So pretend I need a hip replacement and perhaps 2 months of recovery. I have insurance but it is not terrific. I am willing to sign anything stating the insurance I have is not responsible for poor care or any complications in a foreign country provided they contribute X amount to this care as required by the insurance claim like it was in the US.
Why can’t I go to India or something and receive care and take my chances?
Why would the Insurance Company care where I go?
My wag is that they dont want to cover any side effects caused by the surgery. But more generally, insurance companies are soulless greedy corporate bastard asshole dickhead fuckers looking for any God damn reason to not pay out.
The answer to why don’t they pay in [situation in which the contract doesn’t require them to pay] is the obvious ‘they don’t pay when they don’t have to’. Perhaps we should stipulate that and proceed to the more interesting ‘why aren’t insurance contracts written this way’ question, and I think that the waivers the OP mentioned would be a large addition to the needed paperwork that would have to be crafted individually-ish, and the whole contract would be legally difficult to make actually work in the way you describe in practice.
Who says they won’t pay ? My insurance not only covers me worldwide but there are also participating providers outside the US. Not many, but I have out-of-network benefits.
I can’t imagine why your health insurance would be responsible for your care or complications when you receive the care outside the US- they’re not responsible when you receive it in the US. Because they aren’t providing the care in ether case, just paying for some of the bill.
Sure, but it’s win win. I get my hip, they pay less money for what I can claim legitimately.
A WAG, but could there be a tax law or regulatory issue here? I.e. there could be a rule that health insurance must provide for rembursement of expenses incurred with licensed (meaning: licensed to practice in the US) medical practioners. Or there could be a rule that, to qualify for tax deductibilty, a policy must so provide.
Americans already do this in large numbers. Countries like Costa Rica have very low cost but still very good medical care that lots of people take advantage of. It is called “medical and dental tourism” and there are agencies that not only arrange hospital visits in foreign countries, they can also do things like arrange full travel arrangements in a luxury hotel complete with nursing care.
Medical insurance may or may not pay for it depending on the plan but it can work out financially overall even if you have decent insurance and just want to pay out of pocket. Most American medical plans still cost many thousands overall for major procedures. There are many American trained doctors that return to their home country after they complete the American educational requirements and they can make great money in relative terms treating American patients.
Back in the U.S., some things like radiology are already outsourced by hospitals. A doctor in India can read scans quickly and cheaply as long as they have a decent internet connection and the right license.
The cynic in me says it is due to regulatory capture. Medical providers in the US do not want Americans buying medical care obtained from overseas because it is cheaper. The FDA bans Americans from importing pharmaceuticals from overseas (although they don’t really prosecute it), but this law does seem to prevent the large scale importation of meds from overseas. So an individual can import a personal supply of meds from mexico or India, but it isn’t like a pharmacy chain can import millions of doses of it.
I’d assume that regulatory capture also means that Americans can leave the US for medical care, but only in isolation. Doing so in large numbers with the cooperation of insurance programs like private insurance or medicare probably aren’t allowed. So maybe you as an individual can go to Mexico for heart surgery, but major insurance programs making this a mainstream option may be opposed by groups like the AMA, AHA, etc. trying to keep their business model going.
But again, to my knowledge other developed nations have both programs. You can import medical products from overseas as well as get care in other nations.
This happens all the time. Americans buy drugs, and contact lenses from countries where they are cheaper, mainly Canada and Mexico. When you look at elective surgery, like lasik, Americans travel abroad for it all the time.
I’m not going to hunt for a cite, but I’ve read that some employer-sponsored health coverage in the U.S. already routes patients to foreign hospitals for surgery when practical.
And not just Americans.
The phrase to google is “medical tourism”. It’s BIG business , in many countries.
There are organizations to help you, such as
And detailed price lists in nice, easy-to-read columns ,for any kind of treatment, in any country you want.
Want heart bypass surgery? That’s $123,000 in America–or $28,00 in Israel, $17,00 in Singapore.
That would be one of my guesses; there are probably regulatory reasons on one side or the other.
Another reason could be a perceived lower standard of care in foreign countries. I can’t imagine insurance companies are interested in paying out to fix what some janky foreign doctor did.
The third reason would be an inability to control costs and/or exert any control over the situation.
BTW, in many cases, you’re not going to be at the local public hospital, in a ward with local residents. Instead, there are hospitals in places like Thailand or Singapore that specialize in treating foreigners, with high levels of service and English-speaking staff.
Here’s a 2013 story about an American who traveled to Belgium for a hip replacement in 2007 and paid under $14,000, including the plane ticket, five days in the hospital and a week in rehab.
Why not go to China for organ replacements while you’re at it?
Insurance companies negotiate prices with hospitals, so they pay a lower price than an uninsured person would. So while an uninsured American may save a lot of money by going overseas, the insurance company doesn’t save quite as much by sending their customers overseas.
28 or 17 hundred or thousand?
oops, my typo.
Its 28,000 or 17,000 dollars.
and if you click my link, you’ll see on the whole list: a dozen countries where the $123,000 operation costs much, much less-- down to $7,900 in India.
Why not? You can moralize all you want but if you were going to die without a replacement organ, you can blog about how you feel guilty about (whoever it came from) during the additional years of life post-transplant.
Not moralizing. Actually, have real life experience visiting a childhood friend in China during his liver transplant and recovery. I posted about it on these boards about 10 years ago
BTW, why did you introduce Chinese organ transplants into the conversation?