It's just unthinkable for a normal family in the United States (I understand that these two are in Brazil) to be able to afford this, at least in this day and age.
People have such a strange view of medical care in the US. Medicaid is available to anyone who needs it (i.e. financially plus special medical circumstances).
And all children in the US are able to have medical coverage - if they can't afford it the government pays for it (or gives a pro rated discount).
There is no such thing as not [being able to] have coverage for your kids because you can't afford it.
So basically the old and the young are both covered. The gap is in the middle.
http://www.nytimes.com/2013/08/04/health/for-medical-tourist...
And if younger you should have catastrophic insurance which will pay all but a few thousand of that - and that type of insurance is very cheap.
PS. No one - at all - pays list price for medical care. So completely and utterly ignore such numbers unless your goal is to be disingenuous. The numbers billed by medical providers are from the output of a random number generator, they have no basis in reality, and no one pays it.
You ignore the situation this man was, at 67, not eligible for Medicare and not insurable.
> So completely and utterly ignore such numbers unless your goal is to be disingenuous.
He already pulled strings to get the price of the implant in the US down to $13,000, 'list price, no markup'. Crazy.
And that's something to keep in mind: The strange stories you read are in the news precisely because they are so unusual.
> $13,000, 'list price, no markup'. Crazy.
That's what he paid out of the US as well, I guess that's what it costs.
Please explain why you said $78k in your original post.
No no, you're mixing up different numbers. By the way, the $78k ($13 + $65k) didn't even include the surgeon's fee:
"[...] he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup. But when the hospital’s finance office estimated that the hospital charges would run another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country."
" [...] he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw-based Zimmer Holdings, but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America. "
"The Belgian hospital paid about $4,000 for Mr. Shopenn’s high-end Zimmer implant at a time when American hospitals were paying an average of over $8,000 for the same model."
Paulo and Eliana live at the Hospital das clínicas. It is the school‐hospital (or whatever you call that in English) of Brazil’s biggest, oldest, most influential university, the University de São Paulo. It is also Brazil’s biggest hospital, which makes it probably the biggest at least in South America. Quite naturally, it is the reference hospital for the whole of South America.
I never knew of family involvement in maintaining them. As mentioned, he lost his mother even before contracting polio; I do not know if his father is still alive, or if he has any other family. Same for Eliana.
It would have been quite natural for the Medicine school of USP to care for them as case studios, as polio was once prevalent and a mutant outbreak is still to be feared. But I suspect that, more than that, being a state‐run hospital no one ever thought of ceasing care or returning them to their families, if these are still available. It is not that expensive, as they share a section with other patients — they do have their own room — and need quite common medical equipment. Many doctors and other caregivers, such as chaplains — both are practising Christians, he Evangelical and she Romanist — volunteer time, and a few persons do brave the city’s insane traffic jams (usually measured in peak rush hours kilometers of jams; anything over 100km gets in the news, and that is not rare at all; going over 200km is rare) to visit them in the restricted alloted visit times.
This does not mean we have ‘great national healthcare coverage’. Just that these two were blessed by being referred to the Hospital das clínicas de São Paulo. As the cliché goes, it is a country of contrasts, an euphemism for inequality, often cutting in ways that some foreigners have difficulty in grasping.
<-- works with many Brazilians and spends about a month of each year there.