Entrepreneur Surgeons Making Obama & Co. Their Bitch

Last November I highlighted the efforts and and heroism of these surgeons, those of The Surgery Center of Oklahoma. They even publish their whole price list right on the blog. Check out those prices per surgical procedure; then quickly look at your calendar to assure yourself that no, time travel has indeed not yet been invented and so no, you haven't warped back to the 1960s. There are over 100 different procedures and only a handful are more than $10,000, with the vast majority being under $5,000.

When I blogged that, I believe the chief criticism was on the order of: 'well ya, but how about organ transplants? You're not going to get one of those for $5,000.' ...No, you're not.

...So, how much would YOU pay for a HEART BYPASS OPERATION!? Would you pay $100,000? Would you pay $50,000? Would you pay $10,000 or even $5,000? In these United States, the average heart transplant goes for 1/2 to a million dollars! What if I told you that you're not even going to pay $4,000 for a bypass? You're not even going to pay $3,000. ...But wait! That's not all. If you act within the next 20 minutes, we'll throw in all the secrets of the universe. And I'm not finished! Have your credit card ready and call within the next 20 minutes, and you'll also get this versatile, combination spaghetti pot and clam steamer! Now how much would you pay? This one-time offer isn't going to last long, so take advantage now: total cost to you is only $2,200, in 6 easy payments of $366.66. Operators are standing by, so have your credit card ready and call now!!!

Think it's a joke? Think again: 'No frills' hospitals offering $1000 heart surgery. Let's get to some heavy excerpts.

What if hospitals were run like a mix of The Warehouse and a low-cost airline? The result might be something like the chain of "no-frills" Narayana Hrudayalaya clinics in southern India.

Using pre-fabricated buildings, stripping out air-conditioning and even training visitors to help with post-operative care, the group believes it can cut the cost of heart surgery to an astonishing $1000.

"Today healthcare has got phenomenal services to offer. Almost every disease can be cured and if you can't cure patients, you can give them meaningful life," says company founder Devi Shetty, one of the world's most famous heart surgeons.

"But what percentage of the people of this planet can afford it? A hundred years after the first heart surgery, less than 10 per cent of the world's population can," he told AFP from his office in hi-tech hub Bangalore.

Already famous for his "heart factory" in Bangalore, which does the highest number of cardiac operations in the world, the latest Narayana Hrudayalaya ("Temple of the Heart") projects are ultra low-cost facilities.

The first is a single-storey hospital in Mysore, two hours drive from Bangalore, which was built for about 400 million rupees (8.8 million dollars) in only 10 months and recently opened its doors.

Set amid palm trees and with five operating theatres for cardiac, brain and kidney procedures, Shetty boasts how it was built at a fraction of the cost of equivalents in the rich world.

"Near Stanford (in the US), they are building a 200-300 bed hospital. They are likely to spend over 600 million dollars," he said.

"There is a hospital coming up in London. They are likely to spend over a billion pounds," added the father of four, who has a large print of mother Teresa on his wall - one of his most famous patients.

"Our target is to build and equip a hospital for six million dollars and build it in six months."

I've long used a meme I first read in the early 90s: "Outcompeting God." That is, while people are going out of their way to offer you "prayers" for yours and your loved one's health problems (literally, the least they can do), there are those who might be a better target for your prayers.

The Mysore facility will be followed by others in the cities of Bhubaneswar and Siliguri.

Each will owe its existence to Shetty's original success story, his pioneering cardiac hospital in Bangalore which opened in 2001.

About 30 heart surgeries are performed there daily, the highest in the world, at a break-even cost of 2,200 dollars. Most patients are charged more than this, but some of the poorest are treated for free. [...]

By running the operating theatres from early morning to late at night, six days a week, it is inspired by low-cost airlines which keep their planes in the air as much as possible.

The British-trained surgeon sniffs at the output of Western counterparts who might do a handful of operations a week. Each of his surgeons does up to four a day on a fraction of the wages of those in the West.

"Essentially we realised that as you do more numbers, your results get better and your cost goes down," he said. [emphasis added]

Ha! Yea, I still remember the intelligentsia's—those who get almost everything wrong almost all of the time—typical hand-wringing predictions of doom during the debate over airline deregulation of the '70s. And guess what? The lowest cost, most highly utilized aircraft and crew like Southwest Airlines, here in the States, enjoy some of the top safety record stats.

I understand the counter-intuitive aspect of that, so let me give you a personal example.

Back from 1984-1987, when I was doing my first tour on my first ship, the USS REEVES (CG-24) (And that pic in the Wikipedia article? Yep, I was present for that first US Navy ship visit to China in 40 years), guess when the toughest days at sea were? The first 2-3 days. Why? Because steam plants, turbine pumps, turbine bearings, condensers, distillation plants, steam-driven electrical turbine generators, motor-generators, joints & flanges for pipes delivering superheated steam at 1200 psi...and on down the line, always run best when never shut down. Moreover, the dozens to hundreds of people running all of that equipment 24/7 at sea do best when doing it almost every day with only short breaks from the complex nature of the integrated tasks.

...Or, perhaps my electrician's mate of the watch, 2nd day at sea, casually reaches down and turns the load balancing knob for the two in-service 2,500KW SSTGs (ship service turbo generators), such that it overloads one, which trips its breaker, transferring the whole load to the other, tripping that breaker as well? Suppose further that the neither the emergency gas turbine generator fore, nor the emergency diesel generator aft, successfully started prior to exhausting their automatic-trip, high pressure air flasks that turn the starter turbines when you have no power to start them? Suppose you go dark and dead in the water at 2am in the middle of the South China Sea?

Just speculating about how embarrassed I could possibly be, should something like that have ever happened :)

SYSTEMIC 'COLLAPSE'

Public spending on health in India amounts to just four per cent of GDP, less than Afghanistan, according to the World Health Organization.

A lack of private insurance and a public system that has "collapsed" according to the country's rural development minister means an estimated 70 per cent of healthcare spending is borne by Indians out of their own pockets.

So is Shetty a sharp-witted businessman who has spotted a gap in the market or a philanthropist?

"We believe that charity is not scalable. If you give anything free of cost, it is a matter of time before you run out of money, and people are not asking for anything free," he said.

His first foreign venture is a hospital on the Cayman Islands, targeting locals who would normally travel to the US for expensive treatment, and he says he would love to expand into Africa.

From 6,000 beds now in 17 clinics, he aims to expand privately-run Narayana Hrudayalaya Hospitals to a group with 30,000 beds in the next five years.

"The current regulatory structures, the current policies and business strategies (for healthcare) that we have are wrong. If they were right, we should have reached 90 per cent of the world's population," he said. [emphasis added]

Obama, his "care" and his bullshit, are Soviet in scope, fascist in practice. He does not give a fuck of a "care" in the world beyond repaying his own political loans, at your expense.

Turns out, after all, it's not exactly rocket surgery. Speaking of loans to repay, you know what I'd do at the drop of a scalpel, if I was a heart surgeon in residency? I'd have my résumé on Dr. Devi Shetty's desk before he gets to the office tomorrow morning. I'd stop sourcing and spending student loan funds like a drunken sailor with a trust fund and my "Salary Requirements" would be: $0. You'll save a lot of money.

The fact is, if you aspire to be a heart surgeon, there is one thing, and one thing for which there is absolutely no substitute and is worth its heart-weight in platinum: doing a lot of heart surgeries and doing them everyday and often. You'll do best to consider yourself a mechanic of medicine—well skilled and competent because of your daily practice of it.

Comments

  1. My first reaction was that four heart surgeries a day may lead to fatigue and mistakes, but it makes sense that these heart surgeons would probably be taking less time and doing a better job with more practice. Afterall, speed and accuracy comes with practice.

    Side note about Mr. Obama and his care: I would like to thank him for cutting my part-time job from a full 40 to 29.5 hours next year. I appreciate that one, while I’m trying to stay afloat paying for college and daily living expenses.

  2. It’s be fantastic to get the price of open heart surgery down to those levels; a back of the envelope calculation has me at about $400k so far for my current hospital stay and dual VAD surgery, and I am still waiting for that transplant. Totally crazy numbers that no one should reasonably have to afford, though obviously if I had it and had to, I’d gladly pay it to stay alive. Fortunately my insurance is covering the stay to the point that I’ll be getting away with a $500 copay and I think that’s it.

  3. Just under 30 hours, eh Todd?

    Well, as Sean just posted in comments in the other thread, no predictable consequence is unforeseen.

    Of course, there is a balance between enough action and enough rest. Everyone who actually deals in such matters hands on understands this. It’s completely a bottom-up reality, and top-down authority will always take every ounce of credit for everything good while shuffling blame aside for everything bad.

    That’s actually included in the all the secrets of the universe package, if you order now,

  4. Geoff

    First, glad you’re still with us (readers, I’ve known of this story for a couple of months now from Geoff–obviously heavily drugged at the outset, and his dad).

    Geoff, consider that soon, you might just be able to take a vacation to India every few years and just get a new heart, as preventative maintenance. The way they are driving it, you’ll probably be more willing to just pay out of pocket than bother with all the paperwork to get your co-pay.

  5. Haha well there’s still the issue of getting that organ, though hopefully it won’t be long before we’re growing organs from stem cells or at least 3D printing them. I wonder if India’s organ donation system is opt-in or opt-out. Our opt-in system here in the states makes things very difficult for the likes of me.

  6. Geoff, a competent, recognized market for organs would fix all of that in a “heartbeat.” And such a market would also provide organs for the poor. What’s better than no heart at all? One with at least a few years left from a lifelong smoker and alcohol abuser that killed himself while drunk in a car accident. Sold cheap.

    I’m sensitive to the wishes of what happens to the remains of people once dead. That’s why atheism is important. FWI, I’ve had my organ donation sticker on my driver license for as long as I think they have provided the option–though I would prefer my body to be ravaged by Amazonian women upon my untimely death.

    You take what you can get.

  7. As an atheist myself, I’m not particularly sensitive to the wishes of what happens to the remains of people once dead, though I do think that freedom of religion dictates that people should have the right to make that choice for themselves. With that said, most people are just too lazy to fill out the organ donation box either way; countries where they have an opt-out system, 80+% of people don’t opt out, whereas in countries like the US the numbers are essentially reversed, with only ~20% of people opting in.

  8. Natalie says:

    The US government is already paying half of the health care expenses, and most of it is on chronic illnesses caused by lifestyle. I’m rooting for the system collapse. More government control means it’s going to collapse sooner. With the disease management gone, people either have to pull their shit together or go the way of the dinosaurs. It might be intentional, too. The powers that be must know it’s unsustainable (same goes for Social Security, public education and any other government monopolies), but taking it away is not wise politically (not to mention, there’s still some more money that can’t be spent), so it’s easier to ruin it with more regulation and then blame “capitalism”. Also, all famous fascists didn’t like physical degeneration.

  9. beans mcgrady says:

    Hi Richard,
    Your last couple of posts have been home runs(with people on base) in my opinion.
    If you combine the messages with a couple from a few weeks/months back; (the mob-grazing video etc) we can reasonably begin to see that so many of the “drastic problems facing humanity” are either fictitious or completely solvable, e.g. medical care, global warming, overpopulation, and whatever the next one will be.
    There are a lot of people who seem to be starting to recognize these things. So we have an issue of mismanagement. When ordinary slobs like you and me find these things so obvious, one begins to wonder what is so fucking hard to see about the world.
    I am sure you have grown tired of hearing the same old platitudes repeated as arguments for a larger role of the benevolent hand of government. I certainly have.
    I know you aren’t big on “conspiracy theories”, and in some sense neither am I. I think the whole notion of conspiracy creates a kind of fairy tale boogeyman that invites ridicule for one thing, and destroys the power of individuals.
    But at the same time you don’t seem to have a problem with understanding that the paternalistic assholes who have power would like to have more and, would like to pass that on to their children.
    It is also pretty hard to argue that a look at history will see the same names popping up all over the place. Morgan, Carnegie, Rockefeller, Rothschild, Warburg, etc. Department of Education: Carnegie foundation. Precursor to the AMA, responsible for eliminating all sorts of alternative care methods: Rockefeller. Federal Reserve system:J.P.Morgan(and his merry band). It just goes on and on.
    I tend to have some strong anarchistic leanings myself. Admittedly starting from the Sex Pistols variety and then maturing into something with some substance. I am not convinced that humans couldn’t function that way, even given the complexities of modernity. I also feel that humans are inclined towards society in some form or another, whether that requires, or can survive with some kind of governmental structure is still up for debate in my view.
    You have often suggested that what one should do is limit the intrusion that existing government has in ones own life, and I agree that it is one thing we can do. I would further think it helps to not encourage the bastards by withdrawing whatever support we reasonably can (such as financial, legitimizing the existing systems) without the tax-man coming to put us in shackles.
    But this only works to a certain extent. It may work better for you as a man in his fifties with no intention of having children, but if you take the last hundred or so years and look at the pattern of increased control, both physical and financial, the rise of the surveillance state etc. that does not bode well for the future.
    You may just kind of say fuck the future, and I respect that, but I am maybe a bit younger and more idealistic. Just watching the whole thing collapse doesn’t quite seem helpful either. Every time the thing “collapses”, great depression etc., the same folks seem to make out again.
    Anarchism, Libertarianism, or hell even benevolent dictatorship might look better than the global fascism we are heading towards, but we find our selves in a ‘you can’t get there from here’ kind of situation.
    With regard to this particular post, you seem to be advocating for a grass roots kind of stepping out of the madness. I think that this is the best approach overall, but intelligent people are up against a systematic dumbing down of the populace, so it really requires a lot of effort. In a sense you are doing a great service by bringing a lot of things to the fore that might otherwise not get noticed.(I bookmark shit you link to all the time to share it with others) But I also wonder what other ways We might have an affect on the situation.
    There seem to be a lot of people who read your blog who are disgusted by the general way humanity is manifesting, and I agree. But many of your readers seems to have kind of said, fuck it, if these idiots can’t save themselves, then they don’t deserve saving. (I am not advocating saving the world, but I think you get my point.)
    Anyway, a bit meandering, but I think you probably get my drift. Happy to clarify.
    (Maybe I will even get called a cunt, that would be an honor.)

  10. beans:

    Not much there to disagree with. I would point your to this, however, which is a really interesting book, Myth of the Robber Barons, Burt Folsom.

    http://amzn.com/0963020315

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