Nancy Kuhlman has faced the prospect of undergoing open-heart surgery for most of her life. Diagnosed with a floppy mitral valve when she was in kindergarten, she’s had batteries of tests and medical consultations ever since.
Last year, the inevitable caught up with the 58-year-old restaurateur from Pagosa Springs, and she could postpone valve replacement surgery no longer.
She faced a procedure that typically requires opening her chest, sawing her sternum, replacing the valve and then resting for eight to 10 weeks to recover.
On top of that, the estimate for hospital care alone – not including fees for the surgeon, the anesthesiologist and lab tests – was $150,000. Because Kuhlman has been unable to get health insurance for the past 15 years because of her heart condition, the expense threatened to overwhelm the family.
Still, she didn’t have much choice. So she met with a Denver surgeon and began researching the hospital he recommended.
“It didn’t meet basic standards for cleanliness,” she said. Her friend’s husband had gone there for surgery, caught a staph infection and nearly died.
“No way would I go there,” she said.
She was investigating other hospitals last summer when she saw a report on heart surgery on “Good Morning America.” She couldn’t believe what she was seeing … in India.
“I was blown away by how clean the hospital was and how impressive the operating theaters were,” she said.
Then she heard about Dr. Naresh Trehan, the head of the Escorts Heart Institute and Research Center in New Delhi, and she became convinced that this was the best place in the world for her.
The price – including physicians fees; tests and lab services; two weeks in the hospital; housing, meals, even laundry service for her husband; and shuttle service to the airport – is $13,350. Even with round-trip air fare at $3,300 for the Kuhlmans, it comes to less than 10 percent of the cost of the procedure in Denver.
Now, I know what you’re thinking.
I was too.
For years Americans have been told that they have the best medical care in the world. It’s true, isn’t it?
I called Dr. Lawrence Hergott, clinical director of the cardiac and vascular center at the University of Colorado Hospital, to ask his opinion.
The answer: maybe.
“Evaluating the quality of care is not a matter of ethnicity or country,” he said. The quality of medical care varies widely in this country. Anybody undergoing a procedure like heart surgery should investigate the hospitals and physicians and make an informed decision.
“Few people here ask any questions,” Hergott said, so the care they receive can be terrific – or awful.
Kuhlman did ask questions, though, and while it’s difficult to compare the data assembled by international hospital accreditation agencies with that from domestic medical oversight sources, she’s confident in what she found.
Escorts’ mortality rate was 0.8 percent. The infection rate was 0.3 percent.
The hospital also does more mitral valve replacements than the Cleveland Clinic, widely considered the top U.S. heart center.
Trehan is no slouch in the international medical community either. The past president of the International Society of Minimally Invasive Surgeons trained at New York University was a prominent heart surgeon in Manhattan for 20 years, and performs the state-of-the-art “port access” heart surgery, which eliminates the need to saw through the sternum.
That technique, which reduces recovery time by about two thirds, has not been available in Denver.
“The best place for me to have this done is India – regardless of the price,” said Kuhlman. “I have no hesitation.”
The Kuhlmans leave Wednesday for New Delhi. They’ve scheduled extra time so they can see the Taj Mahal and its magnificent mausoleum.
The symbolism should not be lost on the magnificently extravagant – and doomed – U.S. health care system.
Diane Carman’s column appears Sunday, Tuesday and Thursday. She can be reached at 303-954-1489 or dcarman@denverpost.com.
