Medical Tourism und Globalisation - US Perspective

world-health Medical tourism is choosing to travel outside your local area for medical services. International medical services are “any coordinated out-of-country medical service” that requires a patient to travel to a treatment destination. The medical tourism industry was born as soon as it became clear that lower cost environments of emerging economies could offer first-world care at third-world prices, as well as solutions not available in his or her home country.

Medical tourism is important to people who can’t afford, or cannot obtain, quality health care solutions in their home environment. Knowledge about medical solutions abroad is also very important to people who relocate to live elsewhere (“expats”). These folks need to figure out how to manage their healthcare needs, locate quality health care options and distinguish clinical quality from snake oil solutions.

Medical Tourism and Health Travel Today
In the last few years – and particularly since the recession – the pent up demand for cost effective treatment solutions has permeated to the consciousness of mainstream healthcare consumers, medical service providers and insurance companies. Whereas in the early 1990’s medical travel was reserved for rich, upper class patients, NOW DAYS, we all agree that travel-for-treatment is EVERYONE’s domain. We have come to terms with the fact that it is “OK” to source medical treatment from different corners of our global village world. The era of global healthcare resource sharing has arrived.

The Internet has removed all barriers to healthcare information. Knowledge that was historically the sole domain of physicians has found its way into the hands of patients and empowered them as knowledgeable healthcare consumers.
Throughout the world, medical excellence is found in major metropolitan areas that have great academic infrastructure producing competent physicians and researchers. Some of America’s best known healthcare brands are expanding their presence to countries that are desirable retirement destinations. The proliferation of the brand has an immediate positive effect on quality of medical care.

For example, Johns Hopkins Hospital in Baltimore is aligned with Hospital Punta Pacifica in Panama City and with Clinica Las Condes in Santiago Chile. To understand, and value, all choices offered under the umbrella of “Medical Tourism”, one should consider (and contrast) the experience of accessing care from a hospital in your city of residence.
Other than for routine checkups, typically you might visit your doctor or hospital because something hurts, some symptom is alarming, or something just needs to be fixed. You are not thinking “what do I want to experience and can I get more value out of this”. You’re just trying to get it over with and get well.

That limited concept of a health care experience changes with medical tourism. You’re not restricted to cookie-cutter processes. Let me paint a different picture for you. First, let’s talk about why people travel and then define the “popular” definitions of Medical Tourism through case studies of real experiences.

Why People Travel
People travel around the world from and to locations such as India, Mexico, Costa Rica, Thailand, and the US to find the best medical services and to be treated by doctors whose expertise and reputation are worth the trip.

Seven Primary Reasons to Travel for Medical Care
There are many reasons to travel abroad for medical care. The Primary reasons are cost, quality of care, availability of alternative treatments, privacy, physician expertise and technique, the allure of a “medical vacation”, and often the amenities of more personalized care and luxurious accommodations.
Cost Savings
It turns out that the US medical industry is terribly overpriced. There is a booming market of people who choose to travel abroad for high cost procedures. Others will have medically-light procedures done and save enough money to pay for a vacation abroad. A hip replacement in the US that can cost $45,000 to $92,000 you might get in India for $9,000. Not comfortable with the long air flight to India? CostaRicanMedicalcare.com just arranged for a 64 year old Sarasota, Fla. Resident to travel to Costa Rica for her hip replacement for a cost less than $15,000 – all inclusive including the surgery, recovery facility, airfare and accommodations.

So, you see, it’s not always about price, it’s about matching your comfort level – and your situation – to the quality choices available to you as these examples show
First Time Dental Tourist Saves $30,000… and she’s shouting about it! – Listen to the live interview of a Canadian woman who saved $30,000 in dental care. It’s a great example of dental tourism. First Time Medical Traveler Journals Experience – In the U.S. the cost of a crown is $1,000, in Mexico it’s $250.
Health Savings Accounts and Health Travel in Costa Rica – Insurance Executive paid $1,000 for an Executive Plan Physical that his doctor in the States said would have cost him $5,000 – $6,000.
What’s it Like – Rushing to The Dentist in Brazil? – Expat compares the price of dental work done in Brazil for $320 vs. $4,000 in the U.S.
A Better Deal For US Patients in Canada – Washington State patients save 30 to 70% off the cost of medical procedures in the States by crossing the Canadian border to The False Creek Healthcare Centre in Vancouver, B.C.
“Five Dollars, Please!” – It’s the day-to-day stuff that sometimes reveals the most about health care abroad. At least that was the experience of Angie Johnson, 71, of Panama City, Panama.

Quality of Care
You might think that you have to compromise quality of care for these cost savings There are international bodies such as JCI, patients beyond borders, and ISO that provide certification of medical facilities and providers. The American Medical Association has also recently released nine guidelines for use of medical tourism.

It speaks volumes about quality of care when U.S. insurance companies are now offering insurance products to employers that include options for offshore medical care. Medical Tourism pilot programs include Anthem Blue Cross and Blue Shield (WellPoint), United Group Program, Blue Shield and Health Net, Blue Cross Blue Shield. In addition to JCI and ISO certified medical facilities and providers, outbound patients from the U.S. have an option to travel to U.S. providers (at international sites) or their affiliates and partners.

Role of health plans to incentivize medical travel
U.S. health care organizations that are involved in some of the better-known international collaborations involving medical tourism are Cleveland Clinic, Cornell Medical School, Duke Medical School, Harvard Medical International, Johns Hopkins International, Memorial Sloan Kettering, University of Pittsburgh, and Columbia University Medical School. (Medical Tourism, Update and implications, 2009 6/16, a product of The Deloitte Center for Health Solutions). Global leaders in the industry have built world-class facilities with world-class doctors while bringing back a sense of customer service to medicine. The ability to shop this global market allows consumers to make personal choices about the treatments that are best for them and fit their needs

Availability of Care
A third incentive for medical tourism is availability of alternative treatments. I interviewed a Parkinson’s patient who was nearly wheel chair bound. He had watched his father die a slow and painful death in a wheelchair from the same disease. After some research he found a clinic in Mexico providing Stem Cell therapy. After only three weeks of treatment, he was walking upright and without a cane again. This same therapy was not available in the US. Mexico: A Parkinson Patient Walks Again After Stem Cell Therapy.

Privacy
Here are three common scenarios where privacy is a consideration:
When you have tests, procedures and treatments done abroad, at your own expense, you have control over what you want to disclose on your medical records.
Part of a “boutique” medical experience is recuperating – away from home, away from business and home schedule demands – and where you have complete anonymity.
Also, while women are more prone to “talk” about their cosmetic surgeries, men are more inclined to value their privacy about procedures done abroad – and so it’s not surprising that it’s common for men to have procedures done while away on vacation or in conjunction with a business trip. Even major hotel chains are catering to the privacy of medical tourists. The Ramada is doing it right – a blueprint to follow when catering to medical tourists.

Physician Expertise and technique
I asked a doctor who trained other doctors in advanced techniques, why he would train people to compete with him. His answer was “I can teach them which tennis racket to use, but that doesn’t mean they can play the same game.” Here are some examples of doctors and clinics who are known for their specific areas of expertise:
Vibroliposuction – Why People Are Willing to Travel For it! – weekend and medical vacation junkets to Costa Rica for specialized liposuction techniques.
Eye Surgery in Panama by a Celebrated Doctor – How to find an eye surgeon on top of their game.
Medical Tourists Flock to Canada for Best Quality Hair Transplants – Nearly 80% of their patients travel from Miami, New York, London, Spain, Australia, Italy and Libya to have their surgeries performed by these two renowned surgeons.

Can Your Dentist Pass the Litmus test? – “too many dentists are not up to date with technology, don’t have quality control over the dental product, and don’t have the equipment to provide their patients with the best choices.”

Medical Vacations
A trip and a treatment – often paying for a family vacation with the money you save having needed (or preventative) procedures done abroad. Holistic Wellness Travel a/k/a Spa Destinations also falls within the “medical vacation” category.'Mexico: Cross-Border Dental Care In Los Algodones, (Yuma, AZ border crossing) – my own personal “medical vacation” experience. I can’t wait to have more!

Amenities
Up Close And Personal With Thai Healthcare – doctors making house calls and a team of nurses attending to your every need.
Medical Tourism in India: Where Major US Health Insurers Send Their Insured. – Apollo Hospital’s Platinum Suites with internet café and 24/hr nurse attendants.
A Hotel in Costa Rica Leaves a Lasting Impression – a luxury hotel picks up the tab for EMT visit.

Decreasing Risks of Health Travel Complications
Complications can escalate and eat up any cost savings dramatically. This is where a good medical tourism facilitator is worth his or her weight in gold. Safety Protocol for Medical Tourists – Good Surgery Recovery Requires In-Country Post-op Care. Organize your personal medical records What’s in your wallet may make a difference . . . between life and death – or get help doing it – Online Personal Health Records the Easy Way.

Tips regarding subjective expectations of Medical Tourists
This is common sense, but it may help you identify some risks and take adequate precautions.
How to Pick a Dentist in Mexico – Trust But Verify! – Be careful what you ask for.Medical and Dental Travel – “Meeting Client Expectations”

How US Healthcare Reform is impacting health insurance costs
The pressure on consumers continues to grow. Monday, the Kaiser Family Foundation released a survey showing that people “who buy their own health insurance report the most recent rate increase requests have averaged 20 percent…,” Kaiser Health News reported.

“The foundation surveyed just over 1,000 people who don’t get insurance from their employer, finding that 77 percent reported an increase with their current or previous insurer. Most paid the increase. But 16 percent switched to less expensive plans” (Appleby and Schiff, 6/21). (KHN is a project of the foundation.)

The National Association of Health Underwriters (NAHU), according to a NAHU member, is stating that some large self-insured companies like AT&T, John Deere and Caterpillar, for example, may opt to pay the penalty and not provide insurance to their employees under the current restrictions and regulations.

The example given was that if AT&T with 280,000 employees chooses to drop their employee insurance coverage (for which the company pays 1.5 billion dollars/year) and instead pay the penalty for not providing insurance they would recognize a windfall profit of seven hundred fifty-five MILLION dollars. That’s a sum that qualifies to be labeled “a deal you can’t refuse”.

In the U.S., the volatile health care climate continues to predict stormy weather ahead for our citizens and their family members. How to Weather the Medicare Insurance Crisis.

How US Healthcare Reform Impacts Medical Tourism
What Health Reform Takes Away, Medical Tourism Gives Back – Reflections by leading experts in healthcare on the impact of Health Care Reform on Medical Tourism.
Europeans Weigh in on How U.S. Healthcare Reform Boosts Medical Tourism – The Venice Declaration on Medical Travel