Quality of life and length of life are heavily dependent on health care (as well as on genetics and economics). As health care is gradually extended to the poor of the world, and particularly in Asia, they are discovering ways to provide modern care at very low costs, and not just because wages and salaries are less.  Actually in the US, we should recognize that rising employer and family health care premiums are depressing wages and/or disposable income here! In fact, in 2016 the percent of household income spend on health care -- on average across all American families -- will be 45%!

So, anyway, Asian medical innovation will be affecting your practice and/or your doctor sooner than you realize. China and India are revealing how medical costs can be slashed in the US and EU. How? In various ways, including call centers, remote imaging interpretation and medical tourism. Foreign training of medical professionals willing to immigrate here and work for lower salaries (for a while anyway) is also a factor. But, frugal innovators in India and China are also making cheaper medical devices that work effectively. Companies like China’s Mindray and India’s TRS stripped down imaging scanners that cost one-tenth of similar equipment here. ECG machines in Asia cost $500 or less, instead of $5000, for example. A night in a US hospital room costs 25 times as much as a similarly equipped modern hospital room in India or China. GE, Phillips, Medtronic, and other US companies are investing heavily in these countries, and positioning to participate in these markets effectively, and manufacturing cheaper products. Could this reflect Toyota/Honda versus GM and Ford comparisons in the US during the 1980s?

The Economist says two factors keep good but cheaper devices and infrastructures out of the US. First is that we as patients here don’t care about costs much when employers or government is paying the bill -- patients have to contribute out of pocket more for their care in Asia (so will we soon). Second, they say the FDA’s propensity to be risk averse currently prevents introduction of such products, which can’t afford to go through their expensive and lengthy processes.

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