"In addition, device makers typically require doctors’ groups and hospitals to sign nondisclosure agreements about prices, which means institutions do not know what their competitors are paying. This secrecy erodes bargaining power and has allowed a small industry of profit-taking middlemen to flourish: joint implant purchasing consultants, implant billing companies, joint brokers. There are as many as 13 layers of vendors between the physician and the patient for a hip replacement, according to Kate Willhite, a former executive director of the Manitowoc Surgery Center in Wisconsin."

A simple legal remedy here would be to invalidate this sort of NDA agreement. The government is already involved as a customer in the health care market, and having the courts simply no longer recognize contracts that prohibit disclosure of prices would bring some immediate transparency to many involved.

The law could also go a step further and actually set up/order public listings of prices (this is already done in a lot of industries where vendors try to avoid competing on price).

I was a medical tourist in the opposite direction earlier this year. I'm from Canada, land of free health care, and my doctor told me that I would have to wait 6 months to see a specialist.

My ailment[1] prevented me from sleeping most nights, caused severe, productivity-ending headaches all day, and caused me to pop ibuprofens like candy. My PCP attempted to use water to eliminate what he believed was an earwax impaction 14 times on separate days. It had been almost 2 months of me completely disabled before he was willing to put in a referral to the ENT. When he did, they told me it would be six months. You can imagine my frustration.

So, I had a friend drive me to a clinic in Washington state. A bit of discussion, $900 and two visits later, I had seen an otolaryngologist, he had used a small curette to clean out the ear canal, and I was better. $900 to not cry myself to sleep all day for six months seemed like a pretty good deal to me.

Six months later I got a phone call from an office of an ENT here in Canada. I was unbelievably angry.

[1] I had a condition where the skin had grown over the eardrum in your ear. It required surgery by an otolaryngologist to remove the problem and restore my hearing.

Who's interesting in doing a healthcare tourism startup? Especially if you know the medical system well. Serious. Hit me up.

My wife has gone to Russia twice for dental work (her home country). Was a fraction of the quotes here, including airfare.

It would be interesting to see a breakdown of what really accounts for the majority of the price differences. This article mentions some things in passing but ultimately doesn't conclude with the main quantitative insights.

Some cities in Mexico have a very good medical system for the local rich elite that is very affordable for Americans. This is from my hometown... http://www.chihuahuamedicalcity.com/English/hospitales.html

The magic of the market.

So I get that by cutting out the insurer you are saving some funds, but where does the rest of the difference come from? Are the hospital rooms and surgeons so much cheaper because everyone in those countries pay them rather than just the few people who actually use their services?

Jesus Christ, the price is 5 times lower for a non-EU citizen in Belgium (which is still pretty expensive by worldwide or even European standards)? That's just unbelievable...

Cross-European medical tourism could explode next year, after 2011/24/EU: Directive on patients' rights in cross-border healthcare enters into application.

The directive created a legal framework for patient’s right to seek healthcare in another member state and for reimbursement.

http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2...

Eventually I'll need a lung transplant, and possibly more (I have Cystic Fibrosis). It's one thing to talk teeth and knee joints, but lungs and livers are a completely different story. That said, paying $150K+ isn't something I'm looking forward to (or even know that I'll be able to do), so medical tourism is something I follow closely to see how it develops.

The state should also do some math. What is the cost of having a disabled person, even if slightly ?

So what are the negatives? This NYT article reads like a PR piece for medical tourism... What about malpractice insurance in Belgium/Poland and what happens if there are problems down the road with TFA's hip implant?