Richmond & Langham

2. Sociological Aspects of Medical Outsourcing Monetary benefit to nation Savings passed on to other needs Additional income revenue Lower Costs Country Receiving Patients Country Sending Patients ECONOMIC

3. Sociological Aspects of Medical Outsourcing More tourism promotion in effect Opportunity for family to visit abroad Increased cultural exchanges Greater respect to host nationals Opportunity to encounter others Appreciation given host nation Country Receiving Patients Country Sending Patients SOCIAL

4. Sociological Aspects of Medical Outsourcing Internationalization of practices Potential for redefining of malpractice suits Greater international legal ties Promote development of agreements Country Receiving Patients Country Sending Patients LEGAL

5. Sociological Aspects of Medical Outsourcing Inspections by international medical regulatory boards Concerns for medical standards Reputation importance Questions of safety in follow up Raise issues of international medical ethics Less control of medical practices Increased prestige in medicine for host nation Increased contacts in exchange of people and information Country Receiving Patients Country Sending Patients MEDICAL

6. The Outsourcing of Surgical Procedures to Asia: Note: Angioplasty in Malaysia averages $4,000 - $6,000 Cardiac: $13,000 $10,000- $11,000 $9,000- $10,000 $160,000 – $281,000 Heart Valve (single) $20,000 $12,000 $4,000-$10,000 $100,000 –$123,000 Coronary Artery Bypass $13,000 $13,000 $4,000-$11,000 $35,000 –$83,000 Coronary Angioplasty Singapore Thailand India USA Procedures& Services

7. The Outsourcing of Surgical Procedures to Asia: Singapore Thailand India USA Procedures & Services $12,000 $9,000 $7,000-$8,000 $23,000-$35,000 Mastectomy $5,000 $4,000-$5,000 $3,000 $20,000-$30,000 Hysterectomy $15,000 $15,000 $11,000-$17,000 $48,000-$70,000 Gastric Bypass $390,000 $350 $250-$300 $5,000 Hernia Repair $11,000 $10,000 $8,000-$10,000 $20,000-25,000 Gall Bladder Removal Gastrointestinal and General Surgical:

8. The Outsourcing of Surgical Procedures to Asia: Singapore Thailand India USA Procedures & Services $200 - $300 $1,000-$3,000 Radiology Reading

9. The Outsourcing of Surgical Procedures to Asia: $10,000 $90,000 Spinal Disc $9,000 $7,000 $5,000-$6,000 $63,000-$91,000 Spinal Fusion $8,000 $7,000-$8,000 $4,000-$6,000 $17,000-$20,000 Knee (ACL) Repair Orthopedics: $8,000 $8,000 $4,000-$7,000 $40,000-%60,000 Rotator Cuff $13,000 $10,000 $8,000-$9,000 $40,000-$61,000 Knee Replacement $12,000 $12,000 $9,000 $44,000-$64,000 Hip Replacement Singapore Thailand India USA Procedures & Services

10. The Outsourcing of Surgical Procedures to Asia: Cosmetic: Singapore Thailand India USA Procedures & Services $3,000-$5,000 $3,000-$5,000 $2,000-$3,000 $6,000-$12,000 Breast Reduction $3,000-$5,000 $3,000-$5,000 $2,000-$3,000 $6,000-$12,000 Breast Augmentation $3,000-$5,000 $3,000-$5,000 $2,000-$3,000 $10,000-$20,000 Face Lift

11. The Outsourcing of Surgical Procedures to Asia: $3,000 $3,000 $2,000-$3,000 $7,000-$12,000 Tummy Tuck $3,000 $3,000 $2,000-$3,000 $7,000-$12,000 Nose Surgery $3,000 $2,000-$3,000 $1,000-$2,000 $7,000-$12,000 Liposuction Procedures & Services Cosmetic (continued): USA India Thailand Singapore

12. The Outsourcing of Surgical Procedures to Asia: *Cost of Dialysis can exceed $1,000,000 $21,000-$28,000 $10,000-$18,000 Up to $500,000* Liver $15,000-$20,000 $10,000-$15,000 Up to $500,000* Kidney PRC India USA Transplant Procedures Costs (Dollars)

13. The Outsourcing of Surgical Procedures to Asia: Altruistic Donation PRC India USA Transplant Procedures Yes/No No Yes Liver Yes/No No Yes Kidney

14. The Outsourcing of Surgical Procedures to Asia: Waiting Time PRC India USA Transplant Procedures Weeks (3-5) Weeks (3) Months Liver Weeks (3-5) Weeks (3) Months to Years Kidney