Not sure what you're trying to say here. You seem to be trying to defend the cost of a $100,000 operation by making a snarky comparison with outsourcing an IT project.
Is that actually what you meant?
Is that actually what you meant?
The biggest difference here is if the cost of a heart operation in India would be too high, unlike the US- poor people will have absolutely no option but to die here. That is what it really comes down to. In US it leads to a person getting bankrupt, but in India poor people don't have the luxury of getting bankrupt. In my city(Bangalore) we have government hospitals- though they never acknowledge it officially, but they often administer euthanasia to poor patients. It happens with the poor in nearly all critical illness cases- Heart ailments, cancer, fire accident victims, mental illness. Often the relatives themselves request a euthanasia because the pain, price and duration of treatment is beyond their emotional and financial means.
So you can either make the treatment a little affordable so that people can benefit, while you make some profit out of it. Or they die anyway and you lose some profit.
Innovation in a situation like this is born out of necessity. Its a do or die situation.
In my case: U.S. cost structures, sure, I don't know them, though I do speculate and guess, and asked if someone knows of a hospital with transparent enough data.
Uruguay cost structures are a different bag altogether, since they're mostly government-run and they have to make numbers somewhat public. Add to that one of my brothers working in a hospital (he's a few years from graduating as a doctor) and other sources, and I can get an estimate that I hope is correct to an order of magnitude. A relative has been a customer of the Cleveland clinic, so I know the exact number he paid. I also know the exact number another person paid for the exact same surgery here in Uruguay - it was close to one-tenth, and he chose to pay private rather to go through the public institutions (which have huge delays).
Below is a PDF in Spanish, on an investigative piece from a weekly that goes into great detail on the costs of surgery in Uruguay. I'll just quote some basic numbers:
- Fixed fee per major surgery (medical act) UY$ 27.500 / U$ 1300
- Monthly Head Heart Surgeon salary (per hospital) UY$ 263.000 / U$ 12500
- Other heart surgeons, between UY$ 162.500 and 243.000 depending on seniority and other factors - U$ 8.000 to 12.000 range, per month. Those are close to the best salaries anywhere in Uruguay, usually as well trained as any doctor in the U.S.
- Cost to the hospital per major operation (heart surgery), UY$ 206.000 / U$ 10.000
Smaller operations like angioplasty cost UY$ 60.000 / U$ 3.000
The most expensive surgery is heart transplant, which costs UY$ 684.000 / U$ 32000
All those are set by the government, so those ARE the actual costs (well, actually they were in 2008, I didn't adjust by inflation and exchange rate), no insurance or strange stuff involved. The patient is not billed a cent, but there is a huge delay (months usually), and doctors don't really schedule surgery unless it's critical for the person's health (almost no quality of life procedures through the public system).
http://www.semanario-alternativas.info/archivos/2008/5)mayo/...
PD: Surgeons and Anesthesists have tremendous power, and managed to get paid close to ten times the rate of other doctors.
He probably experienced a lot of difficulty initially in acquiring customers (who opted to go with the much cheaper, Indian consultants), which is why he has such an oversized Internet presence, including on Hacker News - it has helped build a brand for himself that isn't location-specific.
http://www.kalzumeus.com/2013/07/17/kalzumeus-podcast-5-quit...
A more charitable read of my old comments would be "The project(s) were beset by communication issues, terribly managed by the Japanese company (which, in the fine tradition of Japanese companies, I'll take blame for since I was unable to resolve it despite trying), and additionally undermined by pervasive competence issues."
I'm not talking my book here. In the first place, I don't have a book, as I no longer consult. In the second case, Indian BPO firms are less competitive with me than Chinese take out restaurants: our target customers are different, our projects are different, our marketing methods are different, etc etc.