Global∑os® (GlobalEOS)
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Global∑os® (GlobalEOS)
Designing innovative global healthcare programs and mechanisms by way of strategic administrative, management, HIT and concierge services
Curated by Brian Altonen
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Retired in Nicaragua, and Loving It . . . . (because of Health Care Insurance?)

Retired in Nicaragua, and Loving It . . . . (because of Health Care Insurance?) | Global∑os® (GlobalEOS) | Scoop.it

This is part of a series in which Americans age 50-plus profile their adopted overseas locales. Health care insurance costs could most likely become the next major reason for expatriation, not only due to cost, but also Quality of Life for the 50-plus.  

Brian Altonens insight:

 The article--

Retired in Nicaragua, and Loving it. | Affordable health care was just the beginning for expats from Tennessee.By Jim Lynch | The Wall Street Journal . . . .sounds like an Advertisement . . .

 

"Located on the northern shore of Lake Nicaragua, Granada is a flat city of narrow streets and endless, brightly colored walls, some of which are hundreds of years old. These walls are interspersed with occasional doors, some fancy, some plain, behind which can be anything from a palace to an earthen-floored shack. Often referred to as the "City of Doors," Granada is a wonderful town for walking and bicycling, as it features restaurants, shops and markets down every street.

 

. . . Our decision to move to Central America in 2008 was tied in large part to health care. We retired when we were both 62, but Medicare isn't available until age 65. Therefore, we decided to leave the U.S. during this gap and seek good, affordable health care in a new environment.

 

Costa Rica certainly qualified in that regard, but Nicaragua has turned out to be even better. We chose Granada because of its beauty and proximity to the highly regarded Hospital Metropolitano Vivian Pellas, about 45 minutes away on the outskirts of Managua. Health care here is as good as, if not better than, anything we had in our native Tennessee—and a fraction of the cost.


[W]e pay out of pocket for all services and medications. Fees are about 20% to 30% of what they would be in the U.S.  For instance, an office visit to our doctor is $15, and we get his undivided attention for as long as it takes. (He even makes house calls for the same price.) Vivian Pellas hospital accepts several international insurance plans (but not Medicare) and offers two discount plans of its own that, depending on one's age, offer considerable savings."



 

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African medical schools see profound culture change - Fogarty International Center @ NIH

African medical schools see profound culture change - Fogarty International Center @ NIH | Global∑os® (GlobalEOS) | Scoop.it

Before and after: MEPI funding has helped Africa's medical schools move from hard copies of textbooks, which are expensive and quickly out-of-date, to tablets that provide access to the latest information.

Brian Altonens insight:

A lot of African medicine is rapidly becoming westernized, but some parts of African tradition will most likely not change in spite of this growth.   Some countries in Africa, the Middle East, and Asia have decided not to completely replace traditional medicine with what they learned within the western medical teaching facilities.

 

The changes that occur in quality of care in developing countries will probably happen faster than they do in developed countries.  Part of this is due to the legal restrictions that exist in some health care options and the limited progress often being made in spite of high costs.  The improved resources that are now available to professionals within other countries could make for a much healthier marketplace in their traditional settings.  Not only will their care be more affordable, it will also be capable of providing better options for the patient, who can now choose the type and quality of care he/she wants to receive.

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Urbanomics: Comparing health care systems across the developed world

Urbanomics: Comparing health care systems across the developed world | Global∑os® (GlobalEOS) | Scoop.it
Brian Altonens insight:

In terms of competition, the U.S. loses in the global market because of price.  This would be okay, were quality not compromised or perceived to be significantly better.  The problem is the U.S. market is behind in its technology, quality of goods and quality of services, at least according to some of the polls about health care being circulated.  Medical GIS is an example of a technology that companies allowed to fall onto the wayside.

 

In the schematic illustrated above the point being made is exactly how far behind in technology businesses are with in the healthcare industry.  "Executive Measures" detailed above pertaining to CEOs', VPs', Directors', and managers' behaviors, and the concerns for people as patients rather than consumers, score lowest in terms of people skills with the U.S. industries. 

 

Unfortunately, at the business end, this means that total changes in management and leadership are required.  Paradigm shifts need to be made in order for these businesses to out compete the companies abroad.  More efficient cost savings and better targeted programs need to be developed. 

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JCI Accredited Latin American Hospitals ~ Committed to Reducing American Health Care Costs

JCI Accredited Latin American Hospitals ~ Committed to Reducing American Health Care Costs | Global∑os® (GlobalEOS) | Scoop.it
health plan,medical tourism,The American people are now debating on a very big issue: Obama’s Health Care Reform.
Brian Altonens insight:

Global Health Care is a complex, multidimensional health care industry.  First, there is the U.S. and its relationship to global health, which is focused mostly on the products that other countries provide us with.  Then there is the impact of people and culture from other countries on the U.S. health care system, a need brought about by immigration and the needs for health care coverage by these individuals.  They often provide themselves with their own culturally defined forms of health care, along with whatever provisions are afforded to them by the U.S. government and U.S. health care systems.

 

JCI accreditation adds a new dimension to this model.  JCI accreditation makes it more likely for agencies and services in other nations or countries to fill in the gaps currently exist within the U.S. health care system.  It provides patients, U.S. citizens or not, with more options for getting better, and more opportunities to the get best health care for each dollar being spent.

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Medical Tourism and Transnational Health Care | Edited By David Botterill, Guido Pennings and Tomas Mainil | Macmillan

Medical Tourism and Transnational Health Care | Edited By David Botterill, Guido Pennings and Tomas Mainil | Macmillan | Global∑os® (GlobalEOS) | Scoop.it
Medical Tourism and Transnational Health Care by Edited By David Botterill, Guido Pennings and Tomas Mainil.... Bonus Publisher Materials: Praise, Author Biography
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International consortium to develop Ghanaian pharmaceutical companies - BusinessGhana

International consortium to develop Ghanaian pharmaceutical companies
BusinessGhana
An international consortium, including WHO is exploring the possibility of supporting Ghanaian pharmaceutical companies to fight the burden of diseases in Africa.
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Healthcare IT Outsourcing Market Worth $50.4 Billion by 2018, Report Says

Healthcare IT Outsourcing Market Worth $50.4 Billion by 2018, Report Says | Global∑os® (GlobalEOS) | Scoop.it

Healthcare Informatics Magazine | Health IT | Information Technology,Health care information technology & IT strategy news for CIOs, CMIOs & clinical informaticists. Learn about EMR EHR, ARRA HITECH, wireless technologies & meaningful use policy.

Brian Altonens insight:

"Healthcare IT outsourcing Market Worth $50.4 Billion by 2018, Report Says."  $35B was outsourced in 2013.  This amount is expected to grow at a rate of 7.6% per year. 

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21 graphs that show America’s health-care prices are ludicrous

21 graphs that show America’s health-care prices are ludicrous | Global∑os® (GlobalEOS) | Scoop.it
This is the fundamental fact of American health care: We pay much, much more than other countries do for the exact same things.
Brian Altonens insight:

This is a common theme in the international comparisons for health care costs that has been published and republished throughout the past 15 to 18 months.

 

Imagine if several meaningful use measures and several HEDIS and Performance Improvement Projects per year all required some sort of metric indicating that your company had either lowered costs and/or improved both the value and outcomes of particular services being rendered on a per dollar, per capita or month-of-service basis.  

 

How many companies can currently provide proof in HEDIS format that their services and results are worth the investment, per member, per year of enrollment, for given medical conditions and/or quality of life offerings by the company?

 

The current changes in managed care are focused on demonstrating meaningful use and improvements in health care.  Refusals to comply or meet the related HIT, EMR requirements for medical data and managed care could be a sign of irresponsibility, poor judgement, poor management, and/or a company's inability to make adequate changes as needed within its infrastructure.  

 

Common sense tells us that due to competition and poor quality of services alone, this will lead potential consumers to seek out more affordable, high quality care elsewhere.  

 

Providing affordable low cost care at all levels is an important step in increasing preventive, proactive medical care in the U.S.  It reduces the need for higher cost palliative care being provided, and keeps the services "local".

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Health Costs: How the U.S. Compares With Other Countries

Health Costs: How the U.S. Compares With Other Countries | Global∑os® (GlobalEOS) | Scoop.it
Brian Altonens insight:

Lack of health insurance was once the cause for traveling to receive care.  Now cost and savings drive this industry.  After all, why spend 25% more for insurance within an American health care system when you can receive the same services at less than 50% the price?  This impact on cost differences is the same whether you are insured or uninsured. This is the question in consumers' minds that the U.S. industries now have to contend with.

 

The Health Tourism page at http://m.health-tourism.com/medical-tourism/statistics/ says it even better (significantly shortened and paraphrased):

 

Lack of health insurance is the most common factor for medical travel. 

1) Approximately 900,000 to 1.2 million foreign patients traveled to hospitals in Thailand. 

2) In Bangkok, 58,000 U.S. patients sought treatment in 2005, followed by 64,000 in 2006.

3) Singapore medical tourism was 270,000 in 2004 and has an estimated increase of a million patients by 2012. 

4) Latin America, esp. Panama and Costa Rica; in Costa Rica close to 150,000 foreign patients sought care in 2006. 

5) Due to its proximity, Mexico is a top destination for U.S. seniors, with 40,000 to 80,000 retired there and receive much more affordable nursing home and health care services. 

6) Malaysia had 300,000 medical travelers in 2006. 

7) India medical tourism increased from 150,000 in 2002 to 450,000 in 2007.

 

In addition, Americans prefer Mexico, Costa Rica or Panama for dental services or cosmetic surgeries due to proximity.  Southeast Asia and India are choice destinations for orthopedics and cardiovascular treatment due to their high quality healthcare infrastructure and afiliation with several U.S. accredited hospitals and physicians. 

 

The following are the savings obtained by medical tourism. 

 

1) Medical care in Panama costs 40% to 70% less than in the U.S. 

2) Hungary offers a 40% to 50% savings in dental work and cosmetic surgery; Mexico a 25% to 35% savings; Costa Rica a 30% to 40% savings. 

3)  Brazil offers cosmetic surgery services at 40% to 50% less. 

4)  Malaysia offers cosmetic surgery for 25% of the U.S. cost along with traditional alternative medical care options. 

5)  India provides healthcare services at 20% of U.S. cost. 

6) Thailand healthcare services can be obtained at 30% less. 

7)  Singapore offers medical services in 13 JCI ACCREDITED HOSPITALS, for 35% less than U.S. prices.

 

And finally, this Health-Tourism.com article states: 

 

"Companies like Hannaford Bros. Co. located in Maine are considering saving up to 70% on medical costs by offering offshore medical treatments for their employees. In a similar manner, insurance companies like BasicPlus Health Insurance at Roswell are collaborating with global healthcare companies to provide overseas options to members with maximum fixed benefits."

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Colonoscopies Explain Why U.S. Leads the World in Health Expenditures

Colonoscopies Explain Why U.S. Leads the World in Health Expenditures | Global∑os® (GlobalEOS) | Scoop.it
While the American medical system is famous for expensive drugs and heroic care at the end of life, a more significant factor in the nation’s annual health care bill may be the high price tag of ordinary services.
Brian Altonens insight:

Is the quality of care really that much better?  In the most expensive city of the U.S., the cost for a colonoscopy is more than ten times the average amount for a procedure done in Switzerland (US $8,577 vs. Sw $655).  

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Medical Tourism and the Medical Industry in the Asia Pacific. Prof. Anupam, Siba Group Medical Director, Apollo Hospitals Group.

Medical Tourism and the Medical Industry in the Asia Pacific.   Prof. Anupam, Siba Group Medical Director, Apollo Hospitals Group. | Global∑os® (GlobalEOS) | Scoop.it
Brian Altonens insight:

  

Cross-cultural care, choices, and quality, all at a lower cost.  

 

See the presentation on this industry (and source for the above map) at http://www.ha.org.hk/haconvention/hac2011/proceedings/pdf/Symposiums/S4.2.pdf

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U.S. Health Care Prices Are the Elephant in the Room

U.S. Health Care Prices Are the Elephant in the Room | Global∑os® (GlobalEOS) | Scoop.it
Until voters demand transparent and equitable pricing, it will be hard for the United States to control health care spending, an economist writes.
Brian Altonens insight:

International health care is having a new impact on the American health care industry.  Medical Tourism impacts health economics by leaving patients with the sense that they received more cost effective care by employing these services.  Studies have yet to be performed on the quality of service and intermediate to long term effects of this new highly competitive option for health care, especially for surgery. Fear of iatrogenic diseases (antibiotic resistant infections), inadequate patient-caregiver relationships, and perceived poor quality of services are the major risks working against the traditional domestic care routes.  Perceived quality of care and cost for services could be the two major determinants for this new industry. 

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MOST WIRED | HEALTH IT

MOST WIRED | HEALTH IT | Global∑os® (GlobalEOS) | Scoop.it
At Kootenai Health, information technology is no longer seen as a cost center. An IT insourcing strategy has helped the health system realize huge savings and even grow revenue.
Brian Altonens insight:

Some of our best experts are internal IT groups and external local service providers.   A well balanced insourcing-outsourcing plan produces the best results.  With meaningful use, local experience adds that much needed edge on the competition.

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