Podcast no.3 - Global 1, Global 2, Global 3 - Hike!

[Charley Norkus]

Global 1 - during the mid-1800's, a country England conquered a country India, and the result? English spoken in the 2nd largest country in the world. Global 2 - during the 1990's, a company, Hewlett-Packard, acquired hospitals in India and China as customers for its thermal imaging equipment – the result? HP set the standard for transmitting thermal images around the world. Global 3 - an individual radiologist in India contacts his cohorts in the U.S. and offers to help them double their business. In his book, The World Is Flat, Thomas Friedman explains this evolution of globalization and how the "flattening" of the world has made this venture possible: during their daytime, the American doctors digitally transmit their images to India, and then during his daytime hours, the Indian doctor reads, diagnoses, and sends his results back overseas, where they are waiting for his American friends when they arrive at work the next morning. The next step? NPR recently reported that American health insurance companies are now pricing out, encouraging, and actually arranging for their customers in need of major surgery to have the operation performed overseas. Yes, it is cheaper to travel to India, have an operation, and travel back to the U.S. than to have that same surgery performed here. Millions of Americans now buy their little blue pills overseas; would you consider doing the same for by-pass surgery? It might not be your decision.

[Rhonda W]

Cheaper, perhaps. Better, I have my doubts.

This is scary but not shocking. Everything seems to be about the bottom line these days. I'm not sure how much competition based solely on price I want to see in medicine. Competition based on success.rate or other quantitative considerations are fine, but I don't want my medical decisions made on the basis on money. I don't know what the answer is for the huge increases in the cost of health care, but I don't believe this is it.

Maybe that is naive. I suppose many of our decisions about medical care are already made on the basis of cost, especially for people who have limited or no insurance coverage. Should I have this treatment? Do I cut my pills in half so they'll go twice as long? Do I go to a scheduled followup appointment or delay it for a while?

This is a really important topic for me right now because I am having knee replacement surgery early in December. Not something I'd like to go to India for. I'm nervous enough about it here.

[Charley Norkus]

I don't blame you for worrying! But with enough planning, and an understanding enough dr. here in the US, you could arrange for "back-up" or "warranty work" in case anything goes awry later... but as long as we can afford it, I say "Made in America" sounds good to me.