Garisha D – Spinal Surgery Medical Tourism Patient Experience

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Garisha D from Idaho, USA

She contacted Healthbase who arranged medical care trip to India to treat her Spinal condition. She underwent Spinal Surgery in Wockhardt-Fortis Hospital, Bangalore, India with Dr.Rajakumar. Her post-op recovery is going very well. She likes to share her experience.

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Garisha`s Experience

First off, I want to say a BIG thank you! Great communication from the beginning and very responsive to any questions I had, help put me at ease from the start. Quick to respond and even called. 
I could never thank you all enough for the wonderful care I received whilst in India. Everyone was wonderful, from the sisters to the people bringing and clearing my food. I had a wonderful experience and will sing praises of the staff and facilities of the Fortis Hospital in Bangalore! 
I wouldn`t hesitate in recommending the website or hospital. THANK YOU, THANK YOU, THANK YOU!!!!
Forever grateful
 
Garisha D

Viviana P – Deltamotion Hip Implant Surgery Medical Tourism Patient Experience


Viviana P from Panama suffered from right hip end stg arthritis. So she contacted Healthbase who arranged medical care trip to India to treat her orthopaedic condition. She underwent Deltamotion hip Surgery in Apollo Specialty Hospital in Chennai, Tamilnadu, India performed by Dr.Vijay Bose.

Viviana`s Comments

There are  many things that come to my mind. My medical experience was  extraordinary, I felt very well taken care of by the doctors  and in general, by the hospital personel.  Healthbase is very well organized and keep ahead of every detail, thank you.
Also I had the best opinion of indian people. all of them were very special  and kind to me.

Viviana Baker

Healthbase Customer – Paul C- Hip Resurfacing Surgery Experience


Paul C from Canada suffered from arthritis of the hip with bone on bone changes. So he contacted Healthbase who coordinated medical care trip to India to treat his orthopaedic condition. He underwent Hip Resurfacing Surgery in Apollo Specialty Hospital in Chennai, Tamilnadu, India performed by Dr.Vijay Bose.

Paul`s Experience


Just to say we are home safe and sound after a highly successful trip

I am amazed at how good my hip feels even less than two weeks out of surgery
Nothing but praise for Dr. Bose and his team – the professionalism and coordination was exemplary.
 
Thanks to you and Healthbase for all the help in setting the process into motion.
 
Thanks

Paul Connor

Healthbase Customer – Sandy S – Deltaceramic on Deltaceramic Hip Replacement Surgery Medical Tourism Patient Testimonial


Sandy S from Washington (WA), USA suffered from significant dysplasia and sec. OA. She contacted Healthbase who arranged medical care trip to India to treat her orthopaedic condition. She underwent delta ceramic on delta ceramic hip surgery in Apollo Specialty Hospital in Chennai, Tamilnadu, India performed by Dr.Vijay Bose. 

Healthbase facilitated her complete medical travel including medical records transfer, clarification of her questions with the specialist, travel arrangement like hotel room booking, airport pickup arrangement, and visa assistance.

Sandy`s Testimonial

I am doing excellent! I have never experienced any pain, still continuing with exercises for my hip . I share my story with those that know and don`t know of my trip to India and Dr. Bose and about Healthbase. I would do it all again if the need arises. The experience was diffiently life changing for me! I cannnot say enough awesome things about Sara from Healthbase,my questions were always answered in a timely  manner ,and we never felt we were alone on our journey. I would be more than willing to give my number to speak to anyone about our trip and Dr.Bose! In one word it was amazing! Thanks again!
Sandy Steele

Bangalore, July 28, 2010: Fortis Hospitals conducts Asia’s first Custom Fit Knee Replacement Surgery in Bengaluru (formerly Bangalore). 56 and 59-year-old women suffering from degenerative disease of the knee brought to Fortis Hospitals with complications, underwent Asia’s first Custom Fit Knee Replacement Surgery. Patients were discharged within five days of the knee replacement operation. Patients started walking normally within a fortnight, unlike the usual 6-8 weeks required before resuming normal activities in the conventional surgery.

Dr. Sanjay Pai - Lead Orthopedic Surgeon, India

Dr. Sanjay Pai - Lead Orthopedic Surgeon, India

Lead orthopedic surgeon Dr. Sanjay Pai and his team at Fortis Hospitals Bangalore performed this revolutionary surgery by literally remodeling the anatomy of the patient’s knee and recreating or customizing a knee with the right kind of technology and expertise. The new custom fit knee replacement technology designs a perfect instrumentation system that matches the patient’s knee and ensures lesser pain, less tissue damage and faster mobilization.

According to Dr. Pai, “The two operations for knee replacement have been performed for the first time in Asia using the custom fit knee replacement technology. This is indeed a medical breakthrough and likely to revolutionize the way knee replacement surgeries are performed in India. We are glad to be the first adopters of this technology.”

Why Custom-Fit Knee
While conventional knee replacement surgeries retro-fit predetermined sizes of prosthetics on to the patients’ knee, this procedure is very different because it works on the principle that no two patients’ knees are similar. With this technology the patient’s knee is digitally recreated with 3D image mapping after taking into account the bone structure, weight ratios, gender, age and even mechanical alignment. Based on this 3D model the customized knee is created. Something, that just fits them right. This technology ensures far greater accuracy and reduces the operation time by almost 40% and also results in less loss of bone & tissues.

How Custom Fit Knee Works
In short there are 4 steps to building and fitting a Custom-Fit Knee:

  • Step 1: Understanding your knee
    The process starts with a CT Scan of the whole leg from the hips to the ankle which is then used to create an advanced 3D image of the leg structure. The age, weight and gender are also taken into account, creating a complete patient imaging.
  • Step 2: Processing and planning
    With the 3D plan of the leg structure in place, an anatomical model is created to determine the mechanical alignment – the basic philosophy on which the entire process rests. Virtual instrumentation is then done and the surgery is planned accordingly.
  • Step 3: Recreating the knee
    Once the surgery is approved, the Custom Fit instruments are manufactured at state-of-the-art dedicated manufacturing centers. Even the individual patient name and data are etched on each unit to confirm identification during the surgery
  • Step 4: Fitting the knee
    With the Custom Fit instrumentation in place, the knee bone is chiseled to perfection so that the prosthetics fit exactly without any requirement for later corrective surgeries. After a 60 minute surgery, the patient ill have the knee that fits you perfectly.

Benefits of Custom Fit Knee Replacement Surgery

  • Smaller incision
  • Less soft tissue damage
  • Lesser pain
  • Early and better mobilization
  • Better and pain free range of motion
  • Improves alignment and sizing by using computer generated images of the patients anatomy to determine bone cuts and implant positioning preoperatively
  • Better life span of the processes because of the accurate fit and alignment

Related links

If you have heard of medical tourism then you know it is the phenomenon that can buy you top-notch medical care at rock bottom prices with virtually zero waiting times. And you are probably also aware that India is one of the most popular medical travel destinations. What is great about India is you can get not only high quality care for low price but also certain unique treatments that not many other nations in the world offer, especially if you also factor in the unbeatable price. In the article below we talk about hip resurfacing surgery in India – a unique medical breakthrough technique for the treatment of hip pathology.

THE NEED FOR HIP RESURFACING
Your hip is a ball and socket joint. Both the ball and socket are covered by a protective layer of cartilage which makes the joint smooth and hip movements swift.

Any condition that damages this cartilage leads to pain, dysfunction and eventually arthritis. Injury, infection, rheumatoid arthritis, osteoarthritis and bone dysplasias are some reasons that can cause damage to this cartilage thereby necessitating a hip resurfacing surgery.

Traditionally, such issues have been addressed by a total hip replacement (THR) which is a surgery to replace the hip joint by a prosthetic implant. A THR removes part of your healthy bone so the implant can be fixed deeply into the femoral bone. Patients also have certain movement restrictions following a THR surgery.

By contrast, resurfacing, which is a less invasive bone-preserving technology, replaces only the worn, diseased and damaged surfaces of the hip joint, and places an all-metal “ball and socket” implant in the hip joint. Resurfacing allows return to normal and sporting activities post-surgery, reduces the risk of dislocation and makes revision easy (if at all needed).

These reasons make hip resurfacing more favourable over hip replacement in certain specific cases. The anatomy and bio-mechanics after resurfacing mimic a normal hip very closely making it an ideal choice for young or more active patients with non-inflammatory degenerative hip joint disease.

HOW IS A HIP RESURFACING SURGERY PERFORMED?

Birmingham hip resurfacing implant

Birmingham hip resurfacing implant (Image source: Smith & Nephew)


After separating the femur or thigh bone from the hip socket, your surgeon reshapes the head of the femur. Next, the diseased bone and cartilage are removed from the hip socket.

Then, the implant, which comprises of two parts – the metal shell component for the hip socket, and the metal ball component with a short stem for the thigh bone, is placed.

First, the metal shell implant is firmly pressed onto the hip socket. After this the surgeon drills a hole in the femur (so the stem of the femur implant can be fitted into it), fills the metal ball component with bone cement, and fits the ball on top of the thigh bone with its stem into the drilled hole.

Finally, the femur with its new metal head and the hip socket with its new metal shell are put together to form a new resurfaced ball and socket hip joint that looks and functions like a normal hip.

HIP RESUFACING SURGERY AND INDIA
In India, hip surgeons have been practicing the hip resurfacing procedure for over a decade while orthopaedic surgeons in most of the rest of the world are still new to this procedure.

In the United States, for instance, where this procedure is still not commonly performed, FDA approved the first hip resurfacing system only in 2006. It is no wonder then that surgeons in India are much more experienced in this procedure than their counterparts in America.

Today, the majority of hip resurfacing operations are performed in India on Indian as well as foreign patients. Each year thousands of hip resurfacing medical tourists from all across the globe head to India to not only be in safe hands but also enjoy a tremendous amount of savings.

You can find top hip resurfacing hospitals in India that are Joint Commission International (JCI) accredited. Additionally, several of the best Indian orthopaedic doctors are also either educated or trained internationally.

Taj Mahal, India

Taj Mahal, India

Hip resurfacing costs about USD8000 in India . This is so less compared to what U.S. hospitals charge for the same kind of service and quality that you can bring a companion along, spend on sightseeing and still save thousands of dollars.

OVERSEAS PATIENT TO INDIA FOR HIP RESURFACING
Richard, who hails from California, USA, had been suffering from osteoarthritis in his hips for a long time but was unable to get surgery in the United States, earlier because of unavailability of the procedure in the country and later because of the extravagant price tag it came at.

Facilitated by Healthbase, Richard had both his hips resurfaced through bilateral hip resurfacing surgery at Wockhardt Hospitals (now Fortis Hospital) in Mumbai, India, 3 years ago.

Richard after his surgery in India

Richard after his surgery in India (Image source: Healthbase Online Inc., http://www.healthbase.com)

Being an avid sportsperson that he was, barely 12 weeks after his hip surgeries, Richard returned to snorkelling in the sunny Southern Californian beaches. In the past, Richard had problems walking from his car to his front door.

MEDICAL TRAVEL TIPS FOR HIP RESURFACING PATIENTS
Here are the top 5 things every medical tourist needs to do or remember for a successful medical travel trip:

  1. Verify the credentials of the foreign doctor treating you.
  2. Don’t let cost be the driving factor; focus on quality.
  3. Keep your local doctor in the loop.
  4. Don’t keep your trip too short; allow time for recuperation as well as sightseeing.
  5. Engage the services of a medical travel facilitator like Healthbase. These are specialized medical travel agents that connect you with the hospital of your choice while providing all or some other valuable concierge services like detailed information about various procedures, detailed hospital profiles and surgeon profiles, medical records transfer, free surgery quote, pre- and post-consultation with the overseas hospital, feedback and testimonials from previous patients, medical and dental loan financing, passport and visa acquisition, airport pick-up and drop-off, hospital escort, tickets, travel insurance, hotel booking, sightseeing services in the destination country, etc.

Medical tourism, which is the practice of traveling from one place to another for medical care, is no longer limited to patients seeking conventional treatments such as hip resurfacing, spine fusion, knee replacement, heart bypass, lap band, cosmetic surgeries, or dental treatments. Today, many are going overseas to seek “unconventional” medical tourism treatments such as those for cancer.

Cancer patients may be driven abroad by low prices but what remains the prime motivator is the easy accessibility to the latest technology at overseas cancer hospitals.

COMPARING THE US AND ABROAD
Without a doubt USA is the pioneer of the latest medical technologies and the country invests heavily in cancer researches. Such developments have provided remedies for previously irremediable diseases, thereby prolonging and improving the lives of the critically ill. However, these advancements remain beyond the means of those who lack health insurance, simply because of the price tag at which they come, in the US anyway.

But, in India or Singapore or Turkey, for instance, not only are the same state-of-the-art technologies being used, the treatments are offered at a much lesser price making them accessible to a greater part of the populace. It is not uncommon, therefore, to see surgeons in Asia working behind the gamma knife or the CyberKnife or the da Vinci robotic surgical system, treating patients from all over the world and offering their services at a much discounted rate as compared with US rates.

COMMON CANCERS AND THEIR TREATMENTS OVERSEAS
Cancer hospitals abroad treat all types of cancers. Though most types of cancers are suitable for overseas treatment, a patient’s candidacy can only be decided on an individual basis. The more common ones that patients go abroad to cure are prostate cancer, breast cancer and thyroid cancer.

There are several types of cancer therapies available today. Some of them are: surgery, radiotherapy (RT), chemotherapy, palliative therapy, etc. The specific treatment plan designed by the foreign doctor will depend on: (1) the type of cancer, (2) its stage, (3) whether it has metastasized to other parts of the body, (4) the patient’s overall physical health, and so on. The doctor may decide to give a combination of various types of therapies to increase the effectiveness of the treatment.

Following are some examples of cancer treatments given abroad to remove the cancer from the body and to treat the symptoms of the disease:
(1) Surgical resection of the affected organ followed by radiotherapy or chemotherapy to remove any remaining cancer cells.
(2) Depending on distant metastases state and the pathology report, the doctor might use palliative or aggressive radiation therapy.
(3) A high dose IMRT of primary and lymph nodes (LNs).

ISSUES WITH SEEKING CANCER TREATMENT ABROAD
As is well known, the quality of care offered abroad is on par with what is available in the United States. So the treatment quality is not a concern. But what might be of concern is the duration of the treatment.

When you go overseas for a surgery such as a hip resurfacing or a heart surgery, you usually need to spend no more than 2 to 3 weeks in the host country. That’s true for most of the procedures you seek abroad. But in the case of cancer treatment, the duration of the treatment is a big concern. The treatment plan that the oncologist or the doctor designs can run over a period of several months. This means longer stays for the international patient and his companion which in turn translates to higher expenditure on accommodation. To resolve this and to generate more savings, Healthbase recommends seeking long-term accommodation in service apartments instead of hotels as the former cost much less.

Even with higher expenses on accommodation factored into the cost, the resulting savings on treating cancer abroad can amount to approximately 40-80% when compared with the cost of treatment in the United States. For an accurate cost estimate and arrangement of cancer treatment abroad, check out the Healthbase website.

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
FREE surgery quote

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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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Healthbase Collaborates with WellPoint to Bring Affordable Medical Tourism Solutions

Healthbase collaborates with WellPoint to bring affordable healthcare benefits to Americans through an international medical tourism pilot program. Members will now have more choices regarding where to receive care and a greater involvement in the care they receive

BOSTON, Jan. 5 /PRNewswire/ — Healthbase Online Inc., a Boston-based award-winning medical tourism facilitator, has collaborated on a pilot basis with WellPoint, Inc., an Indianapolis-based health benefits company to provide global health care coverage to members of WellPoint’s affiliated health plan in Wisconsin. Healthbase will handle all the medical travel logistics and arrangements for WellPoint members.

According to Saroja Mohanasundaram, CEO of Healthbase (http://www.healthbase.com), “Healthbase is committed to providing high quality medical travel services at affordable cost. Healthbase will assist WellPoint members with coordination of the trip, medical appointment scheduling, digital medical records transfer, and concierge travel service.”

Under this program, effective from January 2009, members who travel for certain non-emergency elective procedures like joint replacement and spinal fusion, will have access to Joint Commission International accredited healthcare providers in India. This will result to lower out-of-pocket costs for members translating into thousands of dollars in total savings. A hip replacement surgery, for example, costing over $60,000 in the US, costs less than $8,000 at an accredited hospital in India.

“We are pleased to work collectively with Healthbase to deliver an international medical tourism pilot product to our clients who are interested in exploring a medical tourism solution,” said Dr. Razia Hashmi, vice president and medical director for WellPoint’s national accounts division. “Medical tourism is a promising option for improving access to affordable, quality health care. Working with Healthbase, our case managers will coordinate all steps of the medical tourism process for members interested in receiving care overseas.”

About Healthbase:

Healthbase is a one-stop source for global medical and dental choices, connecting patients to internationally accredited providers in 14 countries including India, Thailand, Singapore, South Korea, Turkey, Panama, Costa Rica and Mexico. Healthbase caters to individual consumers, self-funded businesses, insurers, benefit consultants, third party administrators and those using Consumer Directed Healthcare Plans (CDHPs) or voluntary benefit plans. More information at http://www.healthbase.com.

About WellPoint, Inc.:

WellPoint, Inc. is the largest health benefits company in terms of medical membership in the United States. WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com.

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