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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GASTRIC BYPASS SURGERY – WHAT CAN IT DO FOR YOU?

Some people have gastric bypass surgery and shed 100 pounds or more. What can this surgery do for you?

To answer this question, you will first need to know what gastric bypass surgery is and how it helps you lose weight.

A gastric bypass surgery also known as Roux en-Y surgery is a medical procedure that reduces the size of your stomach causing you to feel full when you have eaten only a small portion. What your surgeon will essentially do is divide your stomach into two sections – a small upper one and a much larger remnant one using surgical staples (which is why this procedure is also known as stomach stapling). The small top pouch is the one that will hold your food. Your surgeon will also re-arrange your small intestine such that both the stomach pouches remain connected to the intestines.

The reduction in the functional volume of your stomach reduces your food intake. Not only that, the re-arrangement of the small intestine causes food to by-pass the first part of the small intestine resulting in reduced calorie absorption. Both these factors help you lose weight.

But is gastric bypass surgery for everyone who needs to lose weight?

That’s a personal choice or your doctor may prescribe it for you. Generally, it is considered in only those individuals who have tried hard but failed to achieve weight loss through exercise and diet.

Obesity, which is a complex disease, leads to other diseases. Morbid obesity or the accumulation of too much body fat increases a person’s risk for developing other health problems or co-morbidities such as heart diseases, diabetes, etc.

But how much fat is too much fat?

That’s calculated by your body mass index or BMI which is a measure of your weight in relation to your height. In simple words, it tells you how much you should normally weigh for your height and if you exceed that normal weight then you are medically considered overweight. Reducing your weight and therefore, your BMI, helps you control the risk of developing obesity related health problems. (Use the BMI calculator to calculate your BMI.)

Like any other surgery there are risks associated with gastric bypass surgery as well. Some of the risks include gastritis (which is an inflammation of the stomach lining), development of gallstones (caused by significant weight loss in a short time), nausea, vomiting, bleeding, infections, and nutritional deficiency (which can be avoided through nutritional supplements). So, when deciding to have the surgery you should carefully weigh the risks associated with it and the problems that it can solve for you.

Variations of gastric bypass surgery are gastric bypass, Roux en-Y proximal; gastric bypass, Roux en-Y distal; and loop gastric bypass or mini-gastric bypass. Gastric bypass surgery is not the only bariatric surgery available for treating morbid obesity. Some people also consider gastric lap-band as an option.

The cost can be a major deciding factor when considering the surgery. Depending upon your specific medical conditions and insurance terms, your health insurance carrier may or may not cover the costs.

The high cost of healthcare has led some Americans to seek treatment in countries like India, Thailand, Singapore, Mexico and Turkey. This practice of going abroad, which is termed as medical tourism or medical travel or health tourism, is a way of getting low cost high quality medical care. But before you decide to outsource your health care it’s extremely important that you do your homework properly – research the facilities, the surgeons, compare the cost and quality offered by different hospitals, talk to people who have had their surgery overseas, etc.

You can learn more about the growing trend of medical tourism, gastric bypass surgery and other medical and dental procedures by logging on to http://www.healthbase.com.

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