic increase in demand for Medical tourism services for Australian …</p>
<p><a href=’http://www.groundreport.com/article.php?articleID=2872902&offset=2′>GroundReport | Malaysia | Medical Tourism an extra advantage to …</a> – As healthcare becomes increasingly expensive, savvy patients are now looking to Medical Tourism as a cost-effective alternative to receiving medical treatment and Malaysia stands out to be the best option available. …</p>
<p><a href=’http://malaysiahotelnews.blogspot.com/2008/11/medical-tourism-feeling-slight-pain.html’>Malaysia Hotel News: Medical tourism feeling slight pain from turmoil</a> – Mahkota Medical Centre Sdn Bhd chief executive officer Francis Lim was of the view that Malacca could gain from the slowdown. “We may benefit as we still have price advantage over Singapore … unless Singapore adjusts their prices …</p>
<p><a href=’http://www.buzzle.com/articles/the-danger-of-medical-tourism.html’>The Danger of Medical Tourism!</a> – What can appear to be an attractive and relatively cheap prospect for those considering some form of plastic surgery, can often turn into an expensive nightmare. The perils of medical tourism. The Danger of Medical Tourism!.</p>
<p><a href=’http://medicalnewstodayblog.blogspot.com/2008/11/wellpoint-pilot-program-will-provide.html’>Medical News Today: WellPoint Pilot Program Will Provide Coverage …</a> – “It allows the customers to have choice,” Hashmi said, adding, “Certainly the cost difference is striking enough for some procedures.” According to the Star, the proliferation of medical tourism programs like WellPoint’s could “create …</p>
<p><a href=’http://indolac.wordpress.com/2008/11/25/medical-tourism-to-india-all-expenses-paid/’>Medical Tourism to India, All Expenses Paid</a> – In January, Serigraph Inc., a West Bend, Wis., manufacturer, will become the first US company of any size to embrace medical travel or medical tourism, offering employees the option of having certain nonemergency operations, …</p>

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>The impacts of medical tourism – traveling long distances away from home to obtain medical care – which more and more is not about obtaining medical procedures that are not available at home , or seeking improved quality of medical care but in most cases either finding a way of economically “jumping the cue” or reducing the costs of treatment or therapy dramatically.

The cost differential of treatment abroad may only be a portion of the costs of the same procedures at home. To this end not only is it a case of cosmetic elective surgery but rather that insurance companies are coming up with the realization that even after travel costs they are far ahead in most financial accountings. There are issues and other costs true – what of follow-ups in cases of complications and downright negligence true.

However if one is to look at the system in a cold hearted financial sense the insurance companies are still light years ahead – in terms of output costs. In addition these complications and mishaps can be reduced through basic research and inquiries into medical systems and procedures and using well known accredited institutions.

To this point some major health care insurance providers are actually promoting medical tourism to the customers – even to the point of setting up programs , marketing programs and departments to promote , market as well as facilitate the logistics and follow through to the customers and their providers of medical care. It would appear to be a win / win situation for all.

Yet this is not always the case. Medical care and medical care costs in the states and E.U. is driven by both demand and costs. True with medical tourism the demand for medical care and services back home may be reduced. Yet medical tourism at the moment is only scratching the surface. Even the most aggressive of medical insurers estimate that in the range of only 1 to 2 % of their procedures afforded are being serviced overseas via medical tourism.

Yet in the case of the American medical system this small group serves to subsidize the medical system as a whole – providing an essential source of funds to keep the system going and in effect subsidize the health care of those less fortunate, in financial terms, but very demanding overall on the health care system – the aged, the elderly and the poor.

In the end result the demand for health care – the demand side of the supply/demand model will not diminish much. But funding which both funds the system and provides for economies of scales in the health care system will.

Thus while some may benefit from medical tourism, and the insurance companies of health care may benefit from reduced costs – in the end the medical system as a whole as well as the quality of care afforded and provided for may well decrease as well as diminish.

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