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Health Team

Fixing the U.S. Health-Care System?

Posted September 21, 2007 4:37 p.m. EDT
Updated September 21, 2007 7:14 p.m. EDT

Signs of problems in the United States health-care system abound, but some doctors fear attempts to improve the system might ruin what's right with it.

Around 47 million people in the U.S. don't have health insurance, and medical bills are related in some way to half of all bankruptcies. Affordable health care is a prominent part in presidential campaigns from both parties.

The number of people leaving the U.S. for medical tourism is growing, Dr. Kevin Schulman, a health economist at Duke University, said. For example, in India, a new heart hospital charges $2,000 for heart bypass surgery, he said.

"The cost in Medicare here in the United States would be 20 times that," he said.

Besides lower costs, foreign hospitals can also offer excellent care, Schulman said. "We think the quality of surgery, actually, in France or in western Europe is very high," he said.

In health systems, like those in Canada, France and the U.K., care is treated as a right, instead of commodity, but long waits for some tests and treatments can be a problem.

Cathy Wright said she was aware of the pros and cons of U.S. and foreign health-care systems when she needed a second hip surgery. For both her surgeries, she shopped around the world for the best place, in terms of cost and quality.

A French surgeon had replaced her other hip in an earlier surgery, but Wright said, "I didn't have a good recuperation, so I wouldn't recommend it there."

Wright said she chose to not buy insurance, so the costs of surgery in the U.S. might be prohibitive. "The prices in America are just excessive compared to anywhere else in the world," she said.

Wright ultimately turned to orthopedic surgeon Dr. Scott Kelly at the North Carolina Orthopedic Clinic.

"I still think the top methods are probably here," she said.

For Wright, Kelly used a muscle-sparing hip replacement, a technique perfected in the U.S. "I stopped walking with the cane after about a week," she said.

Wright's gamble that th higher price in the U.S. would buy her better results and quicker results paid off, but millions face declining health or death because modern medical advances are simply not available to them.

Kelly said access to affordable care needs fixing.

"The danger, though, is throwing the baby out with the bathwater and revamping the system, and damaging what we do well - which is the higher-end, more technical surgical aspects of medicine in America," he said.