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by whoisjuan 2131 days ago
I keep paying my health insurance premium at my home country just because the health insurance in the US is completely broken. I feel that if you get seriously sick in the US you're in an almost sure path to financial insolvency.

My employer pays probably a shit ton of money for my health insurance and what I get is the most subpar, confusing, broken and sometimes blatantly extortive service ever.

I live in Austin and sometimes I think if I really need a major procedure it would be just simpler to drive to Mexico and get it done there. In fact, that's what many people in South Texas do, so there's your benchmark for how broken is healthcare in the US.

4 comments

You don't even necessarily have the option to shop for service in the USA.

Earlier this year my family had a medical emergency that resulted in us being billed a truly staggering amount of money for services that were technically elective, somewhat unproven, and not necessarily even recommended by the standard of care, and for which the actual sticker price varies wildly from hospital to hospital. But, when an emergency happens, you don't get to shop for hospitals, and you more-or-less unthinkingly do what the care team recommends, because there's simply no opportunity to stop and do any sort of cost/benefit analysis. As luck would have it, we ended up at a hospital that both tends toward the more liberal end of the spectrum in terms of what they do, and tends toward the more expensive end of the price range.

Fortunately our financial hit won't be too bad, because we have decent employer-provided insurance, and that cushions the blow quite a bit. If there's a silver lining, it's that we hit our out of pocket expense limit in the first part of the year, so we basically get everything for free for the rest of the year. But that whole situation is also a big part of the problem. We're nominally in the driver's seat, but, in practice, we really aren't in charge. Because we don't have access to a lot of the information necessary to make informed decisions, but also because we've been insulated from some of the major factors that might motivate an informed decision.

Social criticism in the USA tends to revolve around the "theater" metaphor. We have security theater, we have hygiene theater. I would characterize the underlying principle of the USA's health care system as agency theater.

> I live in Austin and sometimes I think if I really need a major procedure it would be just simpler to drive to Mexico and get it done there.

This even has a name: Medical Tourism.

Friend does this - she raves about the results.
I definitely recommend it for dental work. You can easily find a dentist in Mexico that went to school in the US and has the same credentials. You'll save so much money.
I recommended a friend who needed heart surgery with less than great US health insurance go to India to have it done. US trained doctors, recuperated in accommodations equivalent to a five star resort. Cheap enough they could pay for it in cash.

I am downright surprised I haven't seen a YC startup that performs this sort of medical tourism brokerage to be honest. Take this business model! I'll be your first angel investment.

I love the idea, I imagine it's in a tricky legal area though. And perhaps the people that could pull it off are all profiting off of the US healthcare system well enough to not need to pursue this.

I know the insurance plan that Utah government employees are on will pay you to go to Mexico to get your prescriptions filled. Airfare, hotel, and medication costs are all covered. Free vacation just so the company doesn't have to pay the US prices for drugs.

Just remember that you might be displacing poor locals from getting the treatment instead. Poor countries have bigger shortage of good doctors and they prioritise foreign appointments due to getting paid more than the local prices.

Edit: This is true for India which is a top medical tourism place:

https://www.orfonline.org/expert-speak/implications-india-me...

https://scroll.in/article/931857/with-20-medical-professiona...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC404528

http://www.who.int/hrh/resources/16058health_workforce_India...

You just made this up.

No, really: you just, flat out, made this up.

You have no way of knowing that demand for services in every single country with medical tourism outstrips supply of professionals. You just assumed it.

If it doesn't, which is just as likely (I think more, but I also don't know, and unlike you I won't pretend to know), then you're injecting money into the local economy, while getting medical/dental care at a lower price: win win.

The US has a uniquely onerous path of education and accreditation for medical professionals, with substantial supply-side limitation in the form of slots for medical school. Other places aren't so burdened.

Something to think about.

I wonder if medical tourism provides a capitalist solution to the healthcare problem in the US. Could it be cheaper for a health insurance company to pay for flights to and from other countries along with procedures in those countries? There are a lot of non-emergency medical issues which can be serviced this way. In the long run, such insurance would drive down the price of traditional health insurance as well as the price of the procedures themselves locally.
This employer is already doing that (and pays some of the savings out to the employee/patient)...

https://www.nytimes.com/2019/08/09/business/medical-tourism-...

Though, I'm not convinced that's the "correct" solution from a broad societal perspective.

My state does this for public employees: https://www.sltrib.com/mexico-pharmacy-tourism/
They literally already do this
One glance once you cross over to Nuevo Laredo will show you this isn't a novel thought. Especially for dental and smallish out-patient procedures.
Can confirm. I drove from Austin to Nuevo Laredo for dental work. Park up, walk across the bridge, get dental work for a fraction the of the US price and walk back. Most painful part of the process is going back though US border control.