A pulmonary thromboendarterectomy can tie up an operating room for most of a day. In the U.S., the procedure can cost more than $200,000. Shetty did it for about $10,000 and turned a profit. A cardiac surgeon by training, Shetty is the founder and chairman of Narayana Health, a chain of 23 hospitals across India that may be the cheapest full-service health-care provider in the world. To American eyes, Narayana's prices look as if they must be missing at least one zero, even as outcomes for patients meet or exceed international benchmarks. Surgery for head and neck cancers starts at $700. Endoscopy is $14; a lung transplant, $7,000. Even a heart transplant will set a patient back only about $11,000. Narayana is dirt cheap even by Indian standards, with the investment bank Jefferies estimating that it can profitably offer some major surgeries for as little as half what domestic rivals charge.
[...] Shetty's philosophy of thrift is everywhere. The surgical gowns are procured from a local company for about a third of the cost of international suppliers. The tubes that carry blood to heart-and-lung machines are sterilized and reused after each surgery; in the West, they're thrown away. The machines themselves, along with devices such as CT and MRI scanners, are used well past their warranties, kept running by a team of in-house mechanics. The operating rooms, pieces of real estate so expensive that many hospitals bill for their use by the minute, are also part of the assembly line. Whereas preparing a U.S. surgical theater for the next patient can take 30 minutes or more, Narayana has gotten the process down to less than 15, in part by keeping turnaround teams with fresh instruments, drapes, and other supplies on immediate standby, ready to roll the moment a room is available. Even patients' families are part of the upskilling model.
[...] It's all a far cry from the high-touch treatment Westerners expect, but Shetty is adamant that none of the practices compromise safety. Sterilizing and reusing clamps and tubing is permitted under the standards of the Joint Commission, a U.S.-based body that vets and accredits hospitals worldwide, including Narayana's cardiac hub. Involving properly instructed family members in the simplest care tasks isn't unheard of in Europe and North America, and some studies suggest it may improve patients' prospects. (Unlike busy nurses, relatives have just one person to focus on.)
The data appear to back Shetty up. In part because its huge volumes help surgeons quickly develop proficiency, the chain's mortality rates are comparable to or lower than those in the developed world, at least for some procedures. About 1.4 percent of Narayana patients die within 30 days following a heart bypass, according to the Commonwealth Fund, which studies public health, compared with 1.9 percent in the U.S. Narayana also outperforms Western systems in results for valve replacements and heart-attack treatment, the group found.
[...] Per capita, central-government spending on health care in India is lower than in any other major economy.
(Score: 3, Insightful) by krishnoid on Wednesday May 22 2019, @09:48PM (2 children)
And an extremely vested interest in the outcome.
(Score: 2) by Nerdfest on Thursday May 23 2019, @05:09AM (1 child)
One way or the other ...
(Score: 2) by krishnoid on Thursday May 23 2019, @05:25AM
+1, Evil Villain Laugh
(Score: 2) by esperto123 on Wednesday May 22 2019, @10:07PM (3 children)
Costs of health related services in the US are insane, everyone agrees with that, but the numbers this post shows are dangerously low. Being more efficient and having personnel at lower cost (doctors in India definitely earn less than in the US) help, but hospital supplies are expensive not only because hospitals will pay more but because they have special needs, the supplier has to take very special care to not contaminate what it delivers as this can lead to infections, which leads to longer hospital stays, more costs with treatment, adverse effects to patients and even death. Cutting corners in health care is very dangerous, of course, in a very poor are, risky assistance is better than no assistance, but I would never pay $14 for a endoscopy that is not heavily subsidized by the state, it is probably riskier to make the exam than not finding out the problem.
(Score: 2) by takyon on Wednesday May 22 2019, @10:21PM (1 child)
We aren't even doing what we need to be doing to prevent infections:
New Sanitation System Halves Healthcare Associated Infections and Cuts Related Costs By 75 Percent [soylentnews.org]
As an aside, India managed to send something to Mars for $74 million.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 2) by krishnoid on Wednesday May 22 2019, @10:28PM
That was definitely the case ten years ago [newyorker.com]. I assume it's improved since then, but then again, I assume something this simple would have already been in place half a century ago.
(Score: 1, Informative) by Anonymous Coward on Thursday May 23 2019, @05:15AM
If the following numbers are really true who is cutting more corners?
(Score: 0) by Anonymous Coward on Wednesday May 22 2019, @11:23PM (1 child)
I had one once for spinal surgery. He changed his diagnosis after the second surgery many times... "you're completely healthy, there's nothing wrong that I can see, you can go back to work" to "You need a third surgery" in the span of 30 seconds. I went to another doctor and was told I needed two more spine surgeries, and even more as I get older, and I'm un-hireable.
(Score: 0) by Anonymous Coward on Thursday May 23 2019, @04:29AM
Doctor: Everything looks pretty successful from I can see. How are you feeling after the surgery?
You: I feel shit. I mean it doesn't hurt anymore, and I can even jump and spin around no problems.
Doctor: Excellent. If you take it easy, you probably won't need any more surgery. I'll call the nurse to get you discharged.
You: (Jumping around and doing limbo rock moves.) Owwww!!
Doctor: What?
You: I think I popped my back and it hurts worse than before!
Doctor: Sheeesh. Now it looks like you'll need at least one more surgery and you'll be fine
You: Fuck that! I want a lifetime of medicare benefits!
Doctor: Oh.
Doctors 1 to 42:.. No. .... No.. .... Hell no..... No .... No. ... Yep, no. ... etc.
..
You: Hi Doctor #43, my back is hurting worse than ever, do I need surgery.
Doctor #43: Well, it looks like you'll need a lifetime of surgery.
You: Woohoo!!! I love you doc.
Doctor #43: That's why I'm paid the big bucks!
(Score: 1) by fustakrakich on Wednesday May 22 2019, @11:34PM (1 child)
How much extra does that cost?
La politica e i criminali sono la stessa cosa..
(Score: 3, Interesting) by krishnoid on Thursday May 23 2019, @12:06AM
Well, considering a lot of medication is manufactured in India and China, probably not that much.
(Score: 2) by krishnoid on Thursday May 23 2019, @12:37AM (4 children)
Labor in India is a lot cheaper, so any processes that can use more people instead of expensive/more technology -- e.g., general cleaning, inventory, sterilization, operating theater reconfiguration/restocking, etc. -- produce a different landscape when it comes to cost considerations. So the optimizations differ from organizations that instead leverage technology or standardize purchasing [jhu.edu] to gain efficiencies.
(Score: 0) by Anonymous Coward on Thursday May 23 2019, @04:42AM (1 child)
The problem with standardised purchasing and technology solutions is they put the purchasing power into the hands of people that susceptible to kickbacks. And we know how that industry works.
If I sell you a $10 item, I'll get 'outbid' by the guy that sells the same thing to you for $100, but gives you a $50 cash kickback^w rebate.
(Score: 0) by Anonymous Coward on Thursday May 23 2019, @05:40AM
Well whatever the US doing is worse:
https://www.vox.com/health-care/2018/12/18/18134825/emergency-room-bills-health-care-costs-america [vox.com]
https://www.huffpost.com/entry/hospital-prices-cost-differences_n_3232678 [huffpost.com]
The US has a 900 bed hospital with 1300 billing clerks...
https://www.pbs.org/newshour/economy/why-does-health-care-cost-so-m [pbs.org]
It's so precious for mothers to hold their babies that they charge for it:
https://www.cbsnews.com/news/doula-explains-why-hospital-charged-parents-39-to-hold-newborn-baby-in-viral-post/ [cbsnews.com]
I've read the explanations on why they do it but what they're doing is like a restaurant billing an old lady for a waiter helping to walk her to her car. Yes it's "precious", is good for safety and it does cost the restaurant. Doesn't make it less of a WTF.
(Score: 2) by driverless on Thursday May 23 2019, @06:25AM (1 child)
This is wierd. A thread about India that's gone to nearly a dozen messages and no-one's jumped in with the standard white supremacist/neo-Nazi obsession with Indians toiletting habits. Are they all asleep? Still recovering from celebrating Führergeburtstag?
(Score: 2) by krishnoid on Thursday May 23 2019, @07:15AM
Not a white supremacist, but hey, I'll jump in on rich poop [businessinsider.com], poor poop [bbc.com] concerns. The absolute numbers differ by multiple orders of magnitude, but hey, you gotta start the discussion somewhere.
(Score: 4, Informative) by SemperOSS on Thursday May 23 2019, @08:19AM
When I studied Business Administration, US health care costs were among the highest (if not the highest) in the world and it does not seem to have changed since then. This is through a number of inefficiencies like the cost of retaining droves of lawyers to negotiate with numerous insurance companies, who again need droves of lawyers on their side; the baffling fact that medicines are (substantially?) more expensive than in the neighbouring countries (who would have thought that in a so-called "free market" economy?); the high salaries of doctors; and the high expectations of dividends for the shareholders, to name a few. Oh, and the number of mostly unnecessary tests and possibly procedures to avoid the possibility of litigation.
The Indian hospitals are tuned to optimise the efficiency in every way possible, and obviously utilise the fact that skilled labour is so much cheaper there than in the US of A. India, like Cuba, has a very high degree of incredibly well-educated people, who may be earning really well by local standards but considered low-paid by Western standards. It all adds up favourable in the price comparison.
I don't need a signature to draw attention to myself.
Maybe I should add a sarcasm warning now and again?