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Floating pharmaceutical research center, free of regulations, political interference, – cutting edge research as redtaping free as it gets…
The global pharmaceuticals market is worth US$300 billion a year, “political, regulatory, and legal interference” is the single biggest issue in pharmaceutical research and the reason why so few new blockbuster products come out of the research pipelines now. So opening a “interference free research and development space” on the oceans will definitly be worth going after…

 

 

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Wilfried Ellmer

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-- Edited by admin on Sunday 3rd of July 2016 04:24:20 PM

Oceanic low cost health services available to anybody

Seasteading platforms free of political interference can provide what your country full of political interest can not pull off...

“The best location to build a hospital on the planet today is a ship that is parked in the US waters just outside its territory,” Dr. Devi Shetty said.  “The site at the Cayman Islands is the closest approximation that fits the bill.”

We have been following Devi Shetty’s humanitarian accomplishments every since Nishant Bagadia, former VP of Neuhealth, and Peter Wei, author and medical student at Duke University, independently acknowledged Shetty’s famous hospitals in India as precedents for seasteading. Now Dr. Shetty himself is speculating about the sea.

The Wall Street Journal dubbed Dr. Shetty “The Henry Ford of Health Surgery.” He created 14 hospitals that offer coronary bypass surgeries to Westerners for about $5,200 USD, and in turn he offers medical insurance to millions of rural poor Indians for 25 cents a month. His hospital’s success rates are equal to or better than the U.S. hospitals, which currently charge an average of $144,000 USD.

But why fly to India to cut medical costs when you can visit a nearby island?

“By building such a healthcare institution in a British protectorate right outside the US regulatory structure,” Shetty told The Economic Times, “which can work with US doctors and experts for the US patients, one can show what is possible in healthcare even in the developed world and at what cost.”

Patients Beyond Borders, which counsels patients seeking medical travel, estimates that well over a half million people will travel abroad for treatment in 2014, and the numbers will grow 15 to 20 percent each year as baby-boomers overwhelm the system.

Exaggeration? Deloitte Consulting, the largest financial services network in the world, published an article in 2008 estimating that the number of Americans who travelled abroad for healthcare jumped from 750,000 in 2007 to 1.6 million in 2012, and that this number could increase by a factor of ten over ten years.

Healthcare in the US is not going to get cheaper any time soon. A terrifying study published in the March/April 2012 issue of the Annals of Family Medicine claimed the typical American family would spend $20,000 on health care that year, and that if current trends continue, health insurance premiums will surpass the median U.S. household income in 2033.

To serve the rising wave of US medical tourists, “health cities” are being built in the Cayman Islands, St. Maarten, the Bahamas, Barbados, and several other Caribbean states. As all the natural islands surrounding dysfunctional health care systems get used up, there will be increasing demand for man-made islands, starting with medical ships stationed even closer to frustrated patients.

 

http://concretesubmarine.activeboard.com/t57752368/medical-seasteads/

 

Tapping into to unexplored riches of hydrothermal vent biological communities at the mid-ocean ridge....non explored biology = pharmaceutical block buster .... more to come...

Global sustainability requires unrestricted rocket fast technological progress....
concretesubmarine.activeboard.com/t58921987/sustainability-population-growth-consumption-growth-ocean-co/

By
Geeta Anand
Updated Nov. 25, 2009 12:01 a.m. ET

BANGALORE -- Hair tucked into a surgical cap, eyes hidden behind thick-framed magnifying glasses, Devi Shetty leans over the sawed open chest of an 11-year-old boy, using bright blue thread to sew an artificial aorta onto his stopped heart.

As Dr. Shetty pulls the thread tight with scissors, an assistant reads aloud a proposed agreement for him to build a new hospital in the Cayman Islands that would primarily serve Americans in search of lower-cost medical care. The agreement is inked a few days later, pending approval of the Cayman parliament.

Dr. Shetty, who entered the limelight in the early 1990s as Mother Teresa's cardiac surgeon, offers cutting-edge medical care in India at a fraction of what it costs elsewhere in the world. His flagship heart hospital charges $2,000, on average, for open-heart surgery, compared with hospitals in the U.S. that are paid between $20,000 and $100,000, depending on the complexity of the surgery.

The approach has transformed health care in India through a simple premise that works in other industries: economies of scale. By driving huge volumes, even of procedures as sophisticated, delicate and dangerous as heart surgery, Dr. Shetty has managed to drive down the cost of health care in his nation of one billion.

His model offers insights for countries worldwide that are struggling with soaring medical costs, including the U.S. as it debates major health-care overhaul.

"Japanese companies reinvented the process of making cars. That's what we're doing in health care," Dr. Shetty says. "What health care needs is process innovation, not product innovation."

At his flagship, 1,000-bed Narayana Hrudayalaya Hospital, surgeons operate at a capacity virtually unheard of in the U.S., where the average hospital has 160 beds, according to the American Hospital Association.

Narayana's 42 cardiac surgeons performed 3,174 cardiac bypass surgeries in 2008, more than double the 1,367 the Cleveland Clinic, a U.S. leader, did in the same year. His surgeons operated on 2,777 pediatric patients, more than double the 1,026 surgeries performed at Children's Hospital Boston.

Next door to Narayana, Dr. Shetty built a 1,400-bed cancer hospital and a 300-bed eye hospital, which share the same laboratories and blood bank as the heart institute. His family-owned business group, Narayana Hrudayalaya Private Ltd., reports a 7.7% profit after taxes, or slightly above the 6.9% average for a U.S. hospital, according to American Hospital Association data.

The group is fueling its expansion plans through private equity, having raised $90 million last year. The money is funding four more "health cities" under construction around India. Over the next five years, Dr. Shetty's company plans to take the number of total hospital beds to 30,000 from about 3,000, which would make it by far the largest private-hospital group in India.

At that volume, he says, he would be able to cut costs significantly more by bypassing medical equipment sellers and buying directly from suppliers.

Then there are the Cayman Islands, where he plans to build and run a 2,000-bed general hospital an hour's plane ride from Miami. Procedures, both elective and necessary, will be priced at least 50% lower than what they cost in the U.S., says Dr. Shetty, who hopes to draw Americans who are uninsured or need surgery their plans don't cover.

By next year, six million Americans are expected to travel to other countries in search of affordable medical care, up from the 750,000 who did so in 2007, according to a report by Deloitte LLP. A handful of U.S. insurance plans now give people the choice to be treated in other countries.

Some in India question whether Dr. Shetty is taking his high volume model too far, risking quality.

"On one level, it's a damn good idea. My only issue with it comes from the fact that if you pursue wholesale volumes, you may give up something -- which is usually quality," says Amit Varma, a physician who serves as president of health-care initiatives for Religare Enterprises Ltd., a publicly listed financial services group in Delhi. Religare is part of a conglomerate that also owns Fortis Healthcare Ltd., a rival hospital chain.

"I think he has reached the point where if you increase volume any more, you could compromise patient care unless backed up by very robust standard operating procedures and processes," Dr. Varma says.

But Jack Lewin, chief executive of the American College of Cardiology, who visited Dr. Shetty's hospital earlier this year as a guest lecturer, says Dr. Shetty has done just the opposite -- used high volumes to improve quality. For one thing, some studies show quality rises at hospitals that perform more surgeries for the simple reason that doctors are getting more experience. And at Narayana, says Dr. Lewin, the large number of patients allows individual doctors to focus on one or two specific types of cardiac surgeries.

In smaller U.S. and Indian hospitals, he says, there aren't enough patients for one surgeon to focus exclusively on one type of heart procedure.

Narayana surgeon Colin John, for example, has performed nearly 4,000 complex pediatric procedures known as Tetralogy of Fallot in his 30-year career. The procedure repairs four different heart abnormalities at once. Many surgeons in other countries would never reach that number of any type of cardiac surgery in their lifetimes.

Dr. Shetty's success rates appear to be as good as those of many hospitals abroad. Narayana Hrudayalaya reports a 1.4% mortality rate within 30 days of coronary artery bypass graft surgery, one of the most common procedures, compared with an average of 1.9% in the U.S. in 2008, according to data gathered by the Chicago-based Society of Thoracic Surgeons.

It isn't possible truly to compare the mortality rates, says Dr. Shetty, because he doesn't adjust his mortality rate to reflect patients' ages and other illnesses, in what is known as a risk-adjusted mortality rate. India's National Accreditation Board for Hospitals & Healthcare Providers asks hospitals to provide their mortality rates for surgery, without risk adjustment.

Dr. Lewin believes Dr. Shetty's success rates would look even better if he adjusted for risk, because his patients often lack access to even basic health care and suffer from more advanced cardiac disease when they finally come in for surgery.

Dr. Shetty, 54 years old, is a lanky and chatty man. He grew up in Mangalore, another south Indian city, the eighth of nine children. Doctors were gods in the Shetty household, swooping in to save his restaurateur father who suffered from chronic diabetes and fell into diabetic comas several times in the young boy's life.

He had already resolved to be a doctor when his fifth-grade teacher told the class that a South African surgeon had just performed the world's first heart transplant. In that moment, Dr. Shetty says he decided to become a heart surgeon.

After graduating from medical college in India, Dr. Shetty trained in cardiac surgery at Guy's Hospital in London, one of Europe's top medical facilities. He had been operating there for six years when the Birla family, leading industrialists in India, decided to start a heart hospital in Calcutta. Dr. Shetty was brought in as the first director.

On returning to India in 1989, Dr. Shetty performed the first neonatal heart surgery in the country on a 9-day-old baby. He also confronted the reality that almost none of the patients who came to him could pay the $2,400 cost of open-heart surgery.

"When I told patients the cost, they would disappear. They literally didn't even ask about lowering the price," he says.

During that time, Mother Teresa had a heart attack, and Dr. Shetty was called to operate on her. From then on, he served as her personal physician. Two pictures of Mother Teresa still adorn the white walls of Dr. Shetty's office, one with white type saying, "Hands that serve are more sacred than lips that pray."

Dr. Shetty set about pursuing a heart hospital big enough to make a difference in a country where most of the people needing heart surgery can't afford it. His father-in-law, the owner of a large construction company, agreed to build and finance a heart hospital in his wife's hometown of Bangalore.

In 2001, the white-washed, red-roofed Narayana Hrudayalaya Hospital opened on 25 acres that had been a marshland around a cement factory.

A lobby with seating for hundreds is encircled by dozens of offices for surgeons to consult with patients. A giant statue of a many-headed deity -- representing gods in the Hindu pantheon -- stands in the center of the lobby.

In a second-floor operating room one October morning, Dr. Shetty finished sewing a new aorta onto the heart of his 11-year-old patient. The process provided an example of how he slashes costs. Four years ago, the sutures would have been bought from a Johnson & Johnson subsidiary. Today they are made by a Mumbai company, Centennial Surgical Suture Ltd.

Four years ago, Dr. Shetty scrutinized his annual bill for sutures -- then $100,000 and rising by about 5% each year. He made the switch to cheaper sutures by Centennial, cutting his expenditures in half to $50,000.

"In health care you can't do one big thing and reduce the price," Dr. Shetty says. "We have to do 1,000 small things."

He says he would also like to find lower-cost versions of his priciest medical equipment. But the Chinese makers that have brought good quality, cheaper machines to market don't yet have enough local service centers to ensure regular maintenance.

So he is still buying equipment from General Electric Co. He pays $60,000 for echocardiography machines, which use sound waves to create a moving image of the heart, and $750,000 for cardiac catheterization labs, which produce images of blood flow in the arteries and allow surgeons to clear some blockages using stents and other devices.

V. Raja, head of GE's health-care business in India, declined to comment on specific pricing, but says Dr. Shetty drives a hard bargain and wrestles some savings because he is such a big customer. Between Narayana Hrudayalaya and another hospital he runs in Calcutta, Dr. Shetty's group performs 12% of India's cardiac surgeries, Mr. Raja says.

Dr. Shetty also gets more use out of each machine by using some of them 15 to 20 times a day, at least five times more than the typical U.S. hospital.

Cardiac surgeons at Dr. Shetty's hospitals are paid the going rate in India, between $110,000 and $240,000 annually, depending on experience, says Viren Shetty, a director of the hospital group and one of Dr. Shetty's sons.

Dr. Shetty was paid almost $500,000 last year, according to the group's audited financial statements.

Here, too, Dr. Shetty finds additional savings on the per-patient cost. His surgeons perform two or three procedures a day, six days a week. They typically work 60 to 70 hours a week, they say. Residents work the same number of hours.

In comparison, surgeons in the U.S. typically perform one or two surgeries a day, five days a week, operating fewer than 60 hours.

Dr. Shetty says doctor fatigue isn't an issue at his hospital, and in general, his surgeons take breaks after three or four hours in surgery. The morning after Dr. Shetty operated on 11-year-old Mahesh Parashivappa, the boy sat in bed in the pediatric intensive care unit, a white bandage on his bare chest.

Virtually all of the 80 beds in the unit were full. K. Parashivappa, the boy's father, a sugarcane worker from a village eight hours away, held a cup of water to his son's lips. He says he's known his son needed surgery since he was born with a congenital heart defect. The boy has never been able to run and play cricket like other children, hobbled by chronic shortness of breath and weakness.

Mr. Parashivappa says he can't himself pay for the surgery, but it is covered by a farmers' insurance plan that Dr. Shetty began several years ago in partnership with the state of Karnataka, which includes Bangalore.

Nearly one third of the hospital's patients are enrolled in this insurance plan, which costs $3 a year per person and reimburses the hospital $1,200 for each cardiac surgery.

That is about $300 below the hospital's break-even cost of $1,500 per surgery.

The hospital makes up the difference by charging $2,400 to the 40% of its patients in the general ward who aren't enrolled in the plan. An additional 30% who opt for private or semi-private rooms pay as much as $5,000.

The father, in an untucked brown shirt, raised both hands to offer the traditional Indian greeting, "Namaste," to Dr. Shetty as the hospital head stopped by his son's bed. "Thank you for giving my son his life back."

.... i am quite familiar with this topic from my years as product group manager in the pharmaceutical industry, in fact i was in a case where a non FDA approved experimental substance from the research pipeline was handed out to European top medics (university clinics) for special cancer treatment of terminal ill patients. We got a special permit to “circumvent the approval sistem” because all involved top experts considerd it “obsolete and non applieable for terminal illness” even then – that was back in 1994 in Vienna Austria… Interference freedom in pharma research and fast track for new treatments has just increased its urgency since then. A big problem is also this nasty habit of american patients to sue their doctors … for all kind of real or imagined failure… medic science is not always exact science where you can do double blind experiments on geneticly identcial patients to measure “successfull” or “correct” treatment. Even many established treatments are just a “educated guess” this opens the door for endless multi million law suits that are fought on base of “diverging expert opinions” in courts where the judge has no idea of the subject…so moving out of jurisdiction is definitly a way to fast track things in advanced treatments with a high uncertainty component. At the moment the sistem puts a “slow buerocratic apparatus” in charge of the decision what dose of uncertainty is the correct one. In a future this decision might rest in the patients hands supported by a “ethics commission” of medic experts. You might want to choose a different dose of treatment risk for “flu treatment of healthy babies” than for “last chance treatment of terminal ill cancer patients”. The current sistem is not flexible enough. A “blockchain voting sistem” might help to find “politicly correct” decisions without going over the sclerotic FDA approval sistem.

Interference free medical service may just be a part of a bigger quest to independence....

concretesubmarine.activeboard.com/t58935854/subdue-to-nobody/

Get a foothold in ocean colonization:

concretesubmarine.activeboard.com/t49529137/oceanic-frontier-develpment-investment-foothold-in-ocean-col/

The Captain Nemo Lifestyle:

concretesubmarine.activeboard.com/t43942461/the-captain-nemo-float-out-seasteading/

Why oceanic business is the next big thing to come:

concretesubmarine.activeboard.com/t56680633/the-reasons-why-oceanic-business-is-the-next-big-thing-to-co/

Ocean sphere fish farming:

concretesubmarine.activeboard.com/t55433095/ocean-sphere-the-next-wave-of-sustainable-fish-farming/

Ocean colonization gallery:

imulead.com/tolimared/concretesubmarine/picturegallery/concept/

Big things have small beginnings ocean colonization transition, potential:

concretesubmarine.activeboard.com/t58002383/big-things-have-small-beginnings-transition-capability-key-f/

Sustainability on Planet Earth only the oceans can safe us:

concretesubmarine.activeboard.com/t58921987/sustainability-population-growth-consumption-growth-ocean-co/

Free spirited oceanic lifestyle global mobility:

concretesubmarine.activeboard.com/t58935854/subdue-to-nobody/

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This research looks really interesting. Do some universities and students take part in it? It would be a great experience for the final paper, I always had problems with writing, so I needed to pay for a research paper, but now I want to upgrade my skills. I know a lot of students have the same problem, they advised me www.paperial.com this project, which always helped me. So, now I need some good experience of being a part of the project or reading good works.

-- Edited by IsabellaButts on Wednesday 12th of February 2020 03:21:51 PM

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