KRV?s Sandbox

[KRV]

Hello folks, checking in after a long time. Life and Work have been throwing so many challenges over the last few months that getting time to even read the forum, let alone post anything, has been very difficult. This is perhaps what happens to many ‘settlers’ – i.e. those who have spent at least 2 years in India post R2I - with some highly notable exceptions, of course.

I recently commemorated the 500th day of my return to India. I feel like an over-rated movie that has run its course and the only people seeing the show on its 500th day are those hoping to find faults in it or simply wondering how a mediocre movie managed to run for 500 days. It is quite a coincidence that as I write this blog to mark my 500th day of R2I, U.S. Congress has passed what is rightly called as a ‘historic’ healthcare reform bill. While the 40 million uninsured Americans have reasons to cheer, I am sure business owners and high-tax-bracket professionals are feeling uneasy as to what this means to their bottomlines. You have to hand it to President Obama. He managed to achieve what none of his seasoned predecessors ever dreamt of achieving – perhaps, the cumulative wisdom from the collective failures of the previous administrations to tackle the healthcare monster finally helped in taming the beast that represents a sixth of the U.S. economy!

Well, with this historic bill passing in U.S., one of the pillars on which my R2I decision was based has been shaken (it is too early to tell if it has been shattered :wink). My blog readers already know that the state of U.S. healthcare system was one of my drivers for R2I. Now, with baby steps towards universal healthcare (aka Canada/UK/Europe/New Zealand), U.S. may (if we all are lucky and no future U.S. congress repeals this) have levelled the playing field in healthcare. With 500 days outside the U.S., my perspectives are increasingly irrelevant compared to those forum readers in U.S. who will now enjoy the fruits of Obama’s labor. So, please share your thoughts. Do you see this bill markedly changing any of your economic assumptions about U.S. healthcare costs in the coming years? Do you see your own financial situation getting better as a result of a universal healthcare system in U.S.?

[PeterGriffin]

Welcome back, KRV!

Good to see you back and blogging!

[pazham]

Unfortunately, health care in India is very expensive too. I have seen many people that I know are struggling to raise funds in case of emergency. Along with the inflation, we have to do some analysis on the health care expense rise in India.

[sumachechi]

Very true pazham- its expensive because there are more trained people and structures places to offer treatment for conditions which previously one would have been doomed for. Unfortunately, good healthcare is expensive, and what's the need of the hour is to create either in our private finances some contingency for these issues, or for a good all comprehensive health insurance to come up. And I mean one that will cover costs of chronic conditions.

[KirKS]

Unfortunately, good healthcare is expensive, and what's the need of the hour is to create either in our private finances some contingency for these issues, or for a good all comprehensive health insurance to come up. And I mean one that will cover costs of chronic conditions.

It's expensive based on local income, but still the arbitrage opportunity is huge for someone with a choice. Isn't it?

Procedure United States ($) Thailand ($) Singapore ($) India ($)

Heart bypass 130000 11000 18500 10000
Heart valve rep 160000 10000 12500 9000
Angioplasty 57000 13000 13000 11000
Hip replacement 43000 12000 12000 9000
Hysterectomy 20000 4500 6000 3000
Knee repl 40000 10000 13000 8500
Spinal fusion 62000 7000 9000 5500

Source: AMA, June 2007

http://www.indiaprofile.com/medical-tourism/cost-comparison.html

[QUOTE]no matter what procedure you undergo, you are sure to save 75% to 95% of healthcare costs.

[sumachechi]

Kirks
Yes, its cheaper if you compare to other countries. However, what you have put up is a list of elective surgeries. Most of these can also be insurance funded. The real bite comes in times of 'emergency'- acute illness necessitating intensive care, care for cancer- most of the international regimes have expensive drugs ,the price of which does not change much around the world, other chronic disease like kidney failure needing long term dialysis even life long immunosuppression post transplant. None of these sort of conditions are covered by health insurance of any kind.
Ordinary Indians can get wiped out following one intensive care admission for a sick person - and people wrongly believe that hospitals charge money by putting patients in ICU's and billing them high- actually, if you look at the amount of care needed for an ICU patient, cost of consumables, the diligent monitoring, personnel involved- the problem is more that there is no contingency planning available for people to avail of in health emergencies, hence they get stressed rather than actually the expense of healthcare itself.

[pazham]

Totally Agree with Sumachechi. Also you cannot compare money value face to face. It is like saying a coffee in US costs 4$, whereas the same coffee is Rs 20 in India

[KRV]

Folks, let's stop the tangent here. My last blog was not about India's healthcare system. No matter how we slice it, the fact is that for professionals (especially R2Iers who accept jobs in India from US), the health care costs in India are not nearly as daunting. Both countries have insurance plans, but in India, you can choose not be insured if you have relatively modest assets compared to U.S. It is simple math, if you are returning to accept a job at say 1/3rd of US salary, and health care costs are in general 1/8th to 1/20th of U.S. (for similar quality, without any of the unnecessary trimmings) it is easy to see how you fare better on this front.

I would appreciate responses from U.S. side after the landmark healthcare reform bill. One more question to add to my end of blog #11 is how do you see this bill affecting the healthcare costs of elderly immigrants (say, your parents you decide to sponsor for GC)? Will this bill make the situation much easier or more affordable for them?

Thanks,
KRV

[sumeet]

Folks, let's stop the tangent here. My last blog was not about India's healthcare system. No matter how we slice it, the fact is that for professionals (especially R2Iers who accept jobs in India from US), the health care costs in India are not nearly as daunting. Both countries have insurance plans, but in India, you can choose not be insured if you have relatively modest assets compared to U.S. It is simple math, if you are returning to accept a job at say 1/3rd of US salary, and health care costs are in general 1/8th to 1/20th of U.S. (for similar quality, without any of the unnecessary trimmings) it is easy to see how you fare better on this front.

I would appreciate responses from U.S. side after the landmark healthcare reform bill. One more question to add to my end of blog #11 is how do you see this bill affecting the healthcare costs of elderly immigrants (say, your parents you decide to sponsor for GC)? Will this bill make the situation much easier or more affordable for them?

Thanks,
KRV

I agree with you. I know this is not the thread for comparing costs of health care between the two countries, but find it a bit amusing to read people who have R2ied saying health care is very, very expensive in India, expensive it is if you are looking at costs in comparision to mediocre care and facilities available even 10 years back, but if you expect quality care and comforts of a 5 star hospitality as well, how can one keep costs very low?
One shudders to travel to US even for a short time without some health cover, on the other hand I have seen many R2ied people even after months of returning are still running 'bare', if they are not covered by a company insurance, that itself shows comparitively the costs are lower, but as sumechi pointed out if you have a chronic illness/require expensive drugs you will eventually run out of the cover and that is when it impacts ones finances severely.

[sumeet]

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