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To the Editor:
Re "For Medical Tourists, Simple Math" ("Paying Till It Hurts" series, front page, Aug. 4), about the prices charged by medical device manufacturers, focusing on artificial hips and knees:
Contrary to the article's claims, the medical technology industry is highly price competitive. Over the last 20 years, industry prices have increased at only one-fifth the rate of prices for other medical goods and services and only about one-third as fast as the Consumer Price Index. Implants like artificial hips and knees are, if anything, even more competitively priced. Medical technology has consistently accounted for a low and stable 6 percent share of national health expenditures.
While prices have actually declined in inflation-adjusted terms, the industry has continued to develop scores of lifesaving and life-enhancing products. Decades of technological advances allow the patient profiled, who could not even stand without pain before surgery, to resume snowboarding.
Low prices and amazing medical progress. That's a good deal for American patients.
STEPHEN J. UBL
President, Advanced Medical
Technology Association
Washington, Aug. 6, 2013
To the Editor:
Your useful account of the much higher prices for hip replacements in the United States compared with Europe only scratches the surface of the problem. At the heart of this situation is the effective elimination of the competition that international transactions in medical services can provide.
"Exporting patients and importing doctors" is an important way in which we can introduce competition to bring down the exorbitant cost of many surgeries beyond hip replacement. "Long-distance" consultations and treatment (telemedicine) are also effective ways to introduce competition and greatly reduce costs.
Equally, relaxing entry by foreign medical personnel will reduce the danger that we will insure people who will be unable to find doctors to treat them.
JAGDISH BHAGWATI
SANDIP MADAN
New York, Aug. 6, 2013
The writers are, respectively, a professor of economics at Columbia and the chief executive of Global HealthNet.
To the Editor:
Orthopedic surgeons applaud your article's emphasis on joint replacement as a transformative experience. This was demonstrated by the patients profiled, who are back to work, living their active lives.
The article's inclusion of the surgeon's fee for one patient's operation (shown in a graphic) was, however, misleading. The average Medicare reimbursement for an orthopedic surgeon is $1,454 for a total hip replacement, a far cry from the $17,500 for the operation cited in the graphic. Average Medicare reimbursement to a hospital (including the implant) is, as you point out in your article, approximately $12,000, again a far cry from the $44,900 in the graphic.
JOSHUA J. JACOBS
THOMAS FEHRING
Rosemont, Ill., Aug. 5, 2013
The writers, both doctors, are presidents of the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons, respectively.
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