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Health & Wellness

Medical Tourism Is Great -- for Those Who Can Afford It

By Niko Karvounis, Health Beat. Posted August 21, 2008.


Americans going abroad to deal with their medical problems would only cut health costs 1-2 percent -- not enough to solve our greater crisis.
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This article originally appeared on Health Beat.

You've probably heard about "medical tourism," the traveling of patients to foreign countries in order to receive care. But what you may not know is just how popular medical tourism has become: according to Deloitte LLP, an international consulting firm, an estimated 750,000 Americans traveled abroad for medical care in 2007. Aggressive projections put this number somewhere around 6 million by 2010.

As interest in medical tourism increases it's important to understand the nuts and bolts behind its allure, and the risks that it poses -- both for patients and health care systems at home and abroad.

Saving Money

Over the past few years insurers and employers have warmed up to medical tourism as a way to save money: its cheaper for insurance plans to help fund patients' trips to foreign doctors who charge much less for procedures than their U.S. counterparts.

The price differentials  are stunning. According to a recent Deloitte report, Thailand, the world's leading medical tourism hub, saw 1.2 million medical tourists from around the world in 2006. On average, medical procedures in Thailand cost a mere 30 percent of American prices. India, another destination that sees more than 400,000 medical tourists each year, charges just an average of just 20 percent as much as the U.S. Thousands of Americans also flock to Mexico and South America every year for cosmetic and dental surgery, where procedures cost anywhere from 75 to 50 percent less than they do in the U.S.

Data from the University of Delaware offers more specific numbers: "A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India -- and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa."

Sine insurance doesn't cover cosmetic procedures insurers and employers don't care too much about cheaper facelifts (though patients do, of course). But medical tourism isn't all about vanity. According to the National Business Group on Health, some of the most popular procedures pursued by medical tourists include heart procedures (e.g. coronary artery bypass graft, heart valve replacement, pacemakers, etc), orthopedic procedures (e.g. hip and knee replacement), laparoscopic surgery for gall bladder and hysterectomy, and many kinds of transplants. Given this, the consulting firm McKinsey and Co. aggressively estimates that increased medical tourism over the next few years can save health care purchasers as much as $20 billion in benefit pay-outs.

Catching On

Insurers and employers are quickly catching on to the savings opportunity represented by medical tourism. In June, MSNBC reported that  "CIGNA, Aetna and Blue Cross/Blue Shieldhave begun or are considering pilot programs that provide limited coverage for foreign care." Last month CNN reported on an Albuquerque construction firm that has included a medical tourism component in its health coverage that encourages employees to seek care in countries like Costa Rica, Singapore, and India. In South Carolina, BlueCross BlueShield and BlueChoice recently formed an alliance with one of Thailand's premier hospitals to promote medical tourism to its 1.3 million members. United Group Programs, a smaller insurer in Florida, also has begun to offer a plan that sends patients to Thailand for expensive procedures. Insurers Blue Shield and Health Net of California also both offer low-cost policies that allow members to receive medical treatments in Mexico.

It would be wrong to say that providing coverage for medical tourism is common practice amongst employers. A January survey by the International Foundation of Employee Benefit Plans found that just 11 percent of employers cover medical tourism under their plans. Nevertheless, according to the National Business Group on Health, another 9 percent of large U.S. employers are interested or very interested in sending employees off shore for major surgeries over the next five years.


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Niko Karvounis is a Program Officer with The Century Foundation in New York City, where he works on issues of socioeconomic inequality and health care. He is a regular contributor to Health Beat, the Foundation’s health care blog.

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Yeah, like that's going to happen.
Posted by: LMNOP on Aug 21, 2008 4:09 AM   
Current rating: 4    [1 = poor; 5 = excellent]
Let me see if I've got this right. I shouldn't go overseas to get a surgical procedure done at one fifth the cost because it might hurt the American health care system? That's rich. So, the country that outsources everything that it can to get cheaper labor without regard for any harm that exporting jobs does to my opportunities, and so that it doesn't have to pay American taxes, is now suggesting that I consider the impact of my choice on the health of my country's health care system, which fights the implementation of global coverage because the status quo is more profitable.

I've got a news for the globalists: American doesn't mean squat to me anymore either. In fact, i can't wait for these domestic airlines to fail and get those neglected airplanes and nasty stewardesses with attitude the F off of the runways to make room for Air France and Air Canada, who treat their customers like people

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» I agree, Posted by: mgmyers79
Points arising
Posted by: akai ringo on Aug 21, 2008 4:12 AM   
Current rating: 5    [1 = poor; 5 = excellent]
An interesting article which looks at medical tourism from a different perspective from the one I have hitherto adopted. I will look at that later, but for me the first point that jumps out of the article is the need to bear in mind the maxim "caveat emptor" (let the buyer beware). This applies just as much, or more so, to medical services supplied overseas as it does to buying a piece of real estate. You read all the small print, you list up the pros and cons, you take specialist advice, etc. And of course, you apply common sense. If your only language is English, it is common sense that you are far more likely to be understood in India than you are in South America.
But in relation to a wider issue, I have always thought of the main attraction of medical care offered overseas as being for the uninsured. If you need a lifesaving operation, you are an American national living in the US, but you are not medically insured, it is surely possible that even if you do not have the $200,000 demanded by an American hospital, you may well have $10,000 (or whatever) which would enable you to have the operation in India. We saw examples in "Sicko", the presentation, par excellence, of American health care, of the sick being dumped at the side of the road to be picked up, if they are lucky, by volunteer charities.But these people are still human beings.
Of course, if the big insurance companies get in on the act and corner the overseas market, then bang goes that possibility. Alas (from my perspective, at last), as with all things American, the market will decide.
It will have become clear that I am not an American, so a lot of what I have said may be nonsense. If so, I ask you pardon.

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Medical Tourism
Posted by: lavendula13 on Aug 21, 2008 4:48 AM   
Current rating: 5    [1 = poor; 5 = excellent]
The cost in Mexico isn't 50 percent (or even 75 percent) less. It is one-tenth! In the US, a dye test to examine blocked fallopian tubes (HSG test) costs $3,000. In Cancun, it costs $300. When you report such undramatic savings, you encourage people NOT to go abroad for health care. In fact, medical tourism, which curbs the greed of American medicine by simply not funding it, may be the only fix to the US system of escalating prices and abominable health care. In addition, Mexican clinics are actually cleaner, and their staff more knowledgeable and compassionate.

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» The numbers can be misleading Posted by: Balanchine
ba
Posted by: mnstra on Aug 21, 2008 7:53 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I would like to go to Latin America for dental work
anyone have experience with that/?

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» Good luck Posted by: LMNOP
» RE: ba Posted by: anneliese-nyc
» RE: ba Posted by: anneliese-nyc
More should flock to cheap
Posted by: willd4change on Aug 21, 2008 8:08 AM   
Current rating: 3    [1 = poor; 5 = excellent]
health care. I work for a specialist and we recommend the uninsured finance their trip to south america to have surgery. they stay in a five star hotel for 2 weeks and have the surgery they medically need and still save money. Cosmetic procedure are the same way, most of the physicians in India and other up and comming third world countries have been trained in the U.S. and have credentials to back it up. Who gives a rats ass about what it will do to the insurance companies, they are so fucking greedy they deserve to go bankrupt. The medical field isn't to blame, the american way of life is. We live like fat cats compared to every one of the countries mentioned in the artical thats why it is cheap. There is a large trend in the states now doctors are no longer taking insurance, you pay them a annual fee of a few thousand dollars and get seen as little or as much as you need. Now the kicker is the doctor only offers that service to the healthiest patients lmfao. Consumers control everything if you dont buy it they don't get paid. The market will work out some kinks. As for mike moorer and is socialized medicine he can fuck a fat babbies dick I want better care than that dumb ass. You ask real Canadians, French, Germans what they have to pay and give up for that care. I know an easy fix to the medical problem in the US there must be caps on what hospitals can charge and what procedures cost, or any american citizen and ONLY citizens that can't get insurance through work or make less than 50K a year gets a voucher from the federal government for 12K to take to the insurance company of their choice, and by law they have to accept it no strings. NO deductibles and NO co-insuransce. It could work.

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another thing here...
Posted by: ellie on Aug 21, 2008 9:01 AM   
Current rating: 4    [1 = poor; 5 = excellent]
there are procedures and prosthetic devices that have been approved for safety, reliability and use worldwide for over 10-15+ years that are not available in the US... they are still considered 'experimental' or if you are lucky are in 'trials'... many NIH trials are being pulled due to funding cuts... gotta pay for war somehow...

the hook to me seems to be that big pharma-insurance will loose big $$ if these procedures and devices are let loose on the american medical market...

the kicker to my favorite issue, the artificial pancreas for type 1 diabetics is basically just an implanted medical device that is made in the US (medtronic) and used for everything including the kitchen sink already in the US... minimed is their insulin pump division... recently, trials of this same dang medtronic pump were cut off by the FDA for insulin use... gee, coincidence here???

can go to another country have the implant put in and hooked up, but within the past few months,the FDA also yanked trial use approval for the specific Danish made insulin it needs... so you come home with your newly installed pump and have to rely on the black market of smuggling into the US the insulin needed to run it...

islet cell transplants for type 1 diabetes (the cure) are commonplace in the EU and the EU has a huge islet cell 'bank' in Belgium... this transplant is fairly easy to do as transplants go and only need immunosupression drugs that work like a charm but are not available in the US... if the cells don't make it, the cell bank rounds up a new batch for you...

ps... the artificial implanted insulin pump costs less per year to run and are actually safer then external pumps but think of the $$ losses to big pharma...

I am not in the medical field, so my reply may contain simplistic comments, have errors unknown to me, but it illustrates how far behind the rest of the world US medicine actually is...

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» good post Posted by: LMNOP
Insurer and Employer Lawsuits Waiting to Happen
Posted by: FoonTheElder on Aug 21, 2008 9:06 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Just wait until an insurer or employer is sued for a botched operation overseas that they encouraged.

Do the current lawsuit limits through ERISA laws apply when the company has a vested financial interest to send someone overseas for a health procedure? It won't be long before someone brings that lawsuit to the U.S.

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the nasty side of medical tourism
Posted by: AnarchX on Aug 21, 2008 12:29 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
please don't forget the other aspect of medical tourism that occurs: the travelling to 3rd world countries for the purchase of discounted organs from poor organ donors. it's a thriving illegal business in bangladesh and india.

such as the recent case of Dr. Kumar:

http://www.cbc.ca/canada/story/2008/02/04/amit-kumar.html

http://www.thestar.com/News/article/299973

http://www.thestar.com/article/300323

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India is one of the worst to suffer from "medical tourism".
Posted by: maxpayne on Aug 21, 2008 1:58 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Back in the 1970s and 1980s, it was all about brain draining the medical doctors but then again which country wasn't. To make matters worse, in the 1990s and this decades, the folks who are assigned those outsourced jobs in India receive virtually no healthcare and are in fact being denied healthcare thanks to the cruel government in India and the MNCs it does dirty business with. If you think getting emergency care in Europe sucks, it's 10 times worse in India. As a result, more men and women give up any hope of healthcare and death by suicide and severe stress has been skyrocketing. If Americans who lost their jobs actually found out about these heartbreaking tragedies and were truly hell bent on getting their jobs back, instead of making threats to those poor souls, they'd join forces with the working class folks in those countries and hammer both the business and political elites. Sadly though, America is too DYSFUNCTIONAL to see what's really happening right under their noses. The same thing is going on in Mexico, China, India, etc ... to keep the working class as ignorant as possible with junkfood bullshit and infotainment. Perhaps, the long term tightening of oil supplies along with rising prices might offer room for reversing this insanity all over the world.

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Questionable "Facts"
Posted by: dayahka on Aug 21, 2008 4:24 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I know many people who engage in medical tourism--and all of them are older and poorer, not younger and richer, as you suggest (though, to be fair, anyone with a monthly income of over $300 is considered rich in many parts of Asia, Africa, and Latin America).

No one I know thinks this is a way to solve America's health care problems--they help to solve problems for people who cannot afford health care here. Yes, to be sure, a face makeover that goes wrong is a big problem, but most people want elementary health care--a set of dentures in this country costs at least several thousand, but in China or Philippines may cost just a few hundred.

Health care costs in this country are directly linked to high-cost and often unnecessary "cut 'em open and sew 'em up" medical practices here and to the fact that most doctors are simply drug pushers for big pharma, and most of big pharma's drugs are harmful and do not help (but sure drain your wallet), and to the fact that Americans seem to go to the doctor for every little, real or imagined, ill. Most of the drugs cost the same or more in foreign countries, so it's not the drugs people are traveling for.

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» Questionable opinions Posted by: LMNOP
What about The OTHER type of medical tourism
Posted by: rickiey on Aug 21, 2008 6:02 PM   
Current rating: 1    [1 = poor; 5 = excellent]
Ya know, the type that rich people in countries with socialized medicine engage in?

When they decide that damn the cost, they need QUALITY?

They come to the United States.

I'd much rather have the "best that money can buy, for those who have earned it" than be the "Walmart of health care" where it's all crap, but at least its cheap.

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Medical tourism is a viable option for 47 million uninsured
Posted by: HB on Aug 21, 2008 6:32 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
For the 47 million uninsured Americans medical tourism does provide a viable option. If you are faced with the possibility of bankruptcy paying for your $100K surgery, you are most likely to choose the 90% discount and fly to India.

BTW, flying to India isn't as expensive as some people think. A round trip air ticket from US to India costs about $1500 (economy class). I suggest upgrading to business class if you need extra room to move about or choosing a destination that's geographically closer to you if you want to avoid long flights.

Medical tourism may not be a panacea in all cases but you can't ignore its financial benefits in most situations.

Check out what people who have traveled overseas for medical care are saying.

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Want to Retire Early? Leave!
Posted by: asjogren on Aug 21, 2008 8:33 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
If you want to retire before 65 (Medicare age), leaving the US because of health care costs might be the ticket.

I am 56 and have an international health insurance policy - good everywhere in the world. It costs me $162.25 per month. It has a $1000 deductible per year. However, I MUST leave the US and Canada for at least 6 months each year to get this rate. If I never live in the US or Canada, the rate would be about $85 per month. It can be anywhere else - Sweden, Switzerland, New Zealand. I go to Mexico.

How much sooner could you retire if health insurance was $85 instead of $300-$500? How much is your freedom worth?

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» RE: Want to Retire Early? Leave! Posted by: anneliese-nyc
dental work
Posted by: heliana on Aug 22, 2008 11:34 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
This article is a preposterous.
I had dental work done in Eastern Europe for 1/10 of the cost and with better results - as a matter of fact my Eastern European dentist repaired botched work done here in the States. The quality of work and service was incredible.

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