

The Henry Ford of Heart Surgery - sahillavingia
http://online.wsj.com/article/SB125875892887958111.html

======
danteembermage
I think someone ought to pitch building a hospital to the Iroquois League.
They already issue passports, rejecting health law seems in line with tribal
sovereignty claims. I'm sure a US-located low cost hospital could dwarf other
income sources like gambling and tourism.

<http://en.wikipedia.org/wiki/Iroquois_passport>

~~~
donaldc
The difference between issuing passports and building a large-scale hospital
is that only in the latter case is a large amount of money risked. It would be
tricky to find a source of funding for a hospital that may not be able to
operate due to a dispute over health law applicability.

From the perspective of anyone considering funding such a hospital, better to
just locate in a nearby country, such as the hospital mentioned in the article
that is being built in the Cayman Islands.

------
kablamo
Why did this innovation happen in India and not the US or Europe?

Dr Shetty is planning to build a similar hospital in the Cayman Islands for
Americans so I have to assume it has to do with government regulation. Is the
health care system less socialized in India? I would guess it is.

~~~
danteembermage
If you lined up all the words contained in US law, the median word would be
health care related, that has to matter for something. Also AMA enforced under
supply of specialists. Also direct and indirect costs of health care
liability. Also requiring hospitals to serve the ER without regard to ability
to pay. Also low reimbursement rates for medicare, lower for medicaid. Also
third party payment system that makes consumers price insensitive. Also huge
overhead to third party payment system. Also enormously expensive FDA approval
process recovered through drug costs. Also service business in a high wage
country. Any others for the list? I don't mean to be totally negative, we get
a lot of good things out of all that inefficiency, but it doesn't surprise me
that quality can be higher and costs an order of magnitude lower under a
different regulator regime.

------
sbmws
The US is unfortunately one of the highest spenders on health care with the
lowest outcome per dollar spent. It's all part of a severely broken system
that needs reinventing, badly.

~~~
anamax
> The US is unfortunately one of the highest spenders on health care with the
> lowest outcome per dollar spent.

Umm, no. The outcomes are actually quite good considering the population. (No,
you can't just look a lifespan.)

~~~
sbmws
[http://content.healthaffairs.org/cgi/content/abstract/22/3/8...](http://content.healthaffairs.org/cgi/content/abstract/22/3/89)

[http://www.scielosp.org/scielo.php?pid=S0042-968620000006000...](http://www.scielosp.org/scielo.php?pid=S0042-96862000000600009&script=sci_arttext&tlng=en)

It's not just lifespan. Medication and procedure cost, access, technology use,
availability, number of hospital beds and health care workers etc.

The US does however have the access to the most advanced technologies
(probably where the large funds are going), I'll give you that but numerous
other reports show poor outcomes for other general health indicators (teen
pregnancy rates, obesity rates, suicide rates etc..)

~~~
anamax
> I'll give you that but numerous other reports show poor outcomes for other
> general health indicators (teen pregnancy rates, obesity rates, suicide
> rates etc..)

None of those things are affected much by health care. (Birth control is free
in the US It's readily available at the local county hospital and other
places.)

They do, however, affect health care spending, lifespan, etc.

------
clinton
Dr. Shetty has exactly the right ethos in a cumbersome and bureaucratic
industry: "Japanese companies reinvented the process of making cars. What
health care needs is process innovation, not product innovation."

Improving processes in this case will naturally generate better products
(health services). But will also increase the knowledge of these processes,
which will ultimately pave the way for the creation of improved supporting
technologies.

------
pclark
I don't understand _what_ he is scaling? the amount of concurrent operations?

