'Medical Tourism' on the Rise
More Americans Going Abroad for Surgery and Sightseeing
by Richard Daub
With health insurance premiums continually rising in the United States and making coverage less affordable for many, a growing number of Americans are attempting to save money by traveling to other countries for their medical needs.
They are also doing a little sightseeing while they are there.
'Medical tourism,' as it is now commonly known, has become a booming offshoot of the travel industry. Countries such as India, Thailand, and Mexico, to name a few, are already hotspots, while others are ramping up their promotional efforts to capture a share of this lucrative and increasingly competitive market.
Why Are Americans Going Abroad for Surgery?
According to U.S. Census data, an estimated 46 million Americans do not have health insurance. Of the estimated 250 million who do, many have policies that do not cover the cost of certain medical procedures. Other procedures are often only partially covered, leaving the patient responsible for out-of-pocket co-payments that sometimes exceed the total cost of the same operation in another country.
With first-rate medical centers being built in some of the less affluent nations of the world and being staffed by highly trained doctors with degrees from prestigious U.S. universities, the stigma of traveling to regions that were or still are considered 'third-world' for surgery is rapidly peeling away.
"Many hospitals and medical institutions that cater to the tourist market are among the best in the world," said Don Birch, president and CEO of leading Asia-Pacific travel facilitator Abacus International, in the April-May 2006 issue of TravelSmart Asia Watch. "At one level, governments and government agencies want to see the economic benefits, hospitals are competing to provide treatments, and the travel and hospitality providers are also vying to claim a slice of the action."
Abacus International estimates that the countries of Thailand, Singapore, India, South Korea, and Malaysia are attracting a combined 1.3 million medical tourists per year—a number that is annually increasing by 20 to 30 percent, as opposed to the 4 to 6 percent growth in bookings from traditional tourism. They also estimate that medical tourism in Asia will be worth "at least US$4 billion" by 2012.
'Medical Hubs'
India attracted an estimated 100,000 medical tourists in 2005. Singapore annually attracts an estimated 300,000, and Thailand over a million.
Meanwhile, the Philippines is vying to become "the new hub of wellness and medical care in Asia," as stated by Department of Health Secretary Francisco Duque III in January 2006 during the launch of the country's campaign to increase their share of the market.
"The Philippines has a lot to offer potential international medical tourists," said Dr. Paul Ferdinand M. Reganit from the Department of Health Office in Manila during a recent interview with The Erickson Tribune. "It has several comparative advantages, namely: competitive prices; highly skilled and trained physicians (most had their specialty clinical training in the U.S.); most health providers are fluent in English; competent, compassionate, and caring people; world class and JCI-accredited* healthcare facilities [*'Joint Commission International' is an organization that sets accreditation standards for healthcare facilities]; plus, the chance to visit breathtaking tourist spots in the country."
The travel industry has recognized this opportunity. Packages that include airfare, hotel accommodations, and surgery expenses are being offered with the claim of saving up to 80 percent compared to what it would cost in the United States. For example, a $250,000 coronary bypass operation in New York might only cost $50,000 in New Delhi—a deal that would likely be difficult for most uninsured patients to resist. Elective procedures and cosmetic surgery are also very common since these are often not covered by insurance policies.
More than Just Frugality For Some
For some, traveling abroad for surgery is more than just a means of saving money.
A recent example is Hawaii's most famous resident, 75 year-old singer Don Ho. In December 2005, Ho traveled to Bangkok, Thailand, to undergo an experimental stem cell procedure that has not been approved in the U.S. to treat his nonischemic cardiomyopathy, a condition in which the heart becomes weak due to factors other than coronary arterial blockages.
"It was my last hope," Ho told the Associated Press a couple of weeks after the procedure, which he learned of on the Internet. "I'm feeling terrific, 100 percent better. I knew that if I didn't take things into my own hand, I would've been a goner."
The procedure Ho underwent is known as VesCell™, a stem cell therapy offered by a U.S. and Israeli backed company named TheraVitae. The company set up shop in Bangkok because of the city's reputable medical facilities and generally permissive government policies regarding medical procedures.
For VesCell™ therapy, patients travel to Bangkok, where approximately a half a pint of blood is drawn from them—less than the amount of a typical blood donation. The blood is then sent to the TheraVitae laboratory in Israel to allow stem cells known as 'angiogenic cell precursors' ('ACPs') to develop. After about a week, these cells are harvested and sent back to Bangkok, where they are injected back into the patient's heart with the hope that they will generate new blood vessels and tissue to strengthen the coronary muscle within a couple of months.
While the blood is in the lab, patients and family members stay at a five star hotel and are provided with a driver to escort them around the city. The cost of the entire trip, including procedure, lab work, transportation, and accommodations, runs about $30,000.
Risks of Medical Tourism
Though the cost of a surgical procedure may be significantly lower elsewhere, a patient with health insurance coverage who opts to have it done abroad at a lower cost may still end up paying more in the long run.
Most American insurance companies will not cover the cost of procedures performed outside of the United States. They also do not typically cover the cost of aftercare related to surgery performed abroad—even if that care is provided domestically.
"It's all well and good to book these surgeries, but when you have a complication, what's going to happen?" asks Dr. James Whynot, medical director at Erickson –built and –managed Brooksby Village in Peabody, Mass. "Do you get to stay there and they'll treat it appropriately? That you don't know. I think that's the risk of having surgery done in a different part of the world—a regular insurance company here in the States may not cover treatment for that complication."
Also, if a complication arises that is caused by the procedure itself, the patient is usually left without recourse to take legal action.
"That's part of the deal," Dr. Whynot says. "They actually have people sign waivers. Dr. Jones is doing a hip replacement surgery for you, yet, this could happen, this could not happen, this may happen, and if there's any complications, they usually spell out that Dr. Jones is not responsible."
Despite Risks, Growth of Medical Tourism Expected to Continue
Now that information regarding medical procedures is so easily accessible via the Internet and that there are so many more alternatives than there were only a few years ago, patients have also become knowledgeable consumers who are more independent of their doctors and who no longer feel confined to their local medical centers.
With health care becoming less affordable in the U.S. and competition for market share heating up overseas, shopping for a surgical procedure could eventually become as routine as trying to find the best deal on hotel and airfare. Patients may no longer give a second thought to traveling halfway around the world for a procedure that is either not affordable or not available at home—especially if it might save their lives.
Published in The Erickson Tribune, July 2006 |
