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Wednesday, October 11, 2006

Ship the sick overseas

What malpractice?

Union Disrupts Plan to Send Ailing Workers to India for Cheaper Medical Care

Published: October 11, 2006

BANGALORE, India, Oct. 10 — A few weeks ago, Carl Garrett, a 60-year-old North Carolina resident, was packing his bags to fly to New Delhi and check into the plush Indraprastha Apollo Hospital to have his gall bladder removed and the painful muscles in his left shoulder repaired. Mr. Garrett was to be a test case, the first company-sponsored worker in the United States to receive medical treatment in low-cost India.

But instead of making the 20-hour flight, Mr. Garrett was grounded by a stormy debate between his employer, which saw the benefits of using the less expensive hospitals in India, and his union, which raised questions about the quality of overseas health care and the issue of medical liability should anything go wrong.

“I was looking forward to the adventure of being treated in India,” Mr. Garrett said the other day. “But my company dropped the ball.”

The union, the United Steelworkers, stepped in after it heard about Mr. Garrett’s plans, saying it deplored a “shocking new approach” of sending workers to low-cost countries as a way to cut health care costs. Its officials insisted that Mr. Garrett be offered a health care option within the United States.


IndUShealth, a company based in North Carolina that arranges health care in India for Americans, would have made Mr. Garrett’s medical arrangements. The company acknowledged that its plan to send Blue Ridge workers to India was “on hold” but said it was exploring deals with other employers.

The union’s resistance has brought to the fore a critical question in the path of the globalization of the health care industry — who is liable if something goes wrong in an overseas hospital? And underlying all this is the even more explosive issue of potential job losses in the American health care industry, in an economy already sensitive to the large-scale shift of jobs to cheaper overseas locations.

Even as the debate continues about insurers’ role in health care outsourcing, hundreds of uninsured and under-insured Americans have already gone on their own to India for treatments.

With medical costs in India routinely 80 percent lower than in the United States, experts predict that globally standardized health care delivered in countries like India and Thailand will eventually change the face of the health care business.

Providing health care to foreigners could generate $20 billion for India by 2012, according to a study by McKinsey & Company, the consulting firm, although McKinsey did not say how many patients that figure represents. With 150,000 overseas patients last year — though only a small fraction of them Americans — India is already the global leader in importing foreign patients for low-cost treatment. Its best hospitals have Western-trained doctors and are equipped with modern equipment.

Still, cross-border medical liability in countries like India could prove to be a major hurdle, the experts say. In the case of Mr. Garrett, Blue Ridge Paper asked him to sign a release saying that he was “on his own as far as medical liability,” said Bonnie Blackley, the benefits director at Blue Ridge.

Tom Keesling, president of IndUShealth, said “the Indian physician and hospital would be directly responsible for any malpractice.”

Zubin Daruwalla, health care analyst at the consulting firm Frost & Sullivan, said there was no uniform code in India on what could be considered medical negligence and what compensation ought to be paid. “Compared with the huge payouts in the United States, Indian courts award small amounts,” Mr. Daruwalla said

Indian and Thai health care execs see a bonanza coming their way. I see companies being sued for overseas mistakes. This is going to push single payer like nothing else. Why? Doctors and hospitals can see losing business as companies cut cost. Once they realize that, they're gonna back single payer hard.

All it takes is one incompetent doctor overseas to kill this plan dead.

posted by Steve @ 9:36:00 AM

9:36:00 AM

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