Healthcare tourism is the symptom of a damaged U.S. healthcare system

The tragedy involving 4 Us residents who were lately kidnapped and two of them murdered — whilst in search of beauty surgical procedures in Mexico has renewed the dialogue of “medical tourism,” a expression that, in my intellect, implies that their vacation was recreational and enjoyable. I desire the term “outward clinical travel” and would argue that these Americans’ journey abroad need to remind us of how inaccessible wellbeing treatment is listed here and the lengths to which people today will go to get the treatment they want or will need.

I like the phrase “outward medical travel” and argue that their journey overseas need to remind us of how inaccessible health treatment is listed here.

It’s not just about plastic operation: Us citizens go wanting for a extensive vary of treatments abroad, from dental care and hip replacements to fertility therapies, organ transplants and cardiovascular care. For the 30 million Americans with no wellbeing coverage, this sort of strategies may possibly be out of their selling price variety right here in the States.

And even those people who have insurance policies may perhaps find that they can get the treatment they request much less expensive or more promptly in yet another state. 

A root canal in Hungary or Vietnam, for illustration, might be a quarter of the price of the technique in the U.S. The exact same goes for an angioplasty in Malaysia

My cousin, Jessica Koller Gorham, a bariatric surgeon at Ochsner Health in New Orleans, advised me Louisiana’s point out prepare only handles bariatric surgical procedure for 300 state approach-insured personnel for each 12 months for the full point out. The ready listing for fat-loss medical procedures, now three years lengthy, is rising. “It’s insanity,” she said. “And so what do some of these folks do? Mexico is not significantly away.” Traveling for healthcare treatment is generally a desperate measure for all those who have tried the typical route and discovered only barriers.

Having said that, outward health care vacation can have many challenges. Top quality and safety requirements, licensure, credentialing and medical standards for getting strategies are not reliable throughout nations around the world and hospitals. If surgical procedures are executed in substandard circumstances, for illustration, the threat of inadequate effects or problems is larger. Some people may possibly depart the U.S. trying to find therapies that have not been approved in the

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U.S. Healthcare: A Conglomerate Of Monopolies

The Taylor Swift ticketing debacle of 2022 left countless numbers of annoyed ‘Swifties’ without a opportunity to see their preferred artist in live performance. And it also highlighted the trouble that arises when corporations like Ticketmaster attain monopolistic command.

In any field, current market consolidation restrictions opposition, preference and access to goods and products and services, all of which drive up costs.

But there is another—often overlooked—consequence.

Sector leaders that develop as well highly effective develop into complacent. And, when that transpires, innovation dies. Health care gives a prime case in point.

An sector of monopolies

De facto monopolies abound in pretty much each individual health care sector: Hospitals and wellness techniques, drug and device companies, and health professionals backed by private equity. The consequence is that U.S. health care has grow to be a conglomerate of monopolies.

For two a long time, this rigorous focus of power has inflicted damage on individuals, communities and the wellbeing of the country. For most of the 21st century, professional medical costs have risen a lot quicker than in general inflation, America’s existence expectancy (and total health and fitness) has stagnated, and the tempo of innovation has slowed to a crawl.

This write-up, the very first in a series about the ominous and omnipresent monopolies of healthcare, focuses on how merged hospitals and impressive health devices have elevated the rate, reduced the good quality and lowered the advantage of American drugs.

Foreseeable future content articles will glance at drug companies who wield unfettered pricing energy, coalitions of specialist doctors who acquire monopolistic leverage, and the payers (firms, insurers and the governing administration) who tolerate market consolidation. The sequence will conclude with a glance at who stands the finest chance of shattering this conglomerate of monopolies and bringing innovation again to healthcare.

How hospitals consolidate electric power

The healthcare facility marketplace is now household to a pair of seemingly contradictory traits. On one particular hand, financial losses in current decades have resulted in report premiums of healthcare facility (and clinic company) closures. On the other hand, the all round sector dimensions, value and earnings of U.S. hospitals are increasing.

This is no incongruity. It is what happens when hospitals and well being techniques

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Major Improvements Are Coming to U.S. Wellbeing Treatment as Pandemic Emergencies Expire

By Dennis Thompson HealthDay Reporter


WEDNESDAY, Feb. 8, 2023 (HealthDay Information) — Individuals acquired unparalleled accessibility to wellbeing treatment during the pandemic, which include trouble-cost-free community insurance and cost-free tests, treatments and vaccines for COVID-19.

Now, they have to have to get ready for most of that to unwind, authorities say.

“Essentially, Congress and the administration moved to a model of universal health protection for COVID vaccines, treatment options and tests” through the pandemic, mentioned Jennifer Kates, senior vice president with the Kaiser Spouse and children Basis.

But the United States’ public well being crisis declarations linked to the pandemic will close on May 11, as purchased in January by the Biden administration.

And late past 12 months, Congress voted to allow states to conclusion the expanded Medicaid gains presented throughout the pandemic.

“It’s not the case that everything’s likely to finish, but some factors are likely to conclude and some issues are going to change,” Kates explained.

The adjust most People will observe is an conclude to no cost COVID care, starting off with tests, gurus said.

“People were being used to getting eight COVID assessments a thirty day period from the federal government for absolutely free,” reported Dr. Carlos del Rio, president of the Infectious Illnesses Modern society of America. “That, for absolutely sure, is heading to finish.”

Based on their insurance policies status, folks will have to fork out some or element of the price tag of both of those at-dwelling exams as properly as the a lot more complete and exact COVID tests conducted at doctors’ offices and hospitals.

“Testing is likely to come to be something that is likely to be extra like tests for other ailments,” del Rio reported.

Sooner or later, folks will also have to commence forking more than income for COVID vaccines and treatment options like Paxlovid.

Not promptly, even though. The federal govt nonetheless has a offer of Paxlovid and COVID vaccines on hand as a consequence of its pandemic response, Kates mentioned.

“Those goods that ended up obtained by the federal government, we can’t be charged for individuals. All those are compensated for by now,” Kates discussed. “But when those supplies are long gone, that is when every little thing will be moved into the industrial sector.”

This could particularly hit the poor and uninsured, stated Dr. William Schaffner, clinical director of the Countrywide Foundation

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The Coming Collapse of the U.S. Overall health Treatment Process

It’s 4 in the early morning and you awaken with crushing chest ache. Your relatives phone calls 911 and paramedics arrive and diagnose a cardiac party. They inform you that they need to transportation you forty-5 minutes away since your two area hospitals have shut over the last many months. Even when you arrive at the hospital, there is substantial overcrowding and they advise you that there are no ICU beds open up for you in that fifty % of the beds in the cardiac device are “browned out” due to absence of staff. This nightmare is an all too familiar post pandemic truth about the delivery of health and fitness care in our country. This is not the expectation that the general public expects in the shipping of health care in just one of the richest nations in the environment that has been at the chopping edge of wellness care innovation of the last century.

What has led to this publish-pandemic nightmare is multifactorial. The pandemic modified how well being treatment specialists are both of those valued and how they see themselves. Throughout the peak of the pandemic they have been heroes that have been endangering their lives to aid the neighborhood. But now matters seem unique.

All around 7,000 nurses on strike in New York City nursing strike is emblematic of the dire scenario. Nurses, who are necessary to the vital performing of all hospitals, are entitled not only to extra equitable payment and benefits, but in the end safer staffing ratios in all affected person care options. What is ironic is that the strike will drive these extremely health care methods to replace utilized nurses with short-term nurses from staffing businesses, additional compounding their monetary woes, and in the end, their bottom traces. Until eventually we make investments in individuals and their value in health care, we will not be ready to see mild at the close of the tunnel.

Everyday we read about hospitals in the course of the region dropping millions if not billions of pounds for each year. Hospitals are closing urgent care centers, obstetric, pediatric and other services to try to survive. A single of the major aspects that has induced this disaster is the absence of team. Write-up-pandemic clinic staffing has massively lowered with a rise in short term locum staffing dependency. Hospitals and clinicians no for a longer period have

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To prevent medical debt, the U.S. could learn from Germany’s health care system : Shots

Dr. Eckart Rolshoven examines a patient at his clinic in Püttlingen, a small town in Germany’s Saarland region. Although Germany has a largely private health care system, patients pay nothing out-of-pocket when they come to see him.

Pasquale D’Angiolillo for KHN

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Pasquale D’Angiolillo for KHN

Dr. Eckart Rolshoven examines a patient at his clinic in Püttlingen, a small town in Germany’s Saarland region. Although Germany has a largely private health care system, patients pay nothing out-of-pocket when they come to see him.

Pasquale D’Angiolillo for KHN

PÜTTLINGEN, Germany — Almost every day, Dr. Eckart Rolshoven sees the long shadow of coal mining in his clinic near the big brownstone church that dominates this small town in Germany’s Saarland.

The region’s last-operating coal shaft, just a few miles away, closed a decade ago, ending centuries of mining in the Saarland, a mostly rural state tucked between the Rhine River and the French border. But the mines left a difficult legacy, as they have in coal regions in the United States, including West Virginia.

Many of Rolshoven’s patients battle lung diseases and chronic pain from years of work underground. “We had an industry with a lot of illnesses,” said Rolshoven, a genial primary care physician who at 71 is nearing the end of a long career.

The Saarland’s residents are sicker than elsewhere in Germany. And like West Virginia, the region faces economic hurdles. For decades, German politicians, business leaders and unions have labored to adjust to the mining industry’s slow demise.

But this is a healthier place than West Virginia in many respects. The region’s residents are less likely to die prematurely, data shows. And on average, they live four years longer than West Virginians.

There is another important difference between this former coal territory and its Appalachian counterpart: West Virginia’s economic struggles have been compounded by medical debt, a burden that affects about 100 million people in the U.S. — in no state more than West Virginia.

In the Saarland, medical debt is practically nonexistent. It’s so rare in Germany that the federal government’s statistical office doesn’t even track it.

The reason isn’t government health care. Germany, like the U.S., has a largely private health care system that relies on private doctors and private insurers. Like Americans, many Germans enroll in a health plan through work, splitting the cost with their employer.

But Germany has

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Recommendations to improve health and wellbeing of individuals incarcerated in U.S. prisons

Adequately funded policies and procedures are needed to reduce health care disparities in access to and the quality of health care for the U.S. jail and prison population says the American College of Physicians (ACP) in a new policy paper published today in the Annals of Internal Medicine. Health Care During Incarceration: A Policy Position Paper of the American College of Physicians details recommendations to improve the health and wellbeing of individuals incarcerated in adult correctional facilities.

ACP has a long-standing commitment to improving the health of all Americans and opposes any form of discrimination in the delivery of health care services, which extends to our patients who are incarcerated. Many incarcerated patients are dealing with significant unmet health care needs that can include chronic medical conditions, infectious diseases, substance use disorders and mental health conditions. We need to ensure that these patients receive the health care services they need.”

Ryan D. Mire, MD, MACP, President, ACP

ACP’s recommendations include adequate funding for and timely access to necessary health care services that are evidence-based and meet community standards. They also recommend measures to ensure adequate nutrition; opportunity for physical activity; smoke-free policies and smoking cessation interventions; and access to recommended preventive health services. ACP further calls for policies to adequately treat both chronic noncommunicable diseases and infectious diseases. This should include infectious disease prevention and control programs developed with public health authorities. In addition, all persons entering correctional facilities should be screened for substance use disorders and behavioral health conditions and provided with treatment if necessary.  ACP also supports policies that promote the treatment of patients with substance use disorders as an alternative incarceration.

The paper also details recommendations for population segments within correctional facilities. This includes recommendations for how to better meet the needs of incarcerated women; LGBTQ+ patients; aging patients and those living with disabilities or life-limiting illnesses; and immigrant populations.

Lastly, the paper details how health care needs must be included in community re-entry planning for individuals who are released from jail or prison, so that they are able to continue to access health care and social services once they return to their communities. ACP specifically makes recommendations for policies that would help to facilitate or reinstate state Medicaid enrollment.

“Incarceration can negatively affect the health and well-being of millions of patients, their families and communities across America,” concluded Dr. Mire. “As a

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