Preventing curing onset of cataract

Live healthy and long

Rizal Philippines
September 1, 2015

Yesterday, I had new glasses outfitted.  The edges of the lenses were chipped and besides, I have been experiencing blurred vision lately.  When my eyes were checked, the optometrist said I was progressing towards cataract.  Probably because of my diabetes.  The grade a the left went up (this had progressive sign of cataract) while the right eye's grade went down.  But the thought of having cataract of course saddened me.  So I researched on cataract. (Although we had students who were cataract surgeons)

What are cataracts?  They are blind spots or opacities in the eye lenses brought about by advancing age.   It comes earlier with elderly with diabetes (I am 64 with signs of diabetes) About half of 65 years or above would have cataracts (so that puts me in the statistics) and 1,500,000 cataract operations are done annually in the USA. (In the Philippines, because of Philhealth provision there is a slew of cataract operations)   Many opha have free cataract operations in the south.

In India, there is the Aravind hospital that caters to many Indian poor who have cataracts for as low as $5@ operations

From Dr. Whitaker - one of USAs trusted wellness doctor

Cheap cures advocacy and call to action needed

Live healthy and long

Rizal Philippines   |  September 15, 2014



Cheap cures that are skin deep

So far this site has only done this much for cheap cures:

1.  Gathering articles about alternative herbal and plant cures;

2.  Advice on how to live healthy and strong;

3.  Advice on food, nutrition and exercise.

These are when diseases that are mortal and morbid or has not stricken patient.  But it does no explore the hard core of medicine and health issues:   as when the patient is critically ill or in sticken with big C all ready. Or heart disease Intervention and cures cost money.

So it is now time to take stock of the situation and act.

What is happening?

Dr. David Shetty of India, featured at Al Jazeera, philanthropist and cardiac surgeon - founder of low cost largest heart center in the world

Live healthy and long


 Dr. David Shetty and Health City in Cayman island


Philippines,  February 6, 2014.

Wiki on Dr. David Shetty

Dr Shetty and Health City in Cayman Islands from Evolution Shift

From BMJ blog - Can Dr Shetty Scale up affordable health care?

Dr David Shetty, a philanthropist and cardiac surgeon, was earlier mentioned in this post by Dr. Mercola as basis of comparison between heart operation in India and USA.  It would cost about $100,000 in USA, for an indigent about l/100 of that amount.  In the March 14, 2013 issue of Time Magazine, David Brill explained why health care costs in US are high.

 He founded the Narayana Health  in 2001(formerly Narayana Hudayalayana) He founded the hospital because he can not find an employer who buys into his vision.  The heart surgery is the largest in the world with 1,000 beds and does 30 heart surgeries a day.   He has performed l5,000 heart surgeries (can you beat that?)  Fast Company has classified Narayana as one of the 50 innovative companies in the world

How can Dr. Shetty do it:

There are 3 foundations for this capacity of Dr. Shetty to cure many Indians (now about a billion, one of the most populous countries in the world)

1.  Economies of scale.  This is employed by large manufacturing companies and retailers.  Large volume can bring down costs, and exerts a tremendous force on the supplier to lower costs.  Thus cost of procedures in Shetty hospitals is much much lower than either govt or private hospital in India.

2.  Desk for  assisting the needy.

    1.  Working with  foundation such as Heart Foundation that assists patients who need heart bypass or other other expensive heart operations;

    2.  Assisting patients obtain funding/assistance from govt agencies or foundations that help the needy.  The patients need not worry about the money aspect, or turned down for treatment just because he does not have money.  All that patient's family have to worry about is how to make the patient well with their care.

   3.  Cross subsidy  -  60% of the patients of Dr Shetty pay the full amount, 20% pay premium because they can afford to pay;  10% pay a little, 10% are indigent and pay nothing.  The 80% who pay can shoulder the 20% who pay a little or nothing.

He was personal physician of Mother Teresa of Calcutta and did a heart surgery on her.  

   The Aravind hospital is another hospital that offer low cost cataract operation in India, organized by Dr. V.  (He is now dead)

  I hope that we can have this type of hospital in the Philippines.  Many large hospitals and many those that are being put for profit alone.

In the Philippines, it is noted that with the emergence of  world class hospitals:   SLMC, and TMC, the cost of medical care shot up.  The consolidation of hospitals by MVP group:   Riverside, Cardinal Santos, MMC was hoped to have brought economies of scale, but it did not.  The cost of health care merely went up.  Much of medical care in the Phil, amounting to more than P300 billion is 2011, came from out of the pocket.

  If the Lord wills it, I hope I can organize something like that of Dr. Shetty's hospital.  I hope I can muster enough number of former MBAH students who are MDs who are social entrepreneurs who can help me put a hospital just like what Dr. Shetty has put up.  Perhaps Dr. Vega  of Davao Medical Center can share his expertise in running a 2,000 bed hospital and putting up a heart and kidney center, a Director of NCMH, the current Usec and former congresswoman Dr. Garin?

Or can we just ask Dr. Shetty move in the Philippines.  So far he has made his group climb up to 30,000 beds.  He predicts that there will be shortage of health care personnel world wide.  The problem is how to make standardize procedures to lower costs.

,

Are there MDs like Dr.Devi Shetty of India in the PHL?

Live healthy and long

I must have made the mistake of teaching only opportunity seeking for   MD in MBA for Health in a leading GSB in Manila.  I should refocus my syllabus on making hospital care as social enterprise instead instead of molding them into the likes of tycoon.  We need to bring down health care cost in the PHL instead of following the opportunistic pricing/opportunity seeking model of business entrepreneurs as in US (as investigated by Steve Brill for Time Magazine)

We should go to the Doctor to the Barrio model (Dr. Flavier) or even hilots or herbolarios, to be strategic doctors, to use the herbs and food in distant barrio to cure the sick and the poor.

Or follow the Indian models:    Dr. V of the Aravind Hospital envisioned the hospital to be the McDonald of Eye Surgery.  They had operated on millions using operations management method.
and Dr Devi Shetty  of the Narayana Hrudayalaya (NH hospital)  He founded this in 2001 because his employer could not understand his vision.  Heart surgery in NH costs only the equivalent of $l,500 vs. $108,000 in US or $25,000 in the Phil. He also founded the Rabindranath Tagore International Institute of Cardiac Sciences  (RTIICS

 In Davao PHL, it is only $8,000.00  Dr. Shetty believes that costs can be reduced by as much as 50% in a decade by employing economies of scale Thus the costs in India can still go down to $800.00. That is something!

Can there be a philantropist Dr. like Dr. Shetty (most will think that that model is simply shit)?  Can we make health services:

1.  Be in the mold of social business; (the reverse of profit maximization business)

2.  Be operated in an efficient manner to bring down costs?

3.  Be compassionate.

There is no need to have medical tourism campaign if we give excellent medical care at very low costs.  Patients from Arab countries, US, UK, and South Africa visit NH and get quality care at low cost.

Why is health care cost so high in US, and also acting up in the PHL too?

Live healthy and long

Repost from Dr. Mercola archive | August 14, 2013

A heart surgery costs about $1 583 or 95,000 rupees (the Indian currency is on verge of devaluation so it could be even lower) in India and about ten times as much in USA, eg. Cleveland Clinic $106, 385.  Efforts are underway to reduce the price some more in India to about $800 within the decade to make the procedure to most of the Indians who live on less than $2 a day.  (There is the Aravind hospital in India which does a cataract surgery for only $5!!)  Everything could be reduced including supplies and drapes which could be a model for developing countries.

In the US though, every thing is about opportunistic pricing (maximizing because of health care system?) According to Dr. Devi Shetty

This gave rise to medical tourism and prices in other countries, even with the hotel and air travel are much lower than in the US.  Such countries include Thailand, Taiwan and India.  However such travel are risky because of superbugs in such countries, and other risks associated with travel.

Steven Brill of Time Magazine did an investigative piece on US health care cost which are sometimes shocking!  Costs/prices could be staggering. Profit motive, profit maximization.  Health care costs in US total are the health care costs of top ten countries after it;  yet longevity in US is at the tail end.

They also have many unnecessary procedures.

Health care should be more classified as a social business.  And the largest hospitals in the PHL, the big four, Makati Med, TMC, Cardinal, and St. Lukes (two are owned by MVP) are on profit maximization, opportunity pricing trajectory like US (vs the income levels of Filipinos)

If I were given longer life and have more business opportunities, I will have health care facilities patterned after India.

Alternative Cures must be Cheap and even Free

Effective Cures Can be Cheap

Most of the feeds and alternative medicine videos carry with them publication for sale and or nutritionals that are for sale.  Of course that is expected that the web must earn money and so with the professionals who create, write and  design the websites.  Research expenses, travel must be paid for. And therefore, these initiatives need funding and what could be a better way than to make the effort sustainable by selling products and services.

However, this is contrary to the position of some of those who profess AM criticizing the mainstream medicine's profit motive of the big pharma, the medical practitioners regarding their need to make large amounts of money without having arrived at effective cures, feeding their rich lifestyles, and bringing untold misery to the victims financially and physically. Current AM also want to make big money and supplant the pharmas and the mainstream MDs.

I think here the idea of social entrepreneurship, the Thailand model of healthcare, the Aravind hospital, the Chinese medicine and the Ayuvedic medicine, and even the healing doctors and spiritista at the PHL are worth looking into and benchmarking by AM.

I admire more those who favor natural foods, natural herbs and plants for treatment, and some treatments using household items:

Turmeric, and cinammon for diabetes;

Brocolli, graviola, noni, periwinkle, Indian heliotrophe for cancer;

Vit C. cesium chloride, high temp zapping, sodium bicarb, laetrile from apricot, essiac for cancer;

Brown rice as substitute for statins.

Papain, turmeric, and ginger for cancer pain management.

Cherries for joint pains and inflammation.

Foods to strengthen bodys immune system from calciferous vegetables;  cauliflower, cabbage, brocoli

Brisk walking for diabetes and cardiovascular diseases.

Moringa and charantia for diabetes.

They espouse these herbs that are available in the household, in the markets and grocery stores;  are not in capsules, and are not part of multi level marketing, profits, and commission.  I think when products are sold not because of their efficacy but because of the commission schemes, then they are not effective and not really part of AM,  it is still big pharma disguised.

Various Low Cost Models for Health Care.

Effective Cures Need Not be Expensive

So far most of the blogs are on low cost medication;  non on hospitals, health insurance and health care delivery.  Health care will continue to be major industry and expenditures in all nations inspite of the financial crisis.  Money will be made (and many families will be bankrupt) from health care

There are several models for low cost health care.

The Aravind Hospital by Dr.  V

Dr V is now deceased and established  the Aravind hospital.  It is entirely a private business model relying on innovation.  It is started as one unit and now has several branches and has operated on over 2.4 million cataracts.

It relies on several innovation:

l.  Economies of scale and efficiency.  The patients are gathered in various centers for funneling to the operating centers.  An Aravind MD operates an average of 860 patients a year;  the ordinary MD just 200 patients.  Using the same principle as McDonald, Dr. V wanted to operate on million Indians.

2.  Use of paramedics and para nurses  -  Running nurses to get instruments who are high school graduates and medical assistants are trained to assist the very few qualified MDs and nurses who are available

3. Having an integrated system;  having your own lense factory

4.  Cross subsidy.   The very few paying patients subsidizes the many poor patients that Aravind hospital serves.

Aravind Hospital

 Low Cost Hospital, Entrepreneur's Passion

This is the idea of Dr. Devi Shetti, former a heart surgeon of NHS in UK, who envisions a health city. He proposes a $l a month Yeshasvini health insurance scheme and is most welcome to the politicians.  The amount is supposed to take care of health needs of most Indians

In his scheme, the open heart surgery is to cost  only $800.00 per and this is l0x the cost in US or UK.  He has partnered  with a contractor to build a l story low cost hospital building.  It would cost only $4 million  vs $40 million it would ordinarily cost.

The elements here for the cost management are the ff:    health contribution, low overhead construction cost;  the self sacrifice of the Surgeon, Dr. Shetti

Low Cost Health Care in India

Public Policy, Partnership with Private Sector in Thailand

The Thailand example has been cited by no lesss than the UN.  In Thailand, for any disease you pay only 30 baht (or one dollar) and the capitation is l,200 baht or $40.00.  This is made possible by:

l.   Affordable insurance;

2.  Political will (the king wants it, it is the law Prime Minister Thaksin implemented this)

3.  The government put the price caps on all procedure;

4.  The government transfers the health care responsibility to private hospitals (which own 50 of all health care facilities) and pays them according to the budget and the capitation.

So the masses love Thaksin and would have been reelected if he were not exiled.   Of course  many doctors who felt the pinch of the cap hated him for this.  But this is good for many Thais.

Thailands $l health insurance scheme

30 Baht Health Scheme in Thailand

l.  How do the above articles motivate you if you in the public policy sector as DOH?

2.  What changes are  possible?

3.  If you are a Health Care leader, in public or private sector, what can be your action program?

4.  As an entrepreneur, knowing that the health care sector is large booming opportunity, what are the possibilities?  What changes can you handle by the horns? or be in charge of?