Outsourcing America’s Health Care
“Ola, Amigo! Pack your bags, we’re going to Mexico!” bubbled Dr. Franklin Peterson Comstock III, faux physician and money-maker.
“Yeah, I could use a decent vacation,” I replied, figuring he’d pay for both of us since he had just set the world record for the most nose jobs in a 24-hour period.
“What vacation?” he said. “I’m setting up practice.”
“And give up catering to rich people with inflated bank accounts and deflated ethics?”
“Don’t have a choice. I’m getting laid off.”
Comstock had been a rainmaker for the Megabucks Happy Health Care Medical Center for the past decade. There was only one reason I could think of why he’d be laid off.
“Megabucks tired of paying your malpractice insurance?” I asked.
“Not just me,” he said. “Hospital’s laying off most of the staff, making the rest work overtime, and hiring outside contractors. They said it was hard to survive when the profit was down to only 20 or so million a year.”
“I didn’t realize it was that serious,” I said. “You planning to set up private practice to help the poor in Mexico?” I asked admiringly.
“Not a chance! Gonna get rich working for Megabucks!”
“You just said you were laid off.”
“Been laid off in the U.S.,” said Comstock while putting a frozen burrito into the microwave.
“Megabucks/Mexico just hired me. There’s cheaper labor down there.”
“You crazy?” I asked. “You’re the cheaper labor.”
“Obviously you don’t know American business,” said Comstock haughtily.
“Megabucks/U.S. closes its auxiliary operations, and then contracts with Mexican companies for a fifth of the cost in the U.S. They do the work, ship it back to the U.S., and Megabucks bills Blue Cross the full rate as if it was done locally.”
“So where do you fit in?” I asked.
“Just as before. Nose jobs. Breast augmentations. Tummy tucks. All the important medical procedures. But this time, I do it in Cancun.”
“To rich Mexicans,” I said disgusted.
“To rich Americans!” said Comstock. “If they want the best care, they’ll take their private jets to Mexico and then deduct the trip as a necessary business expense.”
“And what about the impoverished and middle-class Americans?”
“If they can sneak across the border, they can also get medical care.”
“What about prescriptions?”
“Megabucks contracted with some of the best drug dealers—I mean pharmacists and chemists—in Mexico. Quality is just as good and it’ll only be four or five times production costs. Unlike the U.S. there’s no TV advertising and six-figure MBAs and lawyers that require drugs to be 30 or 40 times production costs.”
“With prices that low, how do you know there won’t be mass rushes by Americans to grab everything they can?”
“Because there’s security! Every hospital and pharmacy has armed guards with the best automatic weapons smuggled through the God-fearing 2nd Amendment patriotic Southern states.”
“Is Megabucks outsourcing all its operations?”
“Keeping the ER. After tummy tucks and butt lifts, that’s the hospital’s ‘cash cow.’”
“So, then, it’ll have to keep some services like X-Ray and the lab,” I said. “Maybe even a doctor or two.”
“Too expensive,” said Comstock. “Megabucks will hire more residents and foreign-educated doctors, and work them 18 hours a day. More work, less time to complain. Residents will do anything to get experience to pass their boards. May even hire a couple of hospitalists. You know, the ones who graduated at the bottom of their class and can’t even get work in a Free Clinic.”
“I suppose they’ll also do the lab work?” I asked.
“Do you know some of those lab techs are making as much as $30,000 a year! Made sense to lay them off, too.”
“So how will the ER know a victim’s blood chemistry, or if there’s internal injuries?”
“Technology,” said Comstock. “They scan the blood here, and send digital X-Rays to Mexico. Mexican lab technicians—you know, the ones that don’t know about unions and will work for only a few bucks a day—will analyze everything, then text the results back to the U.S.”
“This sounds like it’s not only a way to maximize profits, but also a way to avoid dealing with the President’s health care reform program.”
“Obamacare!” spit out Comstock. “Nothing but socialized medicine.”
“Most countries have forms of socialized medicine,” I countered, “and they not only have good health care but affordable prices to their citizens.”
Comstock put his hands to his ears and began chanting, “We’re Number 1, We’re Number 1.”
“Number 37,” I corrected him. “The World Health Organization ranked the U.S. just below Costa Rico.”
“They’re all Commies,” replied Comstock. “Besides, that study is a decade old.”
“Last year, the independent Commonwealth Fund compared the nations of the United Kingdom against the U.S., and the U.S. ranked seventh of the seven.”
“Yeah, like Americans will go to Canada? It’s covered by snow and run by a queen who can’t even speak English.”
“You and Megabucks are crazy!”
“Possibly,” said Comstock, “but outsourcing is the American way. By the way, do you put ketchup or mustard on a burrito?”
[Dr. Walter Brasch isn’t licensed to practice medicine, but he goes to some excellent physicians who are—and they’re just as frustrated with the costs, insurance companies and myriad forms as anyone else. His current book is the critically-acclaimed mystery novel, Before the First Snow]
8 Responses to “Outsourcing America’s Health Care”
This has been going on for a while. A lot of Americans are traveling to Europe for procedures that aren’t covered by their insurance and are CONSIDERABLY cheaper over here.
Of course, you won’t make a dime on your lawsuit…the courts aren’t as giving over here.
They are also going to hospitals in Malaya, Indonesia, etc. The price of the plane ticket is far outweighed by the savings for the procedures. The procedures are often life-saving operations that would cost hundreds of thousands here.
Obama and the Democrats have taken a lot of heat for the ACA, but it comes from the wrong direction. They didn’t go far enough, NOT they went to far.
First, there are the trips to India, Malaysia, Indonesia, the Philippines, and so on for kidneys (also a big market in buying kidneys from poor people). I wouldn’t trust genetic matching or the quality of surgery there, necessarily.
But what Shannon Lee is mentioning in fact has happened. As many as ten or more years ago one newspaper (Wall Street Journal) had an article about even insurance companies here sending people to Scotland, to name one example, for heart surgery (if I recall correctly).
It’s probably complicating tings but maybe some at least can handle this, too: Please note when discussing or thinking about “health care costs” that there is a big difference between true costs, and what we pay, or charges. Even the die-hard fans of “single payer” don’t seem ever really to understand this, while way back in 1980, at least Ted Kennedy was open about brutal price controls that a “single payer” (buyer) system would make possible, in his speech where he said
(here’s the whole health care speech part)
That such price controls would promptly cause at least relative scarcity or a dearth not seen before of health care where there wasn’t one is a serious concern but we don’t know how bad it would be unless it were tried.
Incidentally, I haven’t noticed many gripes these days about doctors striving for “target incomes” and being more concerned about their golf scores or how their investments are doing than the conditions of their patients. Maybe it’s because of the bigger role insurers pay now in patients’ lives and in doctors’ incomes, too?
Shannon — I’m surprised more insurers don’t ship patients to Canada; it seems a no-brainer from cost savings for needed medical care or procedures, cheaper than shutting folks across the Atlantic.
Probably they’re too cheap to pay for the transportation, leaving that up to the patients to pay if they ever paid for work done there these days.
Medicare and VA have serious problems, and these ought to be solved before giving the equivalent to everybody, R.C., but that’s not to say the (private) insurance scene is rosy; it obviously is not.
One thing not given much press (because so many in and out of the media are so very ignorant so often) that was actually not flaming lefty stuff but apparently a GOP idea, is the federal government providing a means for insuring yourself if you’re high-risk. That is, it is not only assisting the states with high-risk pools but doing the job itself when states decline to do it.
pcip.gov
http://www.ncsl.org/issues-research/health/high-risk-pools-for-health-coverage.aspx
There are problems (including cost problems), but something is being tried.
(not all states have high-risk pools, and high-risk folks often can’t get insurance or are charged prohibitive premiums for it)
Hmm…dunno why Canada isn’t a medical vacation destination. I have a good friend that is a Canadian cardiologist now working in LA. I’ll have to ask him. I know he used to moonlight in Canada until he finally was approved to practice in California. Great doctor btw…high quality for sure.
All I can think it maybe Canada forces Americans to stand in line like the rest of the country. In Germany, private patients or foreign patients paying cash are always at the front of the line.
and I would like to add…
Germans find this acceptable. They believe that everyone should have access to a certain level of health care…even poor people. They also believe that people should have access to something better if they have the wealth to pay for it. So what they have is private and public options….private providing access to the Chief of Surgery…public provides access to someone down the food chain.
and Americans paying cash get access to the Chief.
So with crap like this going on, why do some people (especially but not exclusively Republicans) keep repeating the mantra “we have the best health care in the world”.
By what possible measure are the basing that claim?