Salon.com MobileMy cheap, fast and effective treatment in New Delhi reminded me of everything wrong with American healthcare
I moved to New Delhi a year and a half ago from New York for a new job with a newspaper. When I arrived in India's capital, I figured if I was going to live in the country, I might as well get used to the food, the water and the bacteria that doesn't seem to bother too many natives. I ordered juices, ate cold salads and drank the un-bottled water that restaurants bring customers for free. But I learned the hard way there are better methods for adjusting your body to the new climate. Less than two weeks into my time there, I found myself vomiting at the foot of a 12th century monument, the Qutb Minar.
I had anticipated getting sick in India. Since I had elevated carelessness to the level of doctrine, I had almost guaranteed it. But it was something I hadn't prepared for. I had no idea how to navigate the Indian healthcare system. How would I find a doctor? What if I had to go to the hospital? How different from the American system would it be?
What I hadn't anticipated was that India's treatment would turn out to be so good. And cheap. Unless you happen to be one of the hundreds of millions of Indians who are poor and don't live in a major metropolitan area. The Indian healthcare system is an anarchic hodgepodge, with little insurance, little regulation and a range of services offered by hundreds of government-run, trust-run and corporate hospitals. The care it produced for me was fast, effective, courteous and cheaper than American medicine, even when adjusted for the lower cost of living. But that was the care it produced for me, a middle-class woman in the big city. As America considers healthcare reform, the Indian system is a testament to both the triumphs and the pitfalls of letting the free market heal people.
At first I fought the suggestion to visit a doctor with my stomach bug. I rested and didn't eat much for a few days, hoping it would disappear on its own, like stomach bugs tend to do. I thought that making an appointment, and waiting to see a doctor, and getting ahold of any medication in India, would take more time than just getting better on my own. After all, it took almost 17 hours of phone calls and store visits, and two instances of crying hysterically to customer service reps, for my cellphone to work. If just getting a basic telephone connection was so much effort, I didn't want to think about what a visit to the doctor would be like. But after the third day of diarrhea, and continued inability to eat anything without being hit with an overwhelming wave of nausea, I caved. "OK, let's call a doctor," I told my friends who were taking care of me.
It was about 9:30 in the morning. My friend, who works for an outsourcing firm, called a gastroenterologist -- not a general practitioner but a specialist -- and set up an appointment for 10 a.m. We drove to the hospital, a mile away. It looked brand-new; the floors were shiny and everything glistened. The staff was courteous and the whole place was quiet. The doctor called me in at 10:02. He diagnosed the problem as a bacterial one, gave me a list of what to eat and prescribed a course of antibiotics. The pharmacy counter where I could pick up the drugs was just outside his office. The cost to see the doctor? $6. The pharmacy bill was about $1. Total cost, $7, with no insurance company involvement whatsoever.
Before I left New York, I had spent $20 just on a copay to visit a doctor and get a blood test done, another $20 copay to pick up the test results, and a third $20 installment for a tetanus shot. That was $60, plus whatever my insurance company paid, just so I could get a clean bill of health.
A couple of weeks after my first encounter with an Indian doctor, I had another bout of stomach problems. This time, it was probably a glass of watermelon juice that did me in, and the next morning, I couldn't even keep water down. We called the same doctor on his cellphone, and he prescribed the same antibiotic. When I threw that back up, we called him again, and he said to try a more powerful anti-vomiting drug. We called the pharmacy, which delivered the drugs for free.
It worked, for the most part, but when nausea was still bothering me a few days later, I paid another $4 visit to the doctor. He told me to go to a lab down the street from his hospital and have a blood test and stool sample done. I went in without an appointment and walked out 20 minutes -- and $20 -- later. That afternoon, I picked up the results and read them to my doctor over the phone. The liver function test came back a little high, so he said to take it easy and go back two weeks later for the same tests. I did, and the levels were almost down to normal. The phone calls were free.
Even emergency care in India seems to work along the same lines. The same friend who first called a doctor for me had been in a horrific car accident about eight months before I arrived. He was taking a right turn at 2 in the morning when a truck came from the opposite side, ran into his car and just kept going. His femur was broken like a twig, as were his collarbone and wrist. His lip was split and his nose was hanging off his face.
Two months and a few surgeries later, he walked out of the hospital. He walks now without any aid and has had no major complications. The total bill, paid by his Indian insurance company, was less than $10,000. A similar accident in the U.S. would run up a $200,000 bill and bankrupt almost anyone who didn't have health insurance.
