A TGB READER STORY: Poutine to Padre, Day 7
Happy 94 Years, Millie Garfield

The Price of Murder-Suicide and Medical Tourism

On Monday's discussion here about end-of-life choices, the cost of the drugs used for physician-assisted dying - $3,000 to $4,000 in Oregon – was mentioned. (Thank you all who posted ideas about assistance with the price.)

Soon after that story was posted Monday morning, two related stories popped up while I was reading the news of the day.

The first is short and terribly sad. As the Washington Post reported, Brian S. Jones, shot his wife, Patricia A. Whitney-Jones, age 76, in the head then shot himself three times.

”[The] Washington state couple whom authorities believe died by murder-suicide reportedly left several notes expressing worry that they could not afford treatment for the wife’s severe medical issues.

“The husband, 77, called 911 shortly before 8:30 a.m. Wednesday and told the dispatcher that he planned to shoot himself, the Whatcom County Sheriff’s Office said in a statement. The man said he had written a note for the sheriff with information and instructions.

“The dispatcher tried to keep the caller on the phone, according to authorities, but the man said, “We will be in the front bedroom” and hung up.”

Did you notice that first sentence in the quotation, “...worry that they could not afford treatment for the wife's severe medical issues.” We'll get back to that in a moment.

The second story has a happier ending but still leaves one wondering.

According to Kaiser Health News, on a Saturday morning in July this year, 56-year-old Donna Ferguson from Ecru, Mississippi, met Dr. Thomas Parisi, an orthopedist from Madison, Wisconsin, at Galenia Hospital in Cancun, Mexico, where he performed a total knee replacement on one of Ferguson's knees.

A few hours later, while Ms. Ferguson was already working with a physical therapist, Dr. Parisi flew home to Wisconsin. Ferguson stayed another 10 days at a nearby Sheraton hotel for physical therapy at the hospital twice a day.

”Parisi, who spent less than 24 hours in Cancun, was paid $2,700, or three times what he would get from Medicare, the largest single payer of hospital costs in the United States. Private health plans and hospitals often negotiate payment schedules using the Medicare reimbursement rate as a floor...

“In the United States, knee replacement surgery costs an average of about $30,000 — sometimes double or triple that — but at Galenia, it is only $12,000, said Dr. Gabriela Flores Teón, medical director of the facility.

“The standard charge for a night in the hospital is $300 at Galenia, Flores said, compared with $2,000 on average at hospitals in the United States.

“The other big savings is the cost of the medical device — made by a subsidiary of the New Jersey-based Johnson & Johnson — used in Ferguson’s knee replacement surgery.

“The very same implant she would have received at home costs $3,500 at Galenia, compared with nearly $8,000 in the United States, Flores said.”

Ferguson's Mexico surgery was set up by a new-ish organization, North American Specialty Hospital (NASH), based in Denver.

”[NASH] has organized treatment for a couple of dozen American patients at Galenia Hospital since 2017.

“Parisi, a graduate of the Mayo Clinic, is one of about 40 orthopedic surgeons in the United States who have signed up with NASH to travel to Cancun on their days off to treat American patients.”

Two big things jump out at me about these two stories, especially as 20-odd presidential candidates in the U.S. are arguing over their individual flavors of “Medical for all”:

What is wrong with a country that sends its patients AND its physicians to another country for treatment at a reasonable price?


What is wrong with a country in which an aged couple sets up a murder/suicide pact because they cannot afford medical treatment?

Both of these questions fall into the same category as Monday's question about the high price of the drugs in Oregon's physician-assisted death program.

Any of us could find ourselves in these predicaments. Something is very wrong.


The focus is way off. A healthy country's focus is the livelihood of its citizens, basically speaking.

The difference . . . ? American shareholders gotta get their cut - only in America, an individual's healthcare is a commodity to be bought and sold.

A year or two back there was an extremely interesting series in Time magazine about the American medical system works.

So much, Ronni, so much. Where does one even begin to answer this question? It has not been under just one administration, so we really can't lay all the blame with Trump. Those who have been in Congress for far too long while not righting the wrongs of such basic needs as healthcare must accept most of the responsibility, but citizens who are more inclined to sit at home and complain, yet do nothing to improve things -- not even vote -- ultimately allow the maintenance of an unfair status quo.

I was not familiar with the NASH program, but as you describe it and as inadequate as it may be, it at least sounds like something providing hope to those who otherwise might have none. Many Americans have moved to Mexico to find affordable in-home care and to find an affordable life in retirement over all, and it would be interesting to know how many Americans are choosing the expat life these days and are happier and healthier in it.

As Theodore Parker said in the mid-1800's, and many have repeated since, (while mostly crediting Martin Luther King, Jr.), "The arc of the moral universe is long, but bends toward justice." Perhaps it does, but oh so slowly. None of us are likely to live long enough to see the end to the injustice illustrated in these stories, but the more we raise our voices in response to them, the further down that road we will get. Thank you, Ronni, for providing a forum where this can be discussed, and for educating and encouraging readers to take what actions we can yo make things better for everyone.

I just read an article which said being a 26 year old diabetic in this country is like being given a death sentence. Twenty six is the age where most people are no longer covered under their parents health insurance. And, with doses of insulin costing in upwards of $500-$600 per month, many in this age group just can't afford it. I don't believe in conspiracies, but I can't help feeling there's something going on here.


The kleptocracy in full swing.

So incredibly sad. I don't know how this would work but I have a large 2 bedroom, 2 bathroom plus den apartment close to Toronto. I live alone but would consider a temporary share person. I don't know exactly how immigration works if an American wants to become a citizen of Canada? Food for thought?

Our country more than ever does not care for the old or the poor, especially if they are minorities. It’s all about the almighty dollar....in a word greed

Last winter- Costa Rica we met many retired Americans and Canadians living in the hills of Eskazu, a small upscale Central Valley city outside San Jose.

They had carefully researched places they could live and get reasonably priced medical care, plus own a small retirement home. There was a learning curve tho, learning the language, realizing not everything gets done in a hurry, plus guard dogs that howl at night. Most people have at least one howler.

We got used to the Canine Cantata - starts at dusk..

None of these expats regret their move.

There are many American trained doctors in CR. We heard about tourists getting new teeth, knee, hip replacements.

Also pharmacies - no doctor referrals needed - walk in, say what's ailing you and pharmacist sells you the meds.

Same thing in Mexican border towns near South Padre Island, TX.

Many American trained doctors have over the border clinics. Expat tourists park, walk over the bridge, show passport, enter Mexico and walk to a dentist or medical clinic.

The question is, are you ready to trust your new set of teeth will last? Better do your careful research, get referrals. Some clinics may not be the real deal.

Cheaper yes, often safe but do your research.

Kleptocracy indeed. There's been news stories here in WA state that people are caravanning to Canada to buy insulin. Made me wish my son still lived in Seattle.

It makes me sick (no pun intended) that people will fight against progress that would benefit them for stupid reasons. (A Single-payer medical system is Socialism, I like my insurance plan and will not give it up, I will lose my doctor, etc.) They never do their homework to find out whether these things are true - they're not.

Just like everything else, it all comes down to money. It could work just like Social Security and everybody likes that.

So ... what's wrong with sending patients and physicians to another country for treatment at a reasonable price? It seems stupid on the surface, but we've done it with cars and computers, and maybe that's what it will take for medicine. As for the Oregon case, what happened to Medicare? We want Medicare for all, don't we, at least on an optional (buy-in) basis, if not on a mandatory basis.

I agree with this.

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