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Medscape
2 days ago
- Health
- Medscape
Why Medical Tourism Can Make More Sense Than US Care
This transcript has been edited for clarity. Who out there has seen the movie Super Size Me , where the late, great Morgan Spurlock eats only McDonald's for 30 days? If you haven't seen it, you should. It's wild. Anyway, Spurlock uses this type of experience-based filmmaking to also teach us about value-based healthcare in his show Inside Man , when he goes to Thailand to get worked up for knee pain. Spurlock, like so many Americans, especially those with musculoskeletal injuries, thought he needed an elective procedure. He called all these clinics around New York City, but he wasn't finding much transparency in prices. What he did learn was that the costs were all over the place and there were long wait times. Instead, he plays medical tourism and goes to Thailand to get his care. The Price of Clarity: What $4300 Gets You Abroad For $400 and in only 1 day, he got two expert consultations, an MRI, and found out that he did not need surgery. Spurlock went even further and got more lab work, a cardiac stress test, a capsule colonoscopy, and more consultations. The entire thing, including airfare and accommodations, cost him $4300. What can you get in American healthcare with $4300? It wouldn't include a trip to Thailand. [ Sigh ] Medical tourism. Now, granted, Spurlock was overseas, but this is the definition of value-based care. He had transparent, seamless, coordinated care with the focus on outcomes and not just volume. Over here, it's a completely different story. Meet Mya Neehurtz: A Very American Healthcare Story I came across an email titled "The Surgeon's Record," by editor-in-chief Dr Ben Schwartz, that goes through a hypothetical case showing just how fragmented and complex musculoskeletal care can be. In the post, which can be viewed on his Dem Dry Bones Substack, there's a fictional character named Mya Neehurtz (a great name) who has knee pain, similar to Morgan Spurlock and millions of Americans. The hypothetical journey goes like this. Mya sees her PCP for knee pain, who orders an ultrasound and an x-ray, and obviously, she faces two facility fees because the imaging center is not where her doctor is. Some of the results show bone arthritis and a potential bone mass. The PCP is like, This isn't my area of expertise. Let's order an MRI and get your referral to an orthopedic surgeon . Well, all the surgeons are busy. She can't get in for months unless she goes out of network, so she pays out of pocket. The surgeon is like, Wait, I can't access these images because the systems don't communicate. Also, why did your doctor order all these tests? This is all while the surgeon is really backlogged, so he reorders some images and tries Mya out on noninvasive treatments. Her knee pain continues, and finally, after months, she gets a knee replacement. Examples like this happen all the time in American healthcare with chronic and acute illnesses. In Mya's case, in this example, there's a lack of shared decision-making, there's poor access to subspecialists, and evidence-based guidelines may or may not be followed. Even the technology isn't properly communicating, and I know you could probably relate with this. I see these barriers that happen with patient care all the time. What Is Value-Based Care, Really? Value-based care isn't just a buzzword. According to many experts, including those at the Commonwealth Fund, value-based care is all about getting patients the right care at the right time, while minimizing all these unnecessary and fragmented steps. Value-based care ties provider payments with the quality of care performed, with additional focuses on cost efficiency and equity. Improving health outcomes while reducing waste — what a win. Who wouldn't want that? Now, the Centers for Medicare & Medicaid Services (CMS) has several value-based programs in place, including the End-Stage Renal Disease Quality Incentive Program, Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program. And these programs have three goals in mind: Better care for individuals Better health for populations Lowering cost Lower cost — what a concept. According to a 2019 JAMA article, up to $935 billion is wasted annually on unnecessary services. If you look at this example from Dr Schwartz and then you amplify it across all states and include many more conditions, you can see how this adds up to a large amount of money and time wasted. So, What's Holding Us Back? I agree with Dr Ben Schwartz when he says that we have the capability to have these integrated medical clinics right here. They don't have to just be medical tourism fairytales of places like Thailand. We can have all-inclusive surgery centers that have state-of-the-art, digital health support, and that have everything you need under one roof, including subspecialists you may refer to — imaging, PT, OT, lab work, and more. For now, this seems like the diamond-in-the-rough exception and not the rule. Yes, we need more advocacy and lobbying. As suggested by Dr Maria Ansari in an article posted on the AMA website , we need more data looking at health disparities and actionable items, and then we could potentially follow a payment playbook that involves identifying the right patient population, good benchmarks, and then having transparent feedback. The reality is that we have all the parts to the solution; we just need to put the puzzle together. Now, I'm obviously simplifying a very complex system that is rooted in bureaucracy, but who am I? I'm just a burned-out physician. I'm not a health policy researcher. I want to hear from all of you. How far are we, really, from having a more efficient, value-based healthcare system? What are the barriers? Are there any initiatives that you have come across that work? Comment below.
Daily Record
27-06-2025
- Entertainment
- Daily Record
Last chance to watch award winning crime comedy with 'best actor out there' for free
Fans have just days to watch it before it's taken down BBC viewers have a limited time left to stream a highly-rated crime comedy film for free. BlacKkKlansman is currently accessible on the BBC iPlayer at no extra charge. However, it's set to be taken off the platform on July 8 as announced by the broadcaster. This means that, as of now, movie enthusiasts have less than a fortnight to take advantage of this opportunity. The film narrates the story of Ron Stallworth, an African-American detective who sets out to infiltrate his town's local chapter of the Ku Klux Klan, a white supremacist hate group. The storyline is based on real events and the autobiography of the actual Ron Stallworth, a black police officer who managed to infiltrate a chapter of the Ku Klux Klan. In the film, Stallworth is played by John David Washington, known for his roles in Tenet and The Creator and also being the son of Denzel Washington. Adam Driver portrays a fellow detective assisting Stallworth with his mission, while Topher Grace plays the role of David Duke, who was the grand master wizard of the Ku Klux Klan during that period, reports Birmingham Live. Despite its historical roots, some scenes are dramatised for impact and deviate from absolute accuracy. Nonetheless, director Spike Lee received accolades from both fans and critics for his handling of such a topic. When it first premiered in 2018, one critic described it as: "Lee's most purely entertaining film since Inside Man in 2006, BlacKkKlansman has a timeliness that taps into an imperative national conversation." Another critic agreed, noting: "Blackkklansman helps Spike Lee finally land in the Best Director field where he deserved a place years ago." Although the film did secure an Oscar for Lee, the recognition came in the Best Adapted Screenplay category rather than for directing. Reflecting on the impact of the film, one viewer observed: "An all time great movie on American history and its future. A terrific plot and acting I can't say much more then this. It is a must watch for anyone that likes films about the evils in the world. Not so much as a eye widener as much as a of a jaw dropper. Just fantastic". The central performances were also lauded by another viewer, who praised: "John David Washington is possibly the best actor out right now. His father has an aura that steals any scene and role, but John's range is phenomenal. He has the ability to make you forget who he is in the character, but love the character. He and Adam driver work so well together. Great movie." Further acclaim for the film came from another individual who commented: "BlacKkKlansman masterfully blends biting satire with powerful social commentary, delivering a gripping and thought-provoking narrative that is both entertaining and deeply resonant."
Daily Record
23-06-2025
- Entertainment
- Daily Record
'Brilliant' Netflix thriller starring Scottish icon but fans only have days to watch
Netflix is set to lose one of the most talked-about crime series of recent years - and viewers have until the beginning of July to catch it before it leaves the platform Netflix subscribers have until the start of July to watch one of the most discussed crime series in recent times before it departs from the platform. Comprising just four episodes, this tightly woven mini-series delivers a comprehensive psychological thriller experience in less than four hours - making it perfect for those seeking something both brief and intense. Inside Man intertwines two seemingly unconnected narratives: one tracing a prisoner on death row in the United States, and the other focused on a village vicar in England. The link between them is gradually unveiled as the plot builds suspense across continents. Audiences meet Jefferson Grieff, an ex-criminology professor found guilty of murder, who now spends his remaining days assisting in solving intricate cases from within a maximum-security prison. Simultaneously, across the pond, Reverend Harry Watling finds himself entangled in a moral and legal quandary after an unforeseen incident at his residence sparks a domino effect that quickly spirals out of his grasp. The drama was penned by Steven Moffat, renowned for his contributions to Sherlock and Doctor Who, and initially premiered on BBC One in 2022 before being acquired by Netflix for international viewers, reports the Express. The ensemble includes Stanley Tucci portraying Grieff and David Tennant playing Watling, with additional performances from Dolly Wells as a tenacious tutor, Lydia West as a journalist striving to expose the truth, and Atkins Estimond as Grieff's devoted assistant and fellow prisoner. 'Inside Man' has certainly stirred the pot since its release, collecting varied feedback from critics and audiences alike. While some raised eyebrows over the believability of its plot, a good number of viewers have lauded its bold storytelling, compelling performances, and the deep questions it delves into. An impressed viewer commented on Google Reviews: "I thoroughly enjoyed this show. I enjoy absurdism and morality plays, which is what you'll get with Inside Man. Life is absurd and people are absurd and act in strange ways all the time in real life." Another commended the series's writing and acting chops, remarking: "Utterly brilliant! I am very particular about what I watch and what I like and am a fan of prestige TV". Highlighting the show's fine craftsmanship, another viewer proclaimed: "This is prestige TV at its finest! Steven Moffat once again comes through with a riveting story and some of the best dialogue around. All the actors gave stellar performances but Atkins Estimond was the star of the show as far as I am concerned." The programme's intricate moral dilemmas haven't gone unnoticed either. Declaring it as remarkable, a reviewer stated: "Absolute genius," followed by "A four-hour long thriller and suspense. A real thriller. Sometimes doesn't matter how good we are, how amicably we live with the society, just one moment on a bad day can change and destroy our entire life and the ones we are close to." Note that 'Inside Man' will be departing from Netflix UK come July 1, and remains up for grabs streaming-wise until that date.
The Hindu
02-06-2025
- Entertainment
- The Hindu
Watch: Suparn Verma on wokeness, dark stories and quiet dissent
Watch: Suparn Verma on wokeness, dark stories and quiet dissent: Inside Man Bollywood's genre-chameleon speaks! From Rana Naidu and The Trial to Banda and The Family Man, Suparn Verma has become a defining voice in Indian streaming. In this exclusive interview with Sudhish Kamath for The Hindu, Suparn opens up on Inside Man Episode 2: The creative grind: From journalist to screenwriter to showrunner The woke lens vs. storytelling freedom: Can gray characters still survive cancel culture? The identity of Indian cinema: Why it's NOT fair to compare it to Hollywood The future of OTT: How success has let him stop chasing validation Dark characters & moral responsibility: Why showing consequences matters more than appeasing critics Working across LA, Telugu industry & Hindi cinema: A truly pan-Indian (and global) creator Cinema as history: Why understanding society is essential to telling real stories Against flag-waving, for quiet rebellion: How he navigates censorship with craft 'We are not idols. We're craftsmen.' And much more. Presentation and editing: Sudhish Kamath
Yahoo
21-05-2025
- Entertainment
- Yahoo
Spike Lee Says ‘Highest 2 Lowest' Is Potentially His Last Collaboration With Denzel Washington: 'This Is It—Five'
'The last time I was in this room, I was apologizing for the f*ck-up,' filmmaker Spike Lee joked this morning as he walked into the press conference room in Cannes. The legendary New York filmmaker was referring to 2021, when he served as the Cannes jury president and prematurely announced Titane as the Palme d'Or winner during the closing-night ceremony. More from Deadline Denzel Washington Appears To Have Altercation With Photographer On Cannes Red Carpet Breaking Baz @Cannes: Spike Lee Croons Rodgers & Hammerstein On The Beach But Tunes Out As Talk Turns To Him Making A Movie Musical His Next Project Lynne Ramsay On How Critics Are Misreading Her Buzzy Cannes Title 'Die My Love': "This Postpartum Thing Is Bulls***t" Lee is back here in Cannes with his latest feature, Highest 2 Lowest, a modern 'reinterpretation' of Akira Kurosawa's 1963 classic High and Low, which was itself based on the novel King's Ransom by Ed McBain. While the original follows a shoe company exec who becomes a victim of extortion when his chauffeur's son is kidnapped by mistake and held for ransom, the new film, set in contemporary New York City, sees a music mogul played by Denzel Washington contend with a similar plot. From Apple and A24, the film reunites Lee and Washington for the first time since Inside Man back in 2006. The duo has worked together five times, their credits are including Mo' Better Blues, Malcolm X, and He Got Game. 'Denzel and I didn't know that our previous film, Inside Man, was 18 years ago. We were surprised because it felt like yesterday. But we didn't miss a step,' Lee said of working with Washington, who received an honorary Palme d'Or before last night's premiere screening of Highest 2 Lowest. RELATED: 'I think this is it — five,' Lee added of his collaboration with Washington. 'He's been talking about retirement, even though he's just done another deal. Five films together, they stand up.' This is Lee's sixth time in the Cannes Official Selection, and Monday's premiere marked 36 years to the day since his first appearance with Do the Right Thing. During the presser, Lee was asked about the critical response to that film back in 1989, particularly around critics who said it would cause riots. 'I've had a great experience with this festival, and the people who had their various opinions about Do The Right Thing had nothing to do with the festival. It was just the press,' Lee said. RELATED: 'They said Do the Right Thing would cause riots and Black people would lose their minds,' he added. 'They were telling people to hope to God this film didn't open in their neighborhood. It was pure blatant racism to suggest Black people couldn't make the distinction between what's on the screen. They all misread it, and none of them admitted that they f*cked up.' Highest 2 Lowest was shot across New York, with elaborate action scenes in the Bronx, set against the backdrop of Yankee Stadium. During the presser, Lee was asked about shooting in New York and how he thinks the recent drop in production in the city could be resolved. 'People are hurting, people whose lives are dependent on working in the film industry,' he said. 'The guy [Donald Trump] just said he wants to put a tariff on films made outside the United States. I don't know how that's gonna work. But I don't have the answer for that.' The filmmaker said he simply feels lucky to have been able to shoot several films in New York, adding that he often has pushed back on attempts to make him shoot his New York-based films outside the city. RELATED: Full List Of Cannes Palme d'Or Winners Through The Years: Photo Gallery 'For Do the Right Thing, they wanted us to shoot that film in Baltimore,' Lee said. 'Get the f*ck outta here. We were never doing that.' Slated to hit select theaters August 22 before arriving on Apple TV+ on September 5, Highest 2 Lowest is written by Alan Fox and Lee. Todd Black produced for Escape Artists, alongside Jason Michael Berman for Mandalay Pictures. Exec producers included Lee for 40 Acres and a Mule Filmworks, and Mandalay's Peter Guber, as well as Juniper Productions' Matthew Lindner, Chris Brigham, and Katia Washington. Mandalay's Jordan Moldo served as co-producer. Best of Deadline Sean 'Diddy' Combs Sex-Trafficking Trial Updates: Cassie Ventura's Testimony, $10M Hotel Settlement, Drugs, Violence, & The Feds All The 'Mission: Impossible' Movies In Order - See Tom Cruise's 30-Year Journey As Ethan Hunt Denzel Washington's Career In Pictures: From 'Carbon Copy' To 'The Equalizer 3'
