People are still touring the world when it comes to finding affordable health care.
As the cost of health care services in the U.S. continues to climb, and more people are left in the cold when it comes to health insurance coverage, consumers are opting to travel to another country for medical procedures—and reap a cost savings of more than 70 percent. But in a shaky economy when people are skipping essentials and cutting back on prescription drugs and life insurance does medical tourism still make sense, especially if more Americans have access to care due to the passing of The Patient Protection and Affordable Care Act (PPACA).
Industry leaders say the medical system will be further strained from the passing of the health care reform act because this will open the door to the millions of Americans who had previously been uninsured.
“You’ll see a public and private system unfold over time in the U.S.,” predicts Josef Woodman, author of Patients Beyond Borders. “Those who can’t afford the cost of out-of-pocket care will end up in the public system which will deteriorate. What this means is access to good care will become a problem and more people will cross borders in search of quality care.”
Americans with health insurance have traveled overseas because of rising deductibles and steep out of pocket costs that make it difficult for them to get the same procedures here.
Some of the most common procedures are dental surgeries such as crowns and implants as well as elective procedures like plastic surgery and weight-loss procedures. Orthopedic procedures like hip and knee replacements are also quite popular, in addition to cardiac care. And still, people travel abroad to receive treatment that has yet to be approved by the FDA in the U.S., such as stem cell therapy.
A study published in December 2010 by the Journal of General Internal Medicine reported that the most common destinations for medical treatment were India, Costa Rica and Thailand. However, other emerging medical tourism countries include such places as Greece. For instance, in Crete, “medical tourists” from the United Kingdom seek out care to avoid long waiting lists for medical treatment in the UK. In addition to common surgeries provided at other medical tourism destinations, hospitals in Crete provide treatment for chronic diseases such as kidney disease and also offer In Vitro Fertilization (IVF) at a fraction of the cost in the U.S.
Medical tourism rebounding
Medical tourism slowed dramatically when the recession began in December 2007, but analysts predict it’s on the rise again.
The 2009 Deloitte Center for Health Solutions survey found that medical tourism fell in 2008, by the end of 2009 business would be up again by 20 percent. The study had also predicted patients traveling overseas for medical care would soar 35 percent annually starting in 2010.
Industry leaders originally thought the recession would cause people to pursue cheap medical procedures out of country. But instead, they discovered consumers held off on procedures which caused the medical tourism industry to decline.
In other cases, more people are without insurance and simply didn’t have the funds to travel internationally for care.
“All of the volumes were down,” said David Boucher, president and chief operating officer of Companion Global Healthcare in Columbia, S.C. “People put off knee and hip replacements and anything that was considered an elective procedure.”
Amazing cost savings
Now that the economy is rebounding, the prices overseas are too enticing to ignore, proponents of medical tourism say.
For example, a $12,000 facelift in New York could be as little as $2,500 in Panama. A heart bypass costs from $70,000 to $133,000 in the U.S., according to data from Woodman. But that same procedure is just $7,000 in India and $10,500 in Panama.
A hip replacement costs about $33,000 to $57,000 in the U.S. but the same procedure in Panama is just $5,500. In Thailand, a hip replacement would cost even less, respectively, $12,700.
Gastric bypass in the U.S. costs $35,000 to $52,000 but costs just $9,300 in India and South Korea. Prostate surgery runs $10,000 to $16,000 in the U.S., but is as low as $2,750 in Taiwan.
Woodman points out that the cost for procedures overseas doesn’t include airfare or hotel stays and urges consumers to factor in at least $5,000 for flight and lodging. Even so, some travel agencies, such as HRG Vacation Rentals in Costa Rica, provides “medical vacation” packages that include a stay at a resort while the person is recovering from surgery.
Insurance issues improving
Insurance companies typically don’t cover procedures overseas, but Boucher says that in the last year this has started to change. His company, a medical travel coordinator is a subsidiary of BlueCross BlueShield.
His firm works with 300 employers who have changed their medical plans to include deep discounts for persons who travel overseas. Instead of a typical 80-20 plan (a health plan with a coinsurance provision where the insurance company pays 80 percent of medical costs and the insured pays 20 percent of medical expenses), a company may be willing to cover a knee replacement at 100 percent internationally as well as give employees two free plane tickets.
Even if a person’s employer doesn’t offer these plans, they should still research their insurance company to see if it covers international procedures.
For instance, 31 hospitals in 14 countries are currently covered by Blue Cross Blue Shield.
The Deloitte study also showed that a number of insurance companies were in the midst of pilot programs that include international treatments. The study cites that United Group (United Healthcare) has a program that actively promotes medical tourism to more than 200,000 individuals and encourages them to seek care at Bumrungrad International Hospital in Bangkok,Thailand and Apollo Hospitals in India
Take Caution
Despite this growing niche, many doctors and dentists in the U.S. urge their patients against medical travel. For instance, New York-based dentist Dr. Mark Schlesinger cautions patients against going overseas because he’s seen problems.
He recalls a horrible situation where a patient received implants in India but couldn’t get the implant tightened in the U.S. – because it was a different type of drill used there. The man had to fly back to India for a five-minute procedure, Schlesinger says.
“People who have had bad experienced with it aren’t open to talk about it so you don’t hear about the bad experiences as much as the good ones,” he said. “I’ve seen some absolute disasters and the people always regret it.”
Independent insurance agent Bill Weagle, who is associated with Barber Insurance in Santa Rosa, Calif., also has his doubts about medical travel. He fears medical travel isn’t helping the people who need it the most.
“The people who do this are prone to traveling and they usually have the money anyway,” he says. “The people who are really struggling and can’t afford the insane medical costs don’t have the general knowledge to travel around the world to find the right doctor and get a good deal.”
Do your homework
Picking the right doctor in the U.S. can be a challenge and in a foreign country because mistakes could easily happen without the proper amount of research. Woodman urges consumers to discover whether the international hospital is Joint Commission International (JCI) Accredited. A Joint Commission International Accreditation means that foreign hospitals go through a stringent evaluation process to assure that they meet standards for quality care. The JCI is an independent, not-for-profit organization that has accredited more than 15,000 hospitals in the U.S.
Woodman says nearly 400 hospitals internationally are now JCI Accredited.
He says patients should make sure they understand exactly what type of equipment is used overseas and whether doctors in the U.S. can handle follow up procedures, if necessary.
Patients should also ask about success rates. For larger surgeries such as orthopedic surgery success rates of 98 percent are on target with the U.S.’s rates. He also urges patients to quiz hospitals regarding how many procedures they do annually.
Questions to ask your surgeon before going to another country for a medical procedure
· What are your credentials? Where did you receive medical training? What types of continuing education workshops have you attended recently?
· How many patients do you see each month? Woodman says the ideal doctor should see more than 50 and less than 500.
· What associations do you belong to? Most physicians have a membership to at least one medical association.
· May I call you on your cell phone before or after treatment? Woodman says many foreign doctors welcome communication via cell phone from patients for treatment question.
· Do you practice alone or with others at a clinic? He suggests that patients look for a physician who practices among a group of certified professionals.
· Who is holding the knife during the surgery? Do you do the surgery yourself or do assistants perform the surgery? It’s important to know who will perform the actual surgery.
· What is your policy on follow-up care and can it be performed in the states?
