A Global Economy in Health Care Services? Good!

Kevin Drum laments that people are "Americans Flee America For Overseas Health Care Just Like Canadians."  My response in his comments:

I am confused by your using the word "flee". If I buy a Toyota, no one says I am "fleeing" the US manufacturing system. It is a global economy, and I don't know why the globalization of health care services is anything but a good thing. We have put so many barriers in the way of expanding capacity (licensing, certificates of need, FDA approvals, etc) and legislated so many artificial monopolies in health care, it seems perfectly reasonable, even good news, that competition for medical services is emerging from other countries.


  1. ToddF:

    Poor people aren't fleeing America. They're too poor to travel, plus they have welfare to provide their health care. It's the middle class. Early retirees or maybe just people who don't have insurance who can get an operation much cheaper out of the country.

    Those who virtue signaled on their "moral compass" are the ones responsible for this.

  2. slocum:

    We should keep in mind that U.S. residents traveling to foreign countries for treatment are voluntarily forgoing U.S. licensing and certification of the facilities and medical personnel -- trusting themselves to find ways to assess the quality of care on offer. Wouldn't it be awesome if it was legal to do the same thing *without* having to leave the country?

  3. Q46:

    "America's is bad for poor people, who would go bankrupt if they paid American prices."

    And meanwhile in the UK where healthcare is free at the point of delivery, it is bad for poor people because they cannot get treatment, but then the not-poor cannot get it either so that is OK - equality, so fair.

    And said poor and not-poor people who would go untreated or go dead, 'flee' to other Countries and pay for what they cannot get 'free' at home.

  4. Thomas "Fat" Cat:

    Kevin Drum has a narrative he must maintain.

  5. Zach:

    Remember this the next time a liberal lectures you on the importance of competition. They are horribly inconsistent on just what kind of competition they approve of.

  6. Dan Wendlick:

    The numbers are meaningless without knowing the reasons behind them. It's probably pretty obvious that people are not going across borders for acute trauma care; that just does not make sense. The question becomes are these people going across borders to get medically necessary treatment, like joint replacements, cosmetic-but-medical, like liposuction and non-reconstructive breast implants, or are they counting the Tijuana "cancer clinics" for their horse urine injection "cure" or whatever the fad of the month is. Categories one and three are problems, for differing reasons, but category two falls into the feature category.

  7. hewler:

    Amen! This reminds me tangentially of the school choice argument. Only those with enough money can afford to go somewhere else besides the state dictated 'one size, fits all' answer. Who cares for the poor more? Those who want to give them options or those who 'know best'?

  8. SamWah:

    Paullie "The Beard" Krugman says you are WRONG!!!!!!111111!!!!!

  9. mlouis:

    Actually they tend to be pretty consistent...competition is good for anyone besides them and their friends.

  10. craftman:

    Hey, you're unbanned from Mother Jones!

  11. Aiya:

    I lol'ed, considering what the guy in the White House thinks about competition...

  12. Aiya:

    Is it really that big of a deal to point out that Americans go overseas to get cheaper healthcare, and to think that is a bad thing? Drum isn't bashing competition here so much as he is lamenting the (admittedly) high costs of care in this country.

    I do think Drum is wrong to assume it is "poor" people going overseas. Those are the least likely folks to travel, methinks...

  13. Mercury:

    Yup. But it would be nice if both rich and poor Americans could receive quality, affordable medical care in their own country.

    As I I believe I've argued before here, Cuba, located within spitting distance of God's Waiting Room, should negotiate a capital infusion and 10yr management contract with someone like Google and rebuild their country into a medical care destination economy.

    The US should be doing much the same thing for different reasons. Socialized healthcare (which we've had since WWII) has been mostly about rationing supply in one way or another...because demand is always unlimited, especially as medical technology advances.

    Sounds like the perfect answer to the problem of automation killing jobs faster than people can keep up.

    No everyone can be a doctor of course but pretty much everyone could do something healthcare from technicians, to AI to elder-care.

    How a bout replacing Obamacare with a massive, public/private effort to EXPAND SUPPLY instead of restricting demand?

  14. Ike Pigott:

    I was going to post the same thing, (and thought I would make sure it landed with others who might have noticed.)

  15. sean2829:

    Demand for healthcare is only unlimited because a third party is picking up the tab. If people were really had to choose value for themselves for the money, rather than have the healthcare system maximize its revenue stream, much less would be spent. The country spends twice as much per capita on healthcare (>10K per person) than other industrialized nations and the outcomes for the general population are no better. Median household income was just above $56K last year and the average household consists of 2.6 people so the average household contributes $26K to the healthcare industry. I'd say the healthcare industry is likely too big already.

  16. David in Michigan:

    Exactly. No data on what medical procedure is being sought. I suspect that a significant portion of those going out of the U.S. fall into three categories: 1. Elective plastic surgery, 2. dental work, and 3. desperation treatment for incurable illness (e.g., cancer, et al). The studies cited do not provide enough specificity to make them any more than superficial observations. Consequently, I give them little credibility.

  17. Mercury:

    Demand is unlimited in the sense that advancing medical technology creates demand where before there was none. If a new, outpatient procedure is developed that fixes some ailment (for instance), many people are suddenly lining up to get the procedure whereas before they might defer treatment or live with their condition.

  18. Jesse Nelson:

    I've read of people going to India or Thailand to get treatment for many kinds of problems and diseases, not acute but still medically necessary, from orthopedic issues like hip replacements to liver/kidney or other organ transplants. It's not purely elective treatment.

  19. Dan Wendlick:

    That's my category 1; I'm acknowledging that it happens. I've also read about women going to Brazil to get butt implants. Without knowing which case is dominant, the numbers don't mean a whole lot.

  20. marque2:

    Or die early. It is because we value our lives that we are willing to spend more and more. If we did a Logan's run and everyone was happy dying at 30 or 40 we wouldn't have nearly the healthcare need.

  21. marque2:

    They go to Israel for plastic surgery and Chech republic for in vitro as well.

  22. marque2:

    In England the not so poor can pay for premium healthcare insurance to get a better tier of service.

  23. Mercury:

    You might not get elected with that in your platform...

  24. frankania:

    Here in Mexico, we have IMSS, the govt. health agency which is cheap ($24/month for me) and free for many people. STILL, we have a booming free-enterprise medical system, which I use often because of govt. waiting time and paper-work etc.. I can see a real doctor at Dr. Simi private clinics for $2. Cardiologist for $35, Dentists are REALLY cheap; I paid $10 for a crown replacement last month.