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Medical Devices: As Performance Improves, Coverage often drops

December 18th, 2008
By John Ghysels, Special to Technology-Report.com
First the good news; medical devices are getting smaller, more accurate, more convenient and downright cool.  These devices will, quite literally, save your life. For instance, insulin pumps help control blood sugar levels, resulting in far less stress on the body and fewer medical complications over the long run. The advent of miniaturization, combined with the host of other small devices that we typically carry on our hips, means that these small machines are no longer the conspicuous, noisy bricks they once were.  In fact, many folks often mistake them phones. The list of medical devices is also rapidly expanding, including portable defibrillators, pacemakers, c-pap breathing machines, infant monitors and even future devices that may control depression and other neurological disorders. 
Unobstrusive; Tech-Health

Unobtrusive; HiTechHealth

The bad news is that these life saving devices are expensive. The insulin pump above goes for about $6000, USD, with a 4 year warranty.  This probably explains why many insurers and government programs are dramatically limiting coverage for these wonderous mini-machines. For instance, many private US insurers cover pumps like these subject to a $2000 limitation, if they cover them at all. 
Further, insurance coverage contract provisions for these devices can vary dramatically from one insurance company to another and even between plans offered by the same insurer.  A quick survey by Technology-Report showed shocking differences in coverage for insulin pumps, running the gamut from no-coverage, to 100% coverage, depending on the carrier and plan offered. 
Unfortunately, coverage for most medical devices is often confusing and seldom clearly disclosed. For example, some insurance companies consider insulin pumps as ”Durable Medical Equipment”, subject to strict limitations, while others cover them generously as “diabetic management supplies”, with few restrictions. 
The rapidly rising cost of healthcare is putting more pressure on insurers and cash-strapped government programs all across the world. Ironically, that may mean that as all these medical devices become more useful and accessible to more and more users, that coverage on them is likely to become even more limited.  
Best to keep your eye on your healthplan coverage and do your research before making an investment in one of these wonderous new hi-tech health machines.  Both individuals and governments are now having to make policy decisions on the value of both the quality of life, and even a life itself, when it comes to life improving, and life saving, hi-tech medical equipment. 
Hi-Tech Healthcare

New, Hi-Tech Healthcare: self managed care w/ technology

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Better Tech, lower prices: Overseas Healthcare

December 14th, 2008

Sky-high medical; buyers fly overseas

With sky-high medical prices; buyers fly overseas

 

By John Ghysels, Special to Technology-Report.com

The terribly mis-named “medical tourism” market brings up images of poor, sick Westerners wandering into third world hospitals for care. However, the high-tech of the overseas medical market now available for orthopedics and other fields often puts medical technology in North America or the UK to shame.  This is because cautious and slow to adopt U.S. agencies such as the Food and Drug Administration and tight-fisted government programs such as Medicare drag their feet in approving new treatments and techniques for expensive, high-end procedures. The large national health plans in the Canada and the UK can make things even worse. However, it’s not really their fault. Governments everywhere are struggling to control out of control budgets and spirling costs. 

However, overseas, Western trained doctors apply the latest in medical technology, such as replacing aging knees with new high tech materials and ”resurfacing” hips, (like your auto brakes, I guess) using cutting edge techniques not yet approved in the U.S.  In beautiful, modern facilities in Thailand to Turkey, doctors use newly developed tools for heart surgeries and organ transplants, often obtaining outcomes that exceed those of the finest American healthcare institutions.   

Quietly, this is becoming the most rapidly growing area in healthcare. Because of costs, quality and the suprisingly international nature of many healthcare institutions, it may be poised to become a healthcare tidal wave, as healthplans and retiree medical programs strain to cut costs for an aging population.  

How it works:

This entire area of medical “tourism” is one that requires a bit of getting used to and the information available on the Internet can be confusing at best. However, an extended conversation on this topic with an expert helped to bring things into focus for technology-report.  Basically, it works like this: 

You are sick, but ambulatory, and need expensive care that will cost you at least $6000.   You call an agent or agents and request bids on your medical treatment. The agents all respond with bids, employing a list (or lists) of medical facilities that they have access to, around the world.  You are provided with information on hospitals, quality, doctor training, outcomes and lots of other data. Since you are paying this out of pocket, usually, these agents and the facilities they represent want your business and compete based on medical and service quality.  Travel arrangements and lodging costs for yourself (before and after your care) and a companion are often included in the package price.  Even with travel included, the cost for treatment can be up to 1/3 that of care in the the hyper-expensive U.S market. 

I had one of these medical agents instruct me on this globetrotting, or umm, hobbling, approach to cheap, but high quality healthcare. 

I am told that the technology available varies dramatically based upon the medical facility. Often, particular countries stand out for certain procedures.  The quality is often driven by procedures developed by particular world-class physicians and surgical teams at particular hospitals. These doctors and their teams have developed new techniques and may have earned a planet-wide following of doctors, researchers and now, patients, based upon trusted results which are carefully measured and reported by highly reputable, international healthcare quality organizations.  

I’m told by the agent that the Netherlands has wonderful knees and hips, whereas Mexico is lovely for extensive dental work. Certain facilities in India and Turkey can’t be beat for heart surgury and some hospitals there are world leaders in organ transplants. I am reminded you must bring your donor with you. (Though, I suppose it is optional that you tell them they are the donor before you leave). 

In any case, you medical agent is both your healthcare co-ordinator and travel agent, taking care of all the details, from the moment you and your escort arrive at the airport, through post-op recovery, to the moment you leave for the airport. 

Most folks tap into this service when they don’t have insurance. However, more self-insured employers in the U.S. are experimenting with offering this type of option. TechGhy thinks this means that we could see insurance plans offering this as part of an insurance plan in the near future. If such a plan was competitively priced, this could have a fast and dramatic impact upon the market, especially in overseas medical.

Afterall, if you were a retiree, wouldn’t you appreciate a “free” trip and other financial incentives to receive superior, technologically superior care overseas?  Now, if you were a retiree plan trustee with a diminishing pile of reserves to cover your members, the answer looks like a win-win option. Overseas care is the preferred option for those who need to stretch both their healthcare quality and their dollars. 

For more information on overseas care, contact a quality agent. World Med Assist, http://www.worldmedassist.com/is run by fine, detail-oriented and reputable people and provided some of the information for this article. 

Fairness disclosure: Neither I nor technology-report is affiliated with WorldMed.  

You can check out their video here:  http://www.worldmedassist.com/liver-transplant-India-video.htm and other testimonials here: http://www.worldmedassist.com/medical_tourism_testimonials.htm

John Ghysels, 12/13/2008

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