Baseball and US healthcare October 30, 2008
Posted by Dan Herman in Government, healthcare, Industry.Tags: Data, Government, healthcare, Technology
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If you’re a baseball fan than you’re likely mourning the end of the season and likely familiar with the concepts of “moneyball” and “sabermetrics” and the use of statistics to infer trends, future performance and player investment or drafting strategies. It counters the traditional methods of judging future performance on the basis of personal observation and informed opinion. The concept is most closely associated with Billy Beane, general manager of the Oakland Athletics, and (in theory) explains why small-market teams such as Oakland are able to compete with large-market teams whose budgets dwarf the latter.
This concept of statistic-driven outcomes has its equivalent in healthcare: evidence-based medicine. Yet despite its theoretical value, it’s still rarely used and tough to access. As Billy Beane, Newt Gingrich and John Kerry note in a recent New York Time op-ed, “a doctor today can get more data on the starting third baseman on his fantasy baseball team than on the effectiveness of life-and-death medical procedures.”
All this despite the fact that the US spends more than twice per capita on healthcare than any other country in the world, ranks amongst the worst industrialized countries on health quality, and sees nearly 100,000 Americans killed every year by preventable medical erros. You’d think a moneyball/evidence-based medicine approach to healthcare would gain more traction. (more…)
Free-market healthcare? March 19, 2008
Posted by Dan Herman in Economics.Tags: healthcare, travel
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Earlier in the year I blogged about the true costs of healthcare and the role technology and the Web 2.0 might play in reducing those costs. But maybe we should forget about providing expensive healthcare procedures all–together and instead take a true free-market / division of labour approach and outsource expensive procedures to where they’re cheapest.
Unlikely and politically unpalatable as that may seem, global medical tourism is a $20 billion industry, expected to grow to 40 million cross-border trips by 2010. In the US, 750,000 Americans went abroad for some type in treatment in 2007, and by 2012 that number is expected to top 6 million. Evidently, there are questions about standards but Joint Commission International , a US not-for-profit that accredits American hospitals, has accredited over 140 international hospitals (based on US standards) and expects the number to grow to almost 300 over the next three years.
For host countries, this is big business. For example, according to the Jordanian Ministry of Health incoming medical tourism attracts 120,000 patients a year, and generates between $650 million and $700 million annually. For a country whose total GDP (PPP) comes in at approximately $27billion and total exports at just $5 billion, medical tourism thus represents a pretty significant, and growing, share of the country’s income.
Moreover, for countries such as the US developing country healthcare hosts represent massive potential savings. The Journal of Financial Planning estimates that savings may range from 50 to 95 percent of the U.S. cost.
Here are some examples from the National Centre on Policy Analysis:
- Apollo Hospital in New Delhi, India, charges $4,000 for cardiac surgery, compared to about $30,000 in the United States.
- Hospitals in Singapore charge $18,000 and hospitals in India charge only $12,000 for a knee replacement that runs $30,000 in the United States.
- A rhinoplasty (nose reconstruction) procedure that costs only $850 in India would cost $4,500 in the United States.
Given those cost savings, should government run healthcare outsource expensive procedures and focus their budgets on what they do best, and most efficiently? Sounds a bit like a basic Ricardo-esque gains-from-trade analysis. And perhaps this is the next frontier of globalization: a world where government budgets are divvied up on a per capita basis and citizens shop the world for the best deal on government services…. global government anyone?
