Now that the U.S. is taking steps toward normalizing relations with our cash-poor, doctor-rich neighbor to the southeast, I am hoping that the time is ripe for Medicare to begin using Cuban medical services, as proposed in a February 2013 posting. (See my health care reform proposal for some reasons why every other country can provide health care at a lower cost than us.)
As a taxpayer I am looking forward to complete normalization of ties with Cuba. Keeping Cuba around as an official enemy is a sad reminder of how little return we get on our military and CIA dollars. If we can’t make the Castro brothers do what we tell them to, why should any other political leader listen to us?
[Separately, a friend has just returned from a trip to Costa Rica where he and his wife had complicated dental surgery at a fraction of the cost quoted in Boston. How was it? Here’s how he responded to my emailed question…
I have had nothing but bad/horrendous dental care in the US (part of why I’m having to have so much work done), so the bar has not been set high. I have seen three different specialists from one practice- a cosmetic surgeon, a periodontist, and a general? dentist. They are all US-educated and teach at the university here. Their English is perfect, they are highly intelligent, articulate, and personable. Really, the best professional experience of any type I have ever had. Their office is in Escazu, which is the Weston of CR [Weston is a rich suburb of Boston]. Lots of rich CR clients, the practice is not really oriented towards foreigners, although they do that as well.
]
A great idea, but be prepared for the US health care industry to fire back. For example, drugs in Canada can often be several times cheaper than in the US. However, under the “Prescription Drug Marketing Act of 1987”, it is illegal for anyone other than the original manufacturer to bring prescription drugs into this country.
Also, most people on Medicare do not care about the cost of the services they receive since, for the most part, they do not pay for them. An old lady going to her podiatrist to trim her toenails twelve times a year (the doctor will, of course, find a creative way to bill Medicare for that procedure) is not going to go out of her way to save taxpayers any money.
A lot of the costs in the US system are now hardwired in and you couldn’t get rid of them even if you wanted to. Every time I drive to W. Philadelphia, Penn has added another palatial building to its hospital complex, which is now the biggest employer in the city. Each one of those bldgs cost millions if not billions and someone is going to have to pay off those bonds whether those beds are empty or not. If they are charging $10,000/night now and you send half their patients to Cuba where they will stay for $100/night, now they will bill Medicare $20,000/night for the same bed. They have their claws into us and are not letting go so easy. Drug companies have figured out that they can just add zeros to the cost of drugs – as many as they want – $50 a dose, $500, $5,000 – whatever. If you don’t pay then someone will die.
After discussing your idea with some friends who work in the health care “industry” we can propose an alternative business model for the ship: register it as a US health care facility and take Medicare recipients in cruises where in addition to the usual cruise fare they can receive unlimited medical services (billable to Medicare). The passengers could travel for free the cost to Carnival being offset by the medical billing profit.
A win-win for everyone, but the US taxpayer and local (land-based) Medicare providers.