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Comment by amf12 | Hacker News Reader

> their healthcare system is cheap but kills millions every year due to medical negligence.

This is a problem money can solve though. If you have the money, you can get pretty good medical care in India. "cheap but kills millions" isn't really a problem faced by most people who have the money to afford it.

> The US healthcare system - for all its flaws - has some of the best outcomes provided you have enough money to access it.

> Exactly. You need the money in the US to just be able to afford healthcare here. There are millions of people who don't have insurance (private, medicare), or have expensive deductibles to make healthcare out of reach for some.

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90%+ of Americans have health insurance of one form or another

Having health insurance and getting any real benefit from it are two different things.

Yes, and insurance doesn't always cover every single medical bill. Therefore a lot of people experience extraordinary amounts of medical debt.

No this is not true, you can’t be denied medical treatment in the US even if you don’t have the ability to pay it.

Emergency medical treatment, right?

Yes, but if you “look like you can pay” you can get much more than that.

Right. Anything beyond that nobody is obligated to provide. However, if you're in that level of dire straits there's almost always a way to get it covered. In most states, anyway.

Yes, you can be denied treatment. ERs are just obligated to stabilize patients no matter their ability to pay. Nobody who needs it is getting an insulin supply or chemotherapy without the ability to pay for it.

Healthcare in India also has one very negative aspect which is that more than half of the doctors have qualified due to some form of caste based affirmative action. More than 50% seats in Indian Medical colleges are reserved for "lower castes." It's much easier for a less hard working/bright student to get into the college if he belongs to the lower caste which reduces the quality of doctors so much that a lot of people refuse to get treated by doctors who have lower caste surnames. Atleast in America you are guaranteed you have mostly competent folks treating you, hard to do that in India without doing background checks on the caste of the doctor as well.

How is this any different from saying you would avoid a black/Hispanic/minority doctor in the United States? The US also has affirmative action for medical schools. If anything this problem would be worse in the US, since it's harder to determine race by name here.

Your comment reads as thinly veiled casteism/racism.

I wouldn't even call it veiled.

You can go with doctors with Jewish/Asian last names - that way you chance to hit affirmative action doctor are pretty minimal.

PS I personally never thought about it that way and it’s probably silly to filter like that for routine care but may make sense for high risk surgeries when you can’t do due diligence other way.

And the racist shows up.

The qualifying exams for MBBS degree is the same for everyone. A huge percentage of medical seats are literally purchased by wealthy parents for their kids. Yet the concern is always about low caste physicians, not nepotistic physicians.

The exam is the same, but the scores required vary by a large margin based on if you are in a reserved category or open category.

I'm not saying that someone with a lower exam score cannot be a better doctor than someone with a higher score, but I would assume there would be a strong correlation

I am not talking about the entrance exam. I am talking about the final exam you need to pass to graduate. It is the same for everyone.

Once again, most of the students who qualify in the entrance exam with a lower score are the middle-high income class, donations and payments based upper caste students.

In all my years in India, not once has anyone complained about the upper caste doctors who have literally purchased a seat in medical school, including yourself. Their only concern is caste. The racism is very loud and very clear.

You would be a fool to go to any doctor who has a degree from a random private university in India. So you only go to doctors from reputed govt. colleges like say Maulana Azad or AIIMS where you can't just buy the degree. But here the issue is reservation which is as bad of a problem. So vetting out quota doctors is required here if you want proper treatment. You are saying they all qualify the passing exams on the university? But is there no difference in someone getting barely passing marks to other student getting distinction? I have heard professors giving grace marks to SC/ST students just because they fear being slapped with draconian caste discrimination cases if they fail the undeserving student. If you look at the topmost doctors they are all of unreserved category, now this is not some "racism" but in reality it shows that merit wins in the long run.

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