Sunday, March 25, 2012

Health Care System in India vs. the US

I'm not writing this post myself. Jennifer Kumar alerted me to this post and I think it's very well written and offers a lot of very good information to anyone who is moving from India to the US or the US to India whether that move be temporary or long term.

While his experience is different than mine, I didn't see but one thing in his post I would disagree with (hospitality but I live in one of the worst cities in India so that's no surprise). Yes, doctors in the US do go through the motions, adhere to a strict set of rules and such. Those are in place to protect the majority and as with all things, they don't always work for everyone. Medinces are available in India without a prescription even though the government says they're not supposed to be (says so right on the package).

If you have any plans to visit India, I highly suggest you read this blog post. If you've been to India and the US, share your experiences with him. What are your thoughts on his experiences?

12 comments:

  1. Thanks for sharing! The US is also going to a mandatory health insurance law and I'm not happy about it. I think it's going to cause a lot of the same problems you mentioned having in Swiss. No good can come of it except forcing poor citizens to pay high rates. At last check for a healthy 30 year old woman to have basic health insurance it was almost $500 a month. At minimum wage in the US a person only makes about $1000 a month. It's just not economical to force them to pay so much for health insurance. We do have government insurance which is fairly decent but they don't give that to everyone, you have to meet strict criteria. I think mandatory health care is just wrong.

    I do like the fact that you can get prescriptions and lab tests here whenever you want without a doctors permission and without wait. That's very nice. It's helped me a lot in managing my own care. I'm going to miss that when I go back to the US.

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  2. Thanks for sharing! The US is also going to a mandatory health insurance law and I'm not happy about it. I think it's going to cause a lot of the same problems you mentioned having in Swiss. No good can come of it except forcing poor citizens to pay high rates. At last check for a healthy 30 year old woman to have basic health insurance it was almost $500 a month. At minimum wage in the US a person only makes about $1000 a month. It's just not economical to force them to pay so much for health insurance. We do have government insurance which is fairly decent but they don't give that to everyone, you have to meet strict criteria. I think mandatory health care is just wrong.

    I do like the fact that you can get prescriptions and lab tests here whenever you want without a doctors permission and without wait. That's very nice. It's helped me a lot in managing my own care. I'm going to miss that when I go back to the US.

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  3.  Yeah same in switzerland, my health insurance was around 400 CHF a month back in the days. My income was 2000CHF a month and my rent was 600, so a person like me end up giving up half her salary to have insurance and be under a roof before even eating...not good! I was falling on minimal wage income though so if you have the patience to deal with social services and do paperwork you get a little financial help, so my insurance was taken care of by the State (as in they gave me the money to pay the premium), but you need to know where to turn and how to beg...sadly a lot of people abuse the system on all fronts too.

    That's what I keep trying to explain to DH, about the fact that people in the west don't have that high a disposable income compared to him in India. And of course each person need to be insured separately back home, granted children do pay a slightly less premium than adults, and the fact that the average income for a person is 3500-4000 that means in most families you need a dual income to manage, plus a vast majority of people don't own a house or an appartment there so people end up renting their home their whole life long, developpers don't put their flats for sales, they hand over the management to real estate agencies who rent them out for them. So you don't even get the relief of less of a financial burden after a few decades because you don't use your income to pay back a house loan, this is nut.

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  4. Having lived in the US and India, I find the healthcare systems to be very alike. If you have money--you can get access to good healthcare (at least in major metro areas in India), if you're poor, well, you're screwed. 

    I prefer the healthcare system in Canada a lot more. We have taxpayer funded universal healthcare for all citizens and permanent residents. Yes, you may have to wait for MRIs in non-life-threatening situations, but that's because they're prioritized for people who DO have life threatening situations. 

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  5. Hi I have been reading you blog for awhile and I thought I would comment. 

    I currently live in France on the border of Switzerland (my partner is working in Geneva), I am from the US and the state with mandatory insurance and lived in Asia for a long time (also I am in the health field). So, I thought I would give my two cents worth.  

    Where do I start? Let's start with Massachusetts, which the mandatory health insurance is much different than Switzerland - it is more similar to Germany's system, which has it's fair share of problems, all health systems do. You are not forced to go shopping around for insurance. The states gives the insurance to tkind hose who are unemployed or if their employer does not already qualify. The fees you pay is based on your salary, when I got out of school, I didn't have any, ie I didn't pay. As soon as I got a small part time job, I had to pay. Remember, your full time in employer in the US must pay for health insurance, so we already of have a type of mandatory  system, paying about 500 USD. 

     But yes, already in the US it is a problem with doctor's over prescribing expensive exams because of insurance, this is also a problem in health systems such as India where they hospitals get fees per service. But also, unlike Switzerland but like India, there is a problem with catastrophic health care costs ie people go broke to get quality medical care. There are negatives to all systems, as well as positives. 

    My experience is similar to the blog post. In the US I am more use to being treated like a piece of meat, until I found my Indian trained GP. I love the systems in Asia, because you can just go and get everything done - it really saved a lot of the waiting and anxiety, which is worth something. 

    Though, now living in France, I have to say there is a reason it is consistently rated the best health system in the world. It is a public insurance system, but unlike the British or Swedish NHS system (ie long waits not alot of choice etc, state pays for everything), my GP is down the street, his office is in his house, is extremely nice, my tests have always been that day or the next. And even though I speak French both my doctor and pharmacist write the instructions in English - which I think is very sweet. And it is super cheap, even not as a citizen (unlike Switzerland, which is sooo expensive) , you are treated like a person and it is high quality. I completely understand why it is considered the best in the world. 

    Anyways, Kristi I keep on meaning you write you because I have lived in four other countries that the US. We both have very different memories of the United States, I mean I love the US. And everyone knows without a doubt I truly believe New York City is the greatest city in the world that the world has ever seen.

     But I have found a sort of romanticism takes place when you first leave home. The differences could chalk up to region or economic level.  For example, for me ergonomic design is not common place in the US, except for the super wealthy, especially in contrast to Europe. 

     

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  6.  Oh yeah the French system is indeed one of the best I came accross, not that used it much, other than a minor car crash accident and various skiing induced accidents in my family, even if you are not a resident they treat you well, and they make a very clear bill detailing everthing so that the insurance in Switzerland can get it all sorted out and despite the fact we had to pay the bill immediately in most cases, the costs were about a third of what a similar proceedure just cost accross the border in my homeland! I was living in Geneva at about 10 minutes by foot from the border, and where I lived there was a pharmacy right across the border, all over the counter medicines were far cheaper there, needless to say a lot of Swiss resident took a little walk to France to get their pain killers back in the days

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  7. Indian healthcare is designed according to the needs of indians, many of whom cannot afford medical bills. Cost is the driving factor. It's a simple cost/benefit equation. All capital investments and maintenance expenses are eventually extracted from the customer. To make healthcare affordable for indians, things like hygiene, infrastructure and skilled labour are compromised. What you pay is what you get.

    The threshold of what's inappropriate is higher in india compared to other nations. Conversions between indian patients and doctors can become personal as having a family talk.

    One of the things that determines the quality of a hospital are its nurses. Very VERY important. The only way to know for sure if they are good is through word of mouth recommendations.

    Prescription is not as loose in india as many think it is. The guys is the counter know what sleeping pills are. They know which cough syrups can get you high. They know the generic names of drugs and the diseases associated with it. I have personally bought sleeping pills for a friends mother(rip) who had cancer is her brain. Chemotherapy, best hospital in mumbai, nothing worked. The family gave up and brought her home in her final days. We went to the local pharmacist and had a one on one conversation. That's how we got a supply of sleeping pills for her without prescription because she couldn't sleep in her final days and murmured random names in the night.

    Medical care, mainly the price of drugs are still unaffordable to many indians.

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  8.  http://www.onemint.com/2011/01/19/number-of-income-tax-payers-in-india-and-us/

    Only 3% of the indian population pays taxes. Won't work in india.

    As i said earlier, "what you pay is what you get". If you compare drug prices in india and the west, you'd think whether the indian pharma companies actually make a profit? Some cases are subsidized by the govt. But for the most part, the margin is very low, compensated by the sheer size of the population.

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  9. Here in Amritsar you pretty much seem screwed no matter how much you pay. I've never been to a government hospital, either in the US or in India. I always paid for private healthcare. We have somewhat of a shortage in the US when it comes to certain types of health care workers and it's worse in smaller cities which is why there's so much wait. Thankfully I've never needed any tests for life threatening situations though.

    Did you notice if Canada has the same issues with their healthcare as the UK? A lot of people complain there that immigrants misuse the system and go to those hospitals for insignificant health issues. Like rushing to the ER for a cold. People on government insurance or with no insurance do that in the US as well (citizens and immigrants alike) and I think that's part of why they're trying to force healthcare on everyone. Not that it's a smart choice though.

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  10. Glad to hear you're a long time follower. It does sound like France has some spectacular care options. The US is by far foolproof or great. I myself avoided some places and always paid for privatized hospitals so I could be sure I was getting good care. I was rarely disappointed. They don't over prescribe tests IMO. But, that's expensive privatized care and not a run of the mill doctor sanctioned to accept government insurance. Those are definitely insurance claim hungry.

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  11. I'm not sure the hygeine and such is compromised because of cost issues as much as it is a lack of available cleaning tools in most locations. Women in hospitals still use old rags and the standard Indian brooms to clean with. Those are the same as in the home and I don't even know if anything else is available. In the US, the cleaning practices are regulated and a lot of highly specialized equipment is used that just wouldn't be feasible here because of the higher temps and humidity, etc. Most of the equipment also uses a lot of power and that's not economical here at all.

    There's a good amount of information about medications in the US media. The prices here are cheaper (as well as other countries) because pharmaceutical manufacturers in wealthy western countries get credit (on taxes and such) for supplying them at low costs. They also obtain large research grants for the same reason as part of initiatives to work together with less fortunate countries. In the US people will often get meds from Mexico or Canada for just that reason.

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