I think someone ought to pitch building a hospital to the Iroquois League. They already issue passports, rejecting health law seems in line with tribal sovereignty claims. I'm sure a US-located low cost hospital could dwarf other income sources like gambling and tourism.
The difference between issuing passports and building a large-scale hospital is that only in the latter case is a large amount of money risked. It would be tricky to find a source of funding for a hospital that may not be able to operate due to a dispute over health law applicability.
From the perspective of anyone considering funding such a hospital, better to just locate in a nearby country, such as the hospital mentioned in the article that is being built in the Cayman Islands.
Why did this innovation happen in India and not the US or Europe?
Dr Shetty is planning to build a similar hospital in the Cayman Islands for Americans so I have to assume it has to do with government regulation. Is the health care system less socialized in India? I would guess it is.
If you lined up all the words contained in US law, the median word would be health care related, that has to matter for something. Also AMA enforced under supply of specialists. Also direct and indirect costs of health care liability. Also requiring hospitals to serve the ER without regard to ability to pay. Also low reimbursement rates for medicare, lower for medicaid. Also third party payment system that makes consumers price insensitive. Also huge overhead to third party payment system. Also enormously expensive FDA approval process recovered through drug costs. Also service business in a high wage country. Any others for the list? I don't mean to be totally negative, we get a lot of good things out of all that inefficiency, but it doesn't surprise me that quality can be higher and costs an order of magnitude lower under a different regulator regime.
Presumably protectionism is helping him a bit. I doubt that his surgeons are licensed to practice in the US, regardless of their expertise! It's nice to see the AMA driving progress.
Actually, wikipedia makes it sound as though it is more socialized in India, compared with the USA - http://en.wikipedia.org/wiki/Healthcare_in_India which makes sense given the historical British influence.
However, I think this sort of innovation was way more likely to occur in a developing country, regardless of if the individual or the tax payer is picking up the bill. It is a case of simple market forces as hinted in the article by:
On returning to India in 1989, Dr. Shetty performed the first neonatal heart surgery in the country on a 9-day-old baby. He also confronted the reality that almost none of the patients who came to him could pay the $2,400 cost of open-heart surgery.
"When I told patients the cost, they would disappear. They literally didn't even ask about lowering the price," he says.
The US is unfortunately one of the highest spenders on health care with the lowest outcome per dollar spent. It's all part of a severely broken system that needs reinventing, badly.
It's not just lifespan. Medication and procedure cost, access, technology use, availability, number of hospital beds and health care workers etc.
The US does however have the access to the most advanced technologies (probably where the large funds are going), I'll give you that but numerous other reports show poor outcomes for other general health indicators (teen pregnancy rates, obesity rates, suicide rates etc..)
> I'll give you that but numerous other reports show poor outcomes for other general health indicators (teen pregnancy rates, obesity rates, suicide rates etc..)
None of those things are affected much by health care. (Birth control is free in the US It's readily available at the local county hospital and other places.)
They do, however, affect health care spending, lifespan, etc.
Dr. Shetty has exactly the right ethos in a cumbersome and bureaucratic industry: "Japanese companies reinvented the process of making cars. What health care needs is process innovation, not product innovation."
Improving processes in this case will naturally generate better products (health services). But will also increase the knowledge of these processes, which will ultimately pave the way for the creation of improved supporting technologies.
http://en.wikipedia.org/wiki/Iroquois_passport