uninsured


An excellent article appeared recently in Dallas News that talked about the health care systems in other Western countries and what America can learn from them to resolve its health care woes. Here is the article for a good read…

Tackling the high cost of health care is politically bruising and difficult work around the world. Among developed countries, only the Norwegians rival our level of spending. The French wrestle with rising costs every year. The Canadians are searching for a better model, and have had their eyes on France. But for all their troubles, the French and the Canadians – two bogeymen in the American reform debate – spend much less and live longer than we Americans.

In the last five years, I’ve spent time reporting on health care in 10 other countries to see what they might offer in the way of suggestions to improve the American way of medicine. No one has a perfect system. No one has a permanent solution. But medical spending can be slowed without sacrificing quality. Some do it with government price controls and government doctors, while some do it with government acting as a referee. Neither approach is fatal to medical quality.

The Swiss, the French and the Canadians all use very different approaches to get at the problem, but they get there. And when all else fails, there’s still medical tourism. You can get heart bypass surgery, with a tour of the Taj Mahal, in India for less than 10 percent of the U.S. cost – plus a year’s supply of pharmaceuticals.

I met Carlo Gislimberti, a New Mexico restaurateur, in New Delhi in 2005 while he was waiting for a coronary bypass at the Escorts Heart Institute and Research Centre. He’d had three heart attacks. He had no health insurance. His Albuquerque hospital wanted $120,000 for the operation.

Escorts did the job for less than $12,000.

“It was an absolutely wonderful experience with wonderful results,” Gislimberti said last week when I called him in Santa Fe.

“There was only one thing – the luxury is not there. But the knowledge, the quality of nursing, it was absolutely beyond belief. … I would still today recommend to all the people in my predicament to go abroad.”

Medical tourism is no longer a quirky answer for the desperate and uninsured. The health-consulting arm of Deloitte estimates 1.6 million Americans will seek medical treatment in another country this year. U.S. health insurers, looking for ways to lower costs, are exploring policies that cover such travel.

Gislimberti, now 64, sold his restaurant and paints for a living. His heart ailments qualified him for disability under Social Security, and last year he was accepted under Medicare. He had a pacemaker installed by his Albuquerque hospital in an operation last May.

One thing he learned: “If you have insurance, this country is the greatest. But it you don’t have insurance, this is a Third World country.”

Another lesson: Price competition is coming. A study by the McKinsey Global Institute consulting group last fall found that Americans pay 50 percent to 60 percent higher charges for pharmaceuticals, health insurance overhead and physician services than anyone else in the world. That could make medical tourism irresistible, and a competitive risk to the U.S. medical establishment.

Switzerland is intriguing because employers have gotten out of the insurance business. The Swiss government mandates personal health insurance. Everyone shops among scores of insurance companies to buy a policy. The insurers must offer everyone a basic policy and can’t exclude anyone. The government offers subsidies to people who can’t afford a policy, and fines people who don’t get one.

Swiss medical fees are set in annual negotiations between health care providers and insurers that must win the approval of the canton parliament. (Insurers and hospital chains do the same thing here, but those negotiations are seldom among equals and don’t have a referee like the canton parliament.)

One result of the Swiss approach is that consumers gravitate toward high-deductible policies – insurance that costs less per month, but takes more out of your wallet when you see a doctor. And because they’re paying for it, the Swiss are more cost-conscious health consumers. The Swiss spend about a third less than Americans for medical care.

France and Canada both have national health insurance. In France, this is like Medicare for all. There’s a gap of 30 percent to 40 percent between what the government insurance covers and what health care costs, so a lively market exists for private, supplemental insurance policies.

Doctors can choose compensation under a government schedule revised every year, or they can charge what they like – and forgo a government pension.

Canadians may, famously, wait for nonurgent treatments and surgeries. But they’re quicker to rally around a public health issue like obesity, because the insurance mechanism is part of the provincial government.

“Our wait lists are coming down, but they’re still substantially more than yours,” said Canadian health economist Steven Lewis. “But your system is twice as expensive. It doesn’t insure 45 million people, it underinsures another 45 million, and overall you have a less healthy population. Is that worth sustaining?”

In the current health care debate in Washington, no one argues that we should throw out the U.S. health care model for an import. There are models closer to home – like Temple’s Scott & White – worth emulating.

But there are plenty of places that spend less for equal or better care. It can be done.

By Jim Landers

Further reading:
Medical tourism
Domestic medical tourism
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Vermont leads the nation in the delivery of its health care, while Mississippi is rated the worst, according to a non-partisan study that compares all 50 states and the District of Columbia.

Vermont, Hawaii, Iowa, Minnesota, Maine and New Hampshire ranked 1 to 5 in 38 indicators of health care.

At the bottom were Mississippi, along with Oklahoma, Louisiana, Arkansas, Nevada and Texas.

The Commonwealth Fund Commission’s “Scorecard on Health System Performance,” rated the states on access, quality, costs and health outcomes in a follow up to their 2007 report.

Overall, the states which did best on the Commonwealth scorecard were in New England and the upper Midwest, and the worst states were in the South.

Vermont, with only 640,000 residents, has nearly universal health care coverage with 93 percent insured. Its innovative “Blue Print for Health” focuses on prevention of chronic diseases.

“We’re small. There are 19 cities larger than the state of Vermont,” said Susan Besio, director for health care reform and Medicaid for Vermont.

“But I believe there is something unique about Vermont in terms of its culture,” she told ABCNews.com. “We want to take care of each other and we are a healthy state.”

In Mississippi, however, about 20 percent are uninsured despite having some of the highest rates of hypertension, diabetes and asthma.

According to the report, only 35.7 percent of adults 50 or over in Mississippi receive recommended screening and preventive care.

“When you compare Mississippi on almost any socio-economic profile, we are a struggling population that has a large percentage of low-income individuals, high unemployment rates, low rate of education,” said Robert Pugh, director of the Mississippi Primary Health Care Association.

The scorecard “paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs,” according to co-author Cathy Schoen, who is senior vice president of the commission.

“Where you live matters for access, quality of care and whether you live a long and healthy life. These wide and persistent gaps among states highlight the need for national reforms and federal action to support states.”

For example, 32 percent of working-age adults in Texas are uninsured, compared to only 7 percent in Massachusetts in the most recent survey.

“It’s very hard to have a high performing health care system and hospitals that do well for everyone if you have a high rate of uninsured in the state,” said Schoen.

In 1999-00, there were only two states with 23 percent or more of adults uninsured. But by 2007-2008 there were nine.

Children fared much better, due in large part to the Children’s Health Insurance Program (CHIP) under Medicaid. The number of states with 16 percent or more of children uninsured dropped from nine to three during the same time period.

Other findings of the report were that in a, costs rose and quality improved in areas where outcomes were reported to the public.

Vermont’s ‘Blue Print For Health’ A Model

The Green Mountain state was cited for its model “Blue Print” program. Launched by Republican Gov. Jim Douglas, it covers everything from teaching children healthy eating to helping seniors stay in their homes rather than going to costly nursing homes.

“You betcha, I feel good about the reforms we put in place,” Douglas told ABCNews.com. “It’s centered on quality and containing costs. Care shouldn’t start in the emergency room.”

All Vermonters are encouraged to have yearly exams and adults are notified when they are due for check-ups.

Douglas talks to children about “getting off the couch” and set an example just this week by joining elementary students on a walk to school.

With the second oldest population in the nation, Vermont subsizes care for seniors and the disabled to defray the costs of home care. Nursing home beds were reduced by 200 last year.

In one pilot program, electronic medical records can avert expensive tests like MRIs and x-rays. One emergency room doctor seeing a woman with stomach pains discovered in her online medication history that she had not filled her prescription for ulcer medicine.

“It takes time and so a lot of the fruits come from years of work and planning and cooperation,” said Douglas.

Health Care Affects a State’s Economy

But Mississippi, with the highest infant mortality and low birth rates in the nation, makes access to these Medicaid programs more difficult, according to Roy Mitchell, director of the Mississippi Health Advocacy Program (MHAP).

“I am not at all surprised we were 51st on the list,” he told ABCNews.com. “We are last on several health indicators. Our policy makers work hard at being last.”

Despite one of the highest matches of federal to state dollars in Medicaid funding, the state mandates “face-to-face” eligibility, requiring all new applicants and those reapplying for benefits to come in for an interview.

“As a direct result, 65,000 children have fallen off the rolls,” Mitchell said.

“Mississippi does virtually no outreach at all. They don’t publish where these face to face stations are and what times,” he said. “It’s a bureaucratic maze even to find out where to go. And when they get there they don’t have a certain document.”

Of those, about 77 percent would be eligible, he said. “It’s touted as fraud prevention.”

These disparities between the highest and lowest ranked states could be alleviated with national reform, according to Commonwealth.

The report emphasizes the need for insurance reform that rewards good outcomes, payment reform with an emphasis on prevention and advanced information systems that travel with the patient from physician to physician, saving time, money and preventing errors.

“What the scorecard is showing is that we have a system under stress, no matter where we live,” said co-author Schoen. “The costs are rising more than people’s incomes. We need to act.”

Schoen said she has hope for reform. “There is real leadership and people are taking reform seriously.”

Source: ABC News

Log on to Healthbase to learn about medical tourism or to get a FREE quote for any surgery in the United States or abroad.

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We all know the facts and the figures. About 46 to 47 million Americans are uninsured and with the economic recession not yet over, several more are expected to join the ranks.

The Congress is still debating over a national health care reform which no one knows will lead to what consequences. So, given the current state of affairs, the big question still looms – Who takes care of you when something major comes up? Or, worse yet, What happens if you are aging, start having health problems and no insurance wants to cover you even if you are willing to purchase the most expensive catastrophic policy?

NPR recently ran the story of a 58-year old uninsured American who landed himself into exactly this sort of a situation. Read on…

Fernando Arriola spends his days keeping track of four or five construction projects, and his nights praying for good health. The New Orleans home builder is one of the 46 million people in this country who don’t have health insurance.

Four years ago Arriola, 58, bought a friend’s contracting business, just as New Orleans was starting to rebuild after Hurricane Katrina. He named it New Beginnings Enterprises.

“It was a new beginning for me; it was a new beginning for the city; it was a new beginning for a lot of people we were working with,” he says.

And business has been good. He does mostly residential work, like the quaint mother-in-law cottage in the Garden District where his crew is laying tile and putting on the finishing touches.

Making A Living, But Not Enough For Insurance

Arriola makes about $50,000 a year and says he enjoys working for himself. But what he’s missing is the comprehensive health coverage he had at his former job as a sales manager.

Ever since he’s been self-employed, Arriola has been on a health insurance roller coaster. Initially, he bought a standard policy with a $1,000 deductible to cover his family. Then, when business slowed down and money got tight, he decided to temporarily drop the coverage. When he tried to reinstate it, he could only afford a catastrophic plan.

“I was paying $900 a month for a $5,000 deductible that would cover nothing until I hit that $5,000. So I was paying in essence $15,000 before I had one penny covered. And that was too expensive,” Arriola says.

So he dropped that coverage, only to have second thoughts. And when he tried to get it back, he was denied even the expensive catastrophic policy. Arriola doesn’t know exactly why, but he acknowledges that he and his wife both have high blood pressure and are approaching 60.

“Insurance is nothing more than just a business. And they try to limit their liabilities. So where there’s an older person, they don’t want to cover it,” he says.

Aging Without Coverage

Maria Arriola doesn’t think it’s fair that after years of paying for coverage and not having many claims, now, when they are starting to have health problems, they can’t get insurance.

“There’s nothing you can do about that. As you get older things don’t work so well, so…” she says.

The Arriolas did buy a policy for their two daughters, ages 22 and 16. But Fernando and Maria are uninsured. They pay for doctor visits and prescriptions out of pocket.

If something major comes up, Arriola says he would leave the country for medical services. Arriola is a naturalized citizen and has lived in New Orleans since 1970. But last year, he traveled to his native Guatemala for arthroscopic knee surgery. It cost him less than $1,000.

“Over here [it] would cost me thousands. They have just as good of doctors as they have over here. Most of them graduated from here,” he says.

Not Waiting For Congress To Fix

As for the debate on Capitol Hill over health care reform, Arriola takes a businessman’s approach to the issue: Open up the marketplace, he says, and create a national playing field so consumers will have more options.

But he does not have faith that Congress will come up with a fix because of partisan politics. So, in the meantime, he’s working to do something locally as a member of the board of directors for the New Orleans Faith and Health Alliance. The group is trying to start a health clinic in unused classroom space at a midcity church. Patients would pay based on their income.

“The purpose is to be able to provide the working uninsured medical services. There is definitely a need. I’m a perfect example of it,” Arriola says.

The alliance hopes to start providing care this fall. Arriola plans to sign up. In the meantime, he prays that nothing serious happens. The way the system works now, he says, he’d have to experience a major calamity to get coverage.

“I would have to go into the hospital, I would have to lose my house, I will have to lose all my savings, lose everything for the government to be able to help me. So 40 years of work, 40 years of struggle has to come to nothing. I have to be totally destitute in order for me to be able to get some help.”

Arriola says he doesn’t want anybody to give him anything. He just wants to be able to afford health insurance.

“There has to be a way,” he says.
Source: NPR

For low cost high quality surgery abroad or discount medical services in the United States, call Healthbase at 1-617-418-3436.

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Why Health Care Costs Keep Rising – Analysis and Solutions

It’s no secret that the health care in the United States is expensive. But have you wondered why this is the case? Here’s an excellent analysis of the situation that we came across with proposed solutions of what can be done to cut down prices for the health care consumer – something which we feel you will find useful too. So, read on…

Summary

When economist Charles Wheelan published an analysis titled “The Top 10 Reasons for Soaring Health-Care Costs,” it was refreshing to read about the problem from an economics point of view. What Wheelan did not cover, however, was what we can do to address the issues that continue to cause health care costs to spiral out of control. What follows is a point-by-point look at Wheelan’s top 10 reasons followed by a discussion of what we are doing—or could do—to control costs better.

Analysis

Reason 1.
Nobody Shops for Value

Wheelan argues that when it comes to health care, everyone wants and expects the best. “There’s no medical equivalent of Wal-Mart,” he writes. “Everyone wants Neiman Marcus.”
Solution: Some health plans are addressing this issue by discouraging patients from using expensive facilities for common problems, such as a sore throat, through co-pay incentives and member education. Not only are patients encouraged to find a less expensive facility, they also are encouraged to ask the doctor to write generic prescriptions.
The question is, how do patients know which facilities offer reasonable prices and quality medical care? It will take greater health care cost and quality transparency—and better consumer education—to get health care shoppers to the same level of sophistication they use in buying other high-end goods (e.g., cars), but progress is being made. A number of health plans now offer cost information on various treatment options, and web sites such as HealthGrades offer quality information on doctors, making it possible for people to shop for health care online.

Reason 2.
Medical Innovations Are Usually More Expensive

The basis of medical progress is learning to do new things, no matter the cost. In the case of pharmaceuticals, the system has been designed so new drugs are expensive. Breakthrough medications receive patent protection, and the better the drug, the more its producer can charge. High prices yield high profits, which creates an incentive to develop the next generation of drugs.
Solution:Although we, as a society, have agreed to pay more for innovative medications and medical devices, especially those that introduce new cures, we have not agreed on who is going to pay for them. Part of the solution lies in the expansion of employer-sponsored wellness and health promotion programs that focus on keeping healthy people healthy and helping those who are sick to better manage their illnesses by steering them toward proven treatments. Value-based benefit plan design tries to achieve this by removing barriers that may be barring patient access to the most effective medications.
Furthermore, not all innovations (which include diagnostic tests, imaging tests, medications and medical devices) should be treated equally. While some add value, some do not. One solution is to use a creative plan design that identifies the most effective innovations and reimburses them with a premium.

Reason 3.
Some Health Care Is a ‘Luxury Good’

Used as a technical economic term, a “luxury good” is something wealthy people demand in disproportionately greater amounts than less wealthy people do. Richer societies and richer people within a society have higher expectations for health care. They expect medical fixes—such as hip replacements, stomach stapling and Lasik eye surgery—for problems that people with lower expectations will just tolerate.
Solution: While it’s easy to poke fun at medical tourism, it may well emerge as one of the solutions to this problem. Medical tourism generally involves traveling to another country for non-emergency care, including knee replacements, shoulder surgery and even heart bypasses. A knee or hip replacement that may have a retail price of $65,000 to $80,000 in the United States costs between $8,000 and $10,000 in India. The Deloitte Center for Health Solutions predicts that the number of Americans using medical tourism could jump tenfold over the next decade, to nearly 16 million a year.

Reason 4.
We Don’t Pay for What We Consume

Health care is unique in that neither the service provider nor the patient gets the bill, especially when insurance out-of-pocket maximum provisions are reached. The patient who is directly involved in the transaction has little incentive to control costs when out-of-pocket costs are removed. When insurance companies try to do so, it can lead to arbitrary limits on care, time-consuming hurdles for more expensive procedures and additional bureaucracy for doctors. Even then, it’s easy to game the system.
Solution:One possible solution is moving away from fee-for-service provider reimbursement and returning to a staff-model health maintenance organization (HMO), where providers employed by the health plans are charged with offering patients the most cost-efficient care without compromising quality. Two studies have found that this model works quite well. A 2002 paper in the British Medical Journal (BMJ), “Getting More for Their Dollar: A Comparison of the NHS with California’s Kaiser Permanente,” compared HMO provider Kaiser and Britain’s National Health System (NHS), concluding that Kaiser achieved better outcomes than the NHS for similar inputs. And a 2003 study in the BMJ, “Hospital Bed Utilization in the English NHS, Kaiser Permanente, and the US Medicare Program: Analysis of Routine Data,” which reported on hospital stay lengths, produced similar conclusions.
Over the past few years, several large employers have brought care delivery on-site in the form of clinics, using the same premise as the staff-model HMO. Revisiting global provider payments per admission or bundled payments for treating all the medical needs of specific patients with chronic disease might return to favor.

Reason 5.
Baumol’s ‘Disease’

Not a disease, but an important insight by economist William Baumol on what afflicts certain sectors of the economy, such as health care and higher education. He found that as societies become richer, labor-intensive endeavors, such as health care, become increasingly expensive relative to goods and services that can be produced using less labor. As long as the doctor-patient relationship remains relatively unchanged, health care costs will rise faster than prices in general.
Solution: Because there are no economies of scale, a surgeon cannot perform more than X number of surgeries and a primary care physician (PCP) cannot see more than X number of patients in a day (although we have seen the latter rise dramatically in the past two decades). For them to keep up with others, who are earning more money in less time because of technological advances, they have to increase their unit cost.
Pay-for-performance-type programs can help identify providers who are practicing quality medicine in the most judicious and cost-effective way. Once such high-quality and cost-efficient providers are identified, patients need to be directed to them. Specialized cancer and transplant centers are a good example of where upfront costs are relatively high but long-term outcomes are better and repeat illnesses are fewer.

Reasons 6 & 7.
Living Longer and Living an Unhealthy Lifestyle

Not only are people living longer (which in itself increases health care costs), but too many people are living unhealthy lives. This includes smoking, eating fast food and driving instead of walking, to name but a few.
Solution: While we can’t change the fact that people are living longer (nor would we want to), we can help them live healthier lives. The latest shift in health care is to focus on keeping the healthy healthy and to stop diseases from progressing from bad to worse. This can be achieved through wellness and health promotions, health education and coaching, communicating information on healthy lifestyle choices, and making sure those who need care have access to the right care at the right time to maximize clinical and economic value. People who are at risk or at high risk can be identified via health risk appraisals and sophisticated technology and tools, such as predictive modeling, which uses claims data to identify risk.

Reason 8.
The Uninsured

The uninsured end up costing the system a great deal of money. In a family that is uninsured, a child with a high fever and a bad cough will probably be treated in a hospital emergency room—a very expensive use of a trauma center and its highly trained staff. Or the child might not be treated at all until five years later when he or she develops asthma or another chronic condition that could have been managed far less expensively with better primary care.
Solution: This is a problem that needs government intervention. Although President Barack Obama has pledged to intervene, his health care program has yet to be addressed—specifically, how his programs will cover all Americans in the most cost-effective delivery setting.
One solution that plan sponsors can undertake in the meantime involves helping their pre-age-65 retirees with health insurance. They can take advantage of the innovative solutions that some health plans now offer—allowing employees to prefund premiums that contribute toward buying coverage after retirement but before they are eligible for Medicare.

Reason 9.
The High Cost of End-of-Life Care

Even people who are treated successfully for heart disease or cancer eventually die. Any medical success begets additional medical expense, which is especially true for end-of-life care. The last six months of life are typically the most expensive period of a person’s life.
The escalating cost of treating illness at the end of life raises moral and politically charged issues that are difficult to address: What is the actual value of using expensive treatments on people whose life expectancy is drastically limited, even with the treatment? While other countries have begun to base coverage decisions, in part, on how many years of quality life a treatment is expected to produce—for example, the clinical guidelines created by the U.K.’s National Institute for Clinical Excellence—this issue still seems to be taboo in the United States. Most of these costs are incurred by Medicare and Medicaid.
Solution: We need to be better at considering quality of life in decisions about treatments and services for chronically ill elderly patients. It has been suggested that Medicare and Medicaid could form a governing body of clinicians that can make and authorize these difficult decisions.
In addition, society needs to make better use of hospice care. Employers and plan sponsors should educate their beneficiaries about hospices and the situations in which they are the best option.

Reason 10.
Malpractice Suits

Malpractice is more of a legal problem than an economic one because doctors tend to practice “defensive medicine” out of fear of being sued. Seeking to avoid lawsuits, they have an incentive to over-treat all kinds of maladies. Research shows that physicians in countries such as the United States—where the risk of malpractice suits is high—tend to order more investigative tests than those in countries with less risk, such as the U.K. (See, for example, the New York Times article “Why Does U.S. Health Care Cost So Much?”)
Solution: Washington Post columnist George F. Will has proposed an appropriate solution to this complex issue. We have juries of people who have no knowledge of the complexities of medicine handling decisions on whether a patient’s death resulted from negligence on the part of the physician or whether the doctor did everything in his or her power to save the patient. Instead, the state judicial system could create a panel of highly qualified judges with access to independent clinicians who are familiar with the highly complicated nature of such cases and remove some of the emotional overreactions by juries that result in disproportional monetary awards that should be reserved for cases of gross negligence. This will help physicians use sound clinical judgment instead of practicing defensive medicine.

One More Reason: Lack of Access to Complete Information
Doctors collect and create a lot of information—everything from notes to diagnosis codes. The insurance companies add another level of data. While much of this information could be used to improve treatment and reduce costs, no one is in a position to see it all. A doctor who prescribes a treatment doesn’t know what it costs or whether the patient’s insurance covers it. An insurance company that questions a doctor about a treatment might never receive all of the information it needs. When a patient switches providers, it can result in duplicate tests and services and potentially dangerous treatments. All this creates tremendous administrative waste and resource consumption for providers and payers.
Solution: Electronic medical records (EMR) and health information exchange (HIE) are two steps in the right direction toward health care interoperability (the ability of different information technology systems and software applications to communicate; to exchange data accurately, effectively and consistently; and to use the information that has been exchanged). Developing standards for EMR interoperability is at the forefront of the president’s health care agenda. Many physicians have computerized practice management systems that can be used in conjunction with HIE, allowing them to share patient information (e.g.,lab results, public health reporting), which is necessary for timely, patient-centered and portable care.
Similar movement is happening on the payer side, which is attempting to collect more information from providers as well as consumers. They are making decision-support tools available to their beneficiaries, to help them navigate the system. Some payers are also adopting personal health records, which members can take with them if they change insurance providers.
Another step in the right direction is the patient-centric medical home model, in which a patient’s physician knows everything there is to know about that person’s health care. This requires comprehensive patient management software that allows the physician to coordinate all the care the patient needs.

Conclusion
The good news is, there are potential solutions to most of the reasons health care is so expensive. The real challenge is in getting the different stakeholders to work together to solve this monumental problem.

* Analysis by: GLG Expert Contributor
* Analysis of: Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth
* Published at: http://www.brookings.edu

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Medical Tourism is no longer restricted to outbound medical tourism i.e. Americans seeking care outside of the country. Domestic medical tourism is gathering pace as more and more Americans are now crossing state borders to take advantage of cheaper prices available for quality health care out-of-state. It’s amazing to know that the price differential on healthcare within the same country can be tremendous if only you take the trouble to shop for it.

Recently Healthbase partnered with many health care providers in several states within the United States. The prices on major procedures that these providers offer to Healthbase clients are as low as 10% of the prevailing cost of those procedures in other typical hospitals within the country. Read more about this partnership.

So how can some US providers offer such low rates?
Patients can avail of such low rates if they choose the one-pay option. AARP Bulletin Today recently covered the story of Rodney Larson, an uninsured Minnesota resident and a Healthbase customer who had his triple bypass surgery at a heart care hospital in Kansas.

According to the bulletin,

As a father to nine daughters, electrician Rodney Larson always looks for ways to cut costs. So in 2008 when he was told he needed triple bypass surgery – totaling $80,000 or more – he shopped around.

Rodney Larson traveled within the United States for heart surgery

Rodney Larson traveled within the United States for heart surgery.

Larson, 56, of Boyd, Minn., searched the Internet and found a hospital that would do the surgery for $13,200. The facility, Galichia Heart Hospital in Wichita, Kan., participates in a domestic medical tourism program run by Healthbase Online.

Located in Boston, Healthbase is one of a handful of companies reaching out to U.S. hospitals to provide specialty surgeries at much lower costs than traditional providers. The company also offers international medical tourism – in which patients travel abroad for procedures – but is finding a market for U.S. specialty hospitals.

Most patients who use medical tourism companies are uninsured and must pay upfront for procedures. Larson liked the one-pay option.

“They saved me a lot of money, but the point is, it was excellent care,” he says.

Source: AARP Bulletin Today

Available procedures
Most major procedures are available at discounted rates within the US through Healthbase. Procedures fall in the categories of cardiac, orthopedic, bariatric, spinal, etc.

Want to know if the procedure you need is available and how much it costs?

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Now you can get medical tourism type price and quality for procedures received in the US.

How is that possible?
Because Healthbase has partnered with several US healthcare providers that offer procedures at very competitive prices that are comparable to what American-accredited foreign providers offer.

So now affordable high quality medical care is made available closer to home for patients from the US, Canada and Mexico. Patients from European countries and other nations looking for top quality care in the United States also stand to benefit from this partnership.

According to Saroja Mohanasundaram, CEO of Healthbase,

Majority of our clients from North America are drawn to medical tourism for the cost advantage it offers. However, some may not be able to take advantage of it due to the travel involved. So Healthbase has negotiated with US-based providers to offer the same top US-standard quality of care to our customers at a much reduced rate than what is prevailing. Hence, those who need quick access to top quality healthcare can avail of the low prices right here at home.

We all know that US providers charge a much higher rate to uninsured patients than they do to insured patients or insurers. But not anymore. A heart bypass tagged at over $100,000 (for uninsured patients) can now be had for an 85% discount. Such rates also closely match the lower foreign rates.

Mohanasundaram adds,

Our US providers offer a complete slew of services in all departments of medicine including cardiac (heart bypass, valve replacement, aneurysm repair), orthopedic (hip replacement, total knee replacement), general surgery, diagnostics, and so on

Who to contact for discounts on major procedures conducted within the US?
Healthbase

Further reading:
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All About Laminectomy

What is a laminectomy and why is it necessary?
Laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The spinal cord is made up of vertebrae. Laminectomy is performed to remove the part of the vertebra called the lamina. The removal or trimming of the vertebra widens the spinal canal to create more space for the spinal nerves thereby taking pressure off the nerves in either the back or the neck.

One of the most common reasons for laminectomy is a prolapsed or herniated intervertebral disc. If the herniated disc is in the lumbar region, this can cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. It may also be difficult to raise the leg when it is held in a straight position. A herniated disc in the neck region can cause symptoms including pain, numbness and weakness in the arm. A herniated disc may be triggered by, for example, twisting the back while lifting something heavy. The surgeon will attempt to relieve the pressure on nerves and nerve roots by removing the pulpy material that is protruding from the disc.

What are cervical and lumbar laminectomies?
Laminectomies are named depending upon the vertebrae involved. When the procedure is performed on the neck it is called cervical laminectomy as the cervical vertebrae are involved. Cervical laminectomy is most often performed for a trapped nerve (as may happen for example, in arthritis of the neck).

When it is performed on the lower back affecting the lumbar vertebrae, it is called a lumbar laminectomy. This procedure is often performed for disk protrusions, which may occur after a major accident but also sometimes occur after a quite minor twisting injury of the lower back.

Procedure Details of Laminectomy

What do I need to do before surgery?
The patient will have nothing to eat or drink for 6 to 10 hours prior to surgery and an enema will be given to empty the bowel. A pre-medication injection is usually given to promote drowsiness and to dry up some internal secretions. If you take a daily medication, ask if you should still take it the morning of surgery.

A number of tests are performed before the operation, which include blood tests, urine analysis and sometimes an electrical recording of the heart (electrocardiogram, ECG) and a chest X-ray.

Your surgeon should explain to you the nature of your operation, the reasons for it, the outcome and the possible risks involved. They should be able to tell you the approximate length of stay in hospital that will be required and the number of weeks you will need to recuperate before returning to work. Your anaesthetist will visit you to see how suitable you are for surgery.

What happens on the day of the procedure?
On the day of the surgery, your temperature, pulse, breathing, and blood pressure will be checked. An IV (intravenous) line may be started to provide fluids and medications needed during surgery.

What type of anesthesia will be used?
Laminectomy is usually performed under general anesthesia so you are fully asleep during the operation.

What happens during the surgery and how is it performed?
The patient is placed face-down on the operating table. The exact procedure depends on the location of the herniated disc; example, if the disc is located in the neck, the head is clamped to prevent movement. The skin is marked for incision.

During a laminectomy, the lamina (bone that forms the back of the spinal canal) is removed from the affected vertebra. If the operation is performed on the neck (a cervical laminectomy), it is usually performed through a vertical cut, three or four inches long, along the middle of the neck at the back. The surgeon exposes the bones of the neck beneath the skin and a small amount of bone is clipped away, which relieves the pressure on the nerves. Once the nerve is free of pressure, the incision is closed with stitches or surgical staples. An adhesive dressing is applied over the wound. Sometimes, a plastic drain is left in the wound for a few days after the operation to drain any blood that may have collected under the wound.

What happens after the surgery?
After surgery, you’ll be sent to the PACU (post-anesthesia care unit). When you are fully awake, you’ll be moved to your room. The nurses will give you medications to ease the pain and stiffness in your neck or back. You may have a catheter (small tube) in your bladder. You’ll also be shown how to keep your lungs clear.

Usually, after cervical laminectomy you are nursed up-right in bed for the first day and not allowed to lie flat to prevent excessive build-up of fluid under the wound. If a drain has been inserted into the wound, this is usually removed after two days. You may be allowed out of bed one or two days after a cervical laminectomy. The period of bed rest may be a few days longer for a lumbar laminectomy.

How long will I be in the hospital?
The average length of stay in hospital is two to three days, but this can vary somewhat, according to whether your operation was on the neck or back and on the size and exact nature of the operation performed.
While in the hospital, the patient is taught the proper method of rolling the body in order to maintain proper body alignment. This is most important for the first 48 hours or so. A physiotherapist gives specific instructions on how to get out of bed properly in order to avoid stress and strain on the wound site.

The patient is encouraged to walk, stand and sit for short periods. The patient is taught how to prevent twisting, flexing or hyperextending the back while moving around. Patient is later treated with ultrasound therapy to rehabilitate from this surgery.

What are the risks/complications associated with laminectomy?
Some of the possible complications of laminectomy include:

  • Infection of the wound
  • Blood clots in the legs
  • Splitting open of the wound (wound dehiscence)
  • Injury to the spinal cord
  • Paraplegia or quadriplegia (depending on the site and severity of the spinal cord injury)
  • Post-laminectomy syndrome, consisting of chronic back pain and spinal instability

What should I watch out for?
Once at home, call your doctor if you have any of the symptoms below:

  • Unusual redness, heat, or drainage at the incision site
  • Increasing pain, numbness, or weakness in your leg
  • Fever over 101.0°F

When can I expect to return to work and/or resume normal activities?
Most people need to be off work for between one and three weeks after leaving hospital, depending on the nature of their work. Work that is physically demanding or that involves lifting heavy objects may require a longer time off.

What are the post-operative recovery measures that I should take?
Although guided by a doctor, general suggestions include:

  • Continue taking your medications as advised, especially the full course of antibiotics.
  • If the operation was performed on your neck, you will need to wear a cervical collar for about six weeks.
  • Try to rest as much as possible for at least two weeks.
  • Avoid activities that strain the spine – such as sitting or standing for too long, flexing your spine, bending at the waist, climbing too many stairs or going for long trips in the car.
  • Avoid wearing high-heeled shoes.
  • Sleep on a firm mattress.
  • Continue with any exercises you were shown in the hospital.
  • Beware of heavy lifting for a long period.
  • After two weeks at home, try to have a 10 minute walk each day, unless advised otherwise by your doctor.
  • Report to your doctor any signs of infection, such as wound redness or drainage, elevated body temperature or persistent headaches.

Cost and Availability of Laminectomy

How much does it cost?
The cost of laminectomy surgery varies from surgeon to surgeon and hospital to hospital. The price may go up to tens of thousands of dollars and your insurance may or may not cover the costs. However, the same treatment in some countries is very cheap and costs a fraction of the price tag in the US.

Visit Healthbase to find details about affordable lumbar laminectomy, cervical laminectomy, etc. and get a free quote for your surgery.

Which countries/hospitals is it available in?
Check availability of Laminectomy at our overseas partner hospitals. View our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Healthbase is a medical tourism and dental tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals and dental offices overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

To learn more, visit http://www.healthbase.com and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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