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escribacat On March - 8 - 2010

Since I got laid off from a regular job about two years ago, I have been uninsured. I would really prefer to remain a contractor and work my own hours, but insurance is a big problem. I tried to purchase insurance but was turned down by three companies before I just gave up (I have a history of back problems). I looked into a high risk pool offered by the state but the premiums, deductible and co-payments were so high, and the coverage so limited, it wasn’t worth bothering with.

I’ve seen a doctor only once in the past few years, when my back started acting up and I had to at least get some prescriptions filled. Luckily, by now I have a pretty good arsenal of self-treatments and I was able to fend off another major episode. That was a few months ago.

I have made a point, however, of getting my teeth cleaned often. At one of these cleanings, my dentist informed me that I have “deep pockets,” which has to be the most ironic name in the dental universe. I had to go have a periodontist look at my gums. He wanted to do some work on three of my teeth, at $2,000 each. He charged me $200 to tell me that.

That’s when I started looking at dental tourism. I have friends who live in Mexico and I did quite a bit of research on periodontists in Guadalajara. I found some success stories and some horror stories. Unfortunately, I couldn’t find any solid recommendations so I didn’t pursue it for the time being. I can say, however, that I could buy a plane ticket, hotel, and get all three teeth done for less than the cost of one tooth here. One problem, of course, would be follow-up checks.

During my research, I found a lot of information about medical and dental tourism. New agencies are springing up all the time that cater to this growing industry for Americans who can’t afford the amazingly expensive prices we pay for medical and dental services here. I recently found this very interesting chart on a medical tourism website. If you click on the chart, you’ll be able to read the numbers (it’s too big to display full-sized in the column here):


Some of the numbers on this chart are stunning. What the chart doesn’t explain is why there are such astronomical gaps in prices. Why does a heart valve replacement cost $170,000 in the USA while it costs $1,200 in India and $13,500 in Singapore? Do we do ten times as many tests? Do our doctors have to pay that much more in liability insurance? Do doctors in other nations sew people up with old string? Is it because of all the unpaid emergency room bills in the USA? Despite closely following the HCR debates over the past year, I still don’t have a good idea of why we pay so much more here for drugs and procedures.

Categories: News & Politics

67 Responses so far.

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    • escribacat says:

      BT, Thanks but Juarez does sound pretty dodgy right now with gang warfare and whatnot. I’d actually feel much safer in Guadalajara because I’ve been there and I have friends who live nearby and I’m thinking about going down this summer anyway. I’m just in a holding pattern right now and hoping nothing goes wrong until I figure out what to do, that is, I’m procrastinating because I just don’t want to deal with it!!

  1. Khirad says:

    For all the fears and hyperbole against socialized health care and rations, or killing grandma (be scared!), I counter with this dystopic future of corporate care:


  2. Khirad says:

    I’ve heard some good things about Nogales. On the outside the offices look shady (I’ve seen them), often up cracked adobe stairs on the second floor; but inside I’m told they have up-to-date equipment and diplomas from accredited American schools on their walls.

    Article on dental tourism in Nogales.

  3. choicelady says:

    E-cat -- what about staying home, NOT subsidizing the horrific organ harvesting practices, and finding a good dental school in a cheap city? You probably could work out a pretty equitable cost balance?

    I have a friend, victim of domestic violence, who lost front teeth, and despite her degrees and intelligence, she could NOT get a job until she went to a dental school and got that fixed. But it was wonderful for her! Cost VERY little. The problem, of course, is finding someplace where you can get it done in one or two sessions and then go home, but I bet you could work it out. Being a guinea pig for up and coming dentists is not risky -- they are carefully supervised!

  4. kesmarn says:

    e’cat, I notice that attention is being drawn to the problem of illegal organ “harvesting” (what a bizarre term, but that’s what they call it) and sale. And there’s no doubt about the fact that this is a horrific crime and should be stopped.

    But the procedures on the (wonderful) comparison chart you posted really have next to nothing to do with that problem. Procedures like hip and knee replacements don’t rely on human donors, they use artificial “parts.” Same with things like rhinoplasty and breast implants. Heart valves are mechanical or porcine (from pigs). Now kidney, heart and lung transplants are a different story, but they don’t appear on your list.

    So--bottom line (literally) is: the price differences on the info you posted don’t really have anything to do with organ theft. Bloated medical costs here have much more to do with greedy insurance companies (skimming off $$$ for performing no useful function), greedy equipment and pharma manufacturers and defensive test-ordering for the inevitable CYA purposes for doctors.

    Last but not least: RNs like me are vastly overpaid and underworked. πŸ˜†

    EDIT: Heh. Just realized there’s a second chart under the one I was looking at which did deal with transplants. Nevertheless… 😳

    • escribacat says:

      Kes, Thanks. I didn’t mean for that topic to go off onto illegal organ harvesting! I don’t see how that impacts gum surgery either. I am also aware that nurses are the great workhorses at hospitals (my sister in law is a nurse) and don’t get paid nearly as much as doctors. Somebody is definitely getting rich off the setup in this country.

        • kesmarn says:

          BT, I didn’t mean to take your answer or concerns lightly. I was just saying that heart valve replacement does not rely on human organs (unless American medicine is entirely different from the rest of the world on this technique), so cost differences on that procedure would not include the presumably higher cost of obtaining organs in a legitimate manner. American heart valve replacements either come from pigs or are mechanical. (At least, I’ve never encountered anything other than that in my nursing career.)

          But there are other surgeries where this would be an issue and I respect your concern on those fronts. No disrespect intended.

        • choicelady says:

          I think the issue if I understand, BT is that one subsidizes the other? That well may be true, especially in seriously underdeveloped nations, but I think it may be MORE true in the US than we’d ever like to think.

          That said, I’m not sure it would hold up for dental work. I think things can exist in different ways all at the same time.

          MORE to the point -- why in HELL should she HAVE to go overseas for good dental care?

      • kesmarn says:

        πŸ˜† The last thing either of us wants is cadaver gums, right e’cat?

        • kesmarn says:

          Holy crap! I didn’t know that! (You can tell I don’t work in the field of oral surgery, can’t you?)

          I knew they used cadavers for lotsa stuff, but gums?
          Wow. I learn something every day here!

          • escribacat says:

            They stick the dead guy’s bone onto your jawbone or some gawdawful thing like that.

            • Chernynkaya says:

              HAHA, not quite! They take cadaver bone and grind it into a powder-- sterilizing it repeatedly, one hopes!-- and then they make a kind of paste out of the bone powder. Very witchy-- in an eye of newt kinda way, IMHO.

            • kesmarn says:

              My money’s on Leni Riefenstahl’s…

            • Chernynkaya says:

              Kes- whose jaw does Palin have? The old befuddled aunt on “Bewitched?”

            • kesmarn says:

              …maybe we were too hard on Dubya…

              …it might have been his jaw making him say all that stuff…

              HE GOT HITLER’S JAW!

            • Chernynkaya says:

              ROFLMAO! Yeah, the ghost in my mouth!

              Ever see those poor so-called crazy folks walking around talking to themselves? They’re NOT-- they’re talking to their mouth!

            • kesmarn says:

              That could have it’s benefits, Cher. Whatever might have just come out of my mouth, I could just say: “It wasn’t me. That other guy said it!”

        • escribacat says:

          πŸ˜† Cher is right. That was one of the things the periodontist wanted to do to me for the six thousand bucks.

        • Chernynkaya says:

          Don’t laugh, guys. They DO use cadaver bone to implant when there is bone loss in your gums! I know, because I have some.

          ~~~skeletal grin~~~

  5. KQuark says:

    I feel your pain in every way escribacat.

    Too many people fail to realize the biggest hold big business has over employees is HC. Millions of people work jobs they hate because they fear losing their insurance. Millions of people don’t start small businesses over the same reason. HC security is the one of the biggest reasons HCR must be passed. The compromise plan will give the vast majority of Americans that security just by pooling you and I with millions of people who pay nothing into the system now.

    My case is a prime reason that HC costs are so high. About 90% of my care I simply have not been able to pay for the last 4 years with no insurance. I’m lucky because the vast majority of my HC costs were given to me gratis or simply written off as loss by my providers. So the people who have insurance or can pay out of pocket pay for me now.

    • escribacat says:

      That is such a good point,KQ. The whole setup is geared toward us being worker drones for the monster corporations. I’ve been there, done that. I so do not want any more of it!

      As for the rest of us paying for your bills, that’s what society is for. We pool our resources and when someone gets nailed by hard times, we use those resources to take care of it.

      • KQuark says:

        Yes that’s true and I don’t feel the least bit self conscious when I get care I did not pay for because I payed over $250K and much more if I counted all my insurance premiums. I dumped my 401k twice to pay the fat cats in the system off. The fact is if everyone contributed it would be a much more fair and cheaper system for all.

  6. PepeLepew says:

    Lasik surgery in Canada for my mum = $0. She had to wait a year to get it.
    Lasik surgery for me in the U.S. — not covered by my insurance = $3,000. Furgedaboutit.

    • choicelady says:

      Can your Mum adopt E’cat?

      • escribacat says:

        I think you want Pepe’s mum, although my mum was also Canadian. I just have to fill out some forms to become Canadian as well. That’s one of my options if HCR doesn’t pass.

        • choicelady says:

          Hell I’d do that! But I think you should make clear you have a large, extended family -- KQ, e’cat, etc. -- who will need to come with you. You don’t mind, do you?

          When I lived in upstate NY, I knew lots and lots of people who snuck over the border to get the health care they could not afford in NY, and that was when the prices on premiums were GOOD. The idea that US care is the best is just not true. It has the whizz bangs, but the outcomes are not even top rated for people WITH insurance.

          I have a bug up my butt about this -- the post I did below on over use of competitive gizmos. But there is an even uglier side, and it has cost several friends their lives. Many cities have top rated cancer centers. But in order to attract the “consumers”, hospitals that are LESS qualified with LESS skilled medical providers are setting up competitive practices. The rates of survival are lower, but so are the costs, so if you have skinflint insurance (not necessarily cheaper, just greedier) your “affiliated” hospital MAY be one without the best care.

          Why? Back to the corporate competitive model. Three friends got the second rate hospital on their plans, and they all died of cancers that in other hands would have been survivable. I KNOW it’s anecdotal, but it does make one question the entire process.

          I am with a top rated hospital now, but what if my insurance option gets cut? It’s happened already. I may have no alternative but the second tier one, with fewer choices for treatment, and that is not MY doing but the insurance company’s decision. You know those ads for the Cancer Treatment Centers? Good luck getting there if you don’t have a PPO. You have an HMO? You go where they tell you, even if it means you die.

          Disgusting system. Single payer and full options. Everyone ELSE has it, why not us?

          Oh -- the teabaggers are flooding the town halls with the recess coming up. We all need to be OUT there asking the right questions and making our feelings known. AND -- if you have clergy friends who wear collars, take ’em along. Works wonders!

  7. bitohistory says:

    The dentists in Nogales (50-60 miles from Tucson) are really hurting because of all the news on the drug wars. One dentist advertises on a Tucson radio station that they will come across the border, pick you up in an armored vehicle, do the dental work and return you to the other side.
    That is some ad to go to the dentists.

  8. Chernynkaya says:

    EDITED, DAGNABBIT!! Good point ESCRIBICAT. Why does it cost SO much more?

    I had total hip replacement 2 years ago. The surgery cost $5,000. The hospital stay cost over $60,000 for two nights stay.

    The surgeon is the top doc in LA, and even has a new procedure that only he performs. (I walked out of the hospital without even a cane, but I would have sacrificed such a speedy recovery for a more manageable cost.) The hospital was the biggest in LA-- Cedars-Sinai-- and if I wanted this doc, that’s where I had to go. True, they gave me excellent care, but was it that excellent? I have no idea why it was so outrageously expensive. Of course, I lost my insurance.

    • boomer1949 says:

      Cher,

      As much as I would love, love, love to research and write as well, as escribacat, I can’t take credit for this one. πŸ˜‰

      E’cat lives much closer to you and I’m stuck in middle America with no place to go. πŸ˜†

      boomer :smile:

    • choicelady says:

      Hi Blues T.

      This horrific development is present in the US, at least at the borders. Hundreds of women and children have been found dead missing body parts, and it’s not at all clear where the parts go, but anyone with bucks apparently does not have to worry about jumping to the head of the line for organ donations here in the US. We turn a blind eye to this blood curdling practice.

      No one, to my knowledge, has fully examined US medical costs inside the hospitals. It’s certainly not due to lavish pay for nurses on down the chain! It has a lot to do with the over-consumption by hospitals of big ticket items such as CAT scanners because we’ve imposed the business model on medicine so “competing” for sick people (insured, of course) means your hospital cannot be without all the bells and whistles. In Omaha, NE, there is a huge medical complex downtown with several hospitals more or less converging on one corner (I exaggerate but not by much). They each have the gizmos. One “chain” Bergen Mercy, has a suburban facility about 30 minutes west that ALSO has the CAT scanner. My mother needed one and got sent there where she waited an hour for someone to run the thing, during which time it sat idle. God forbid they’d have sent her DOWNTOWN for one. Nope -- have to have the bells and whistles even if it will not ever pay for itself with use. And heaven forbid hospitals should SHARE equipment!

      So you want reasons why things are so high here? That has a huge part of it all -- the business model, the poor planning, the failure to see medicine as a life issue rather than a business issue.

      That said, it does not rule out the artificial cheapness overseas and perhaps south of our borders of subsidies to us from ghoulish and disgusting practices of human organ harvesting. We need to be mindful of what we’re doing and what impact it might have on the lives of already embattled people.

      At the end of the day, we would indeed have ‘rationing’ if the US had a single payer plan -- but the rationing would not be on PEOPLE it would be on wasteful hospital practices. THAT is the part the medical industry does not wish to discuss, and we buy into what we DO discuss with the fear that if there are two CAT scanner in a city instead of eight, we will be denied care. We have bought the competitive rationale and the belief that everything is a zero sum game, hook, line, and sinker.

        • Khirad says:

          I believe it, I’ve heard of these “adoptions”.

          Makes you ill.

        • choicelady says:

          I don’t doubt you for a second. I’ve worked long and hard on human trafficking, and this is just another disgusting aspect of the largest flow of human slavery and exploitation in history.

          Many people were outraged when the “missionaries” who took those kids in Haiti were arrested, but I celebrated their arrests! I have NO doubt they were up to something despicable. Doctors and so-called missionaries are not intrinsically to be trusted.

          Brazil, under Lula, is working hard to end these practices. They had slaves until his election (probably still do) but he has vowed (and I believe him) to end the practice. But how can he stop all of it when we cannot- or will not?

          Nothing can stop movement of people under cover of night except a willingness to do so.

      • bitohistory says:

        Just a note on scans and their cost. “Research has shown” (by the manufacturers?) that the best scan to see if and how well chemo is working is with a PET scan. The info I received stated canceling without 12 hrs notice would cost $675.
        Best not wake up sick the morning of the scan!

        • kesmarn says:

          B’ito, I had a patient who needed a PET scan and didn’t have insurance. They told her to show up at the scanning center with $4000 or don’t bother to show up at all.

          Gotta love Republican health care compassion!

          • PepeLepew says:

            Yeah, but our system is better than Canada. Look at that Canadian premier coming to the U.S. for a heart operation!

            • KQuark says:

              It’s the art of using anecdotal evidence to prove a fact rather than the whole picture and Republicans do it quite well.

              Sure if you have the money the US is the best HC system in the world. But when it comes to providing citizens access to healthcare we are the worst nation in the industrialized world.

            • choicelady says:

              He did it because he did not want to wait. Everyone in the US has to wait, unless you’re rich. That’s what the rich white folks fear -- they will be like (gasp) everyone else!

            • escribacat says:

              You nailed it, CL. But of course, they can always buy supplemental insurance and get first in line anyway.

            • escribacat says:

              LOL. I’ve seen that posted how many times now? It’s their last defense.

            • kesmarn says:

              Ahhh, Pepe…such a good system we have. You’re right. If only we could get those 43,000,000 without coverage in the door to that system, non?

          • escribacat says:

            I think MRIs run about $3K or more. Not sure what the difference is.

      • Chernynkaya says:

        C’Lady-- Thank you! I completely overlooked the waste and redundancy issue.

    • escribacat says:

      Evidence?

      • choicelady says:

        Hi Es -- cannot speak for India, but can speak for our own borders. I work with refugee programs who first alerted me to this horror. It was, once, mentioned in a horrific story about the young women who work in the maquiladoras. They get locked OUT if they are a few seconds late, and they cannot go back to their boarding houses either. They then become sitting ducks to be kidnapped and either pressed into sex slavery or murdered for their body parts. That is NOT hype. It IS the truth.

        • escribacat says:

          I have been following the story for years of all the murdered women in the maquiladora districts along the border. I assumed it was a serial killer (or killers) and hadn’t heard that there was a possible connection with organ harvesting.

          • choicelady says:

            It’s serial killing, domestic violence, human trafficking AND organ harvesting. The young women could be victims of any of that.

          • Chernynkaya says:

            Me neither, e. The stories I read about those women-- if we are taking about the same ones-- made mention of the police in that town being the murderers and even said they found photos of the women being tortured. I have never heard, though, of any prosecutions.

            However, I will have to follow up on that-- I’ve kind of been unaware fro a couple of years.

            • escribacat says:

              Me too. In fact, I thought they had caught some guy…?

            • choicelady says:

              It is no one thing. There was a (or several) serial killers, but definitely organ harvesting was part of it -- people, including kids, missing significant body parts. Not just Hannibal type sicko stuff. Surgically removed.

              There is nothing under the sun that cannot be made evil. You don’t need a Satan -- people do it just dandy.


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