From the “IT COULD ALWAYS BE WORSE” Department
Let’s face it. American health care has a long way to go toward improving its quality and its availability. But things could be worse. According to today’s BBC NEWS, Sicilian physicians have been billing their state medical program for the treatment of dead patients. Some of the individuals had been dead for 20 years.
At least in our country, when our physicians commit fraud (i.e., Medicaid Fraud), they use patients who are still alive, which is smart, since a living patient can have a “need” for many invented procedures over the course of his lifetime, thereby providing a steady source of illicit income for his American, criminally-inclined doctor.
What a Long, Strange Trip Americans Are Taking
Some things are worth travelling for: the soup dumplings at Joe’s Shanghai in New York’s Chinatown, for example. But according to Choe Sang-Hun in today’s NY Times, many Americans are joining the ranks of medical tourists, and heading to South Korea for that expensive surgery they’ve been putting off. And now, they can combine their sight-seeing and golf with surgical self-improvement.
Why is this happening? As Sang-Hun points out, “[h]eart bypasses, spinal surgery, hip-joint replacements, cosmetic surgery–procedures that may cost tens of thousands of dollars in the United States–can often be done for one-third or even one-tenth of the cost in Asia, with much shorter waiting times and by specialists often trained in the West.”
This trend says something about American medical care, and it is not good. If our health care system was as affordable and efficient as it should and could be, Americans would not be leaving their homes, jobs and families to obtain the care that they need (or want badly, in the case of cosmetic surgery) but cannot pay for. And here is something not addressed in today’s article. What happens when the American medical tourist who comes to Asia for surgery is the victim of medical malpractice? Will he sue the South Korean surgeon in South Korea? This could be a boon for the South Korean plaintiff’s medical malpractice bar, but in practical terms, such suits are unlikely to be brought. The same medical tourists wishing to save time and money by travelling to South Korea in the first place will find it difficult to take more time, money and travel in order to start and continue to prosecute such a lawsuit, assuming that South Korea’s justice system even allows for such actions. And, if such a patient had health insurance here in the States, he may not receive the warmest reaction from his insurer when he seeks coverage for care necessitated by the botched surgery overseas.
“Medicine” and “Tourism” are words that just don’t belong together. But unless things improve for the American medical consumer, this could be just the beginning of an ill-advised trend.
Here is some good news, just to even things out. Many in the medical/legal community have a renewed sense of optimism about our health care system now that Barack Obama will be assuming the presidency. Thomas A. Sharon, R.N., M.P.H., in his blog, discusses what are, in his view, the most pressing challenges in the American health care system, and notes that Obama’s fresh look at the problem will bring a “new awareness to an old problem.”
Medicare’s “Never Events” Policy Belongs in Never-Never Land
Did you know that as of the first week of October, 2008, Medicare no longer reimburses American hospitals when certain “reasonably preventable” events, known as “never events” (because they are never supposed to happen) actually do happen? Kevin Sack reported this story in the October 1, 2008 NY Times, but it has yet to create the uproar that many in the medical/legal community expected it to.
As Kevin Sack points out, this hits close to home, too, since New York is one of a number of states in which the Medicaid program has incorporated as many as 28 “never events” that they will not pay for.