Medical Tourism

Take a Little Vacation, Save on an Operation

 By Janet Fulwood - Universal Press Syndicate

Next time you grumble over your phone call to a U.S. business being anwered by someone in India, consider that the next thing to be outsourced just might be your health care.  As the national debate over America’s medical insurance system rages on, a quiet revolution is taking place behind the scenes.  In growing numbers, the nation’s 61 million uninsured and underinsured citizens are giving up on a system that doesn’t meet their needs and seeking medical treatment abroad - and combining it with sightseeing.

Estimates vary - no government agency or organization keeps track- but some medical experts believe as many as half a million Americans traveled out of the country last year for procedures ranging from dental work and cosmetic repairs to orthopedic and cardiac surgery.

The motivation: savings of 50 percent to 80 percent on procedures performed by doctors often trained in the United States, at hospitals that meet strict standards for patient care and safety.

Wayne King, of Sacramento, California, is a believer in a phenomenon that has been dubbed “medical tourism.”  When his doctors recommended two-level disk replacement to resolve the pain he suffered from a pair of collapsed lumbar disks, the 35-year-old man first tried to arrange the operation at a San Francisco hospital.

He had medical coverage through his employer, but his insurer refused to cover the $105,000 procedure, saying it was still experimental and not approved by the Food and Drug Administration.

King, who works as an insurance claims representative, says he persevered through a series of appeals, but to no avail.  Frustrated, he changed jobs and tried again through his new company’s carrier.

Initially, he says, the procedure was approved. “But two weeks prior to surgery they asked the doctor for clarification on the procedure and pulled coverage,” he says.

Depressed and in increasing pain, King considered filing for bankruptcy just to get his back fixed.  But he couldn’t come up with the $50,000 down payment the hospital required.  At the end of his rope, he decided to outsource his health care.

A segment on “dateline” led him to research the medical tourism phenomenon.  After a couple of false starts, King hooked up with Chicago-based MedRetreat, a leader among the estimated 200 agencies that have sprung up to facilitate the complex arrangements international medical travel entails.

In January, accompanied by his partner, Austin Birdsall, he flew to Penang, Malaysia, where Dr. K. Parameshwaran, an orthopedic and spinal surgeon trained in Malaysia and Scotland, performed the surgery at Gleneagles Medical Centre, a private acute-care hospital with international accreditation.

In the hospital just four days, King was up and walking by the second day after surgery.  Total cost, including travel expenses, surgery, hospital stay and two weeks in a five-star hotel: $27,000.

Back home, King’s doctors were on standby to provide follow-up care, including physical therapy.  He was back at work in six weeks.

 ”The outcome was fantastic, just life-changing,” King says.  “I used to not be able to stand more than 25 minutes at a time, which obviously limited my ability.  Now I’m able to stand and walk and get out on the bike again.”

Medical tourism isn’t new.  U.S. citizens for decades have been traveling abroad for cosmetic surgery and crossing into Mexico for dental work.  But in the past few years, says Josef Woodman, author of “Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Tourism,” high-end hospitals in India, Thailand, Singapore, Malaysia, the Philippines, Costa Rica and elsewhere have been aggressively marketing their services, tempting Americans with cheaper medical care and a degree of pampering virtually unknown in this country.

The difference in cost can be staggering: A heart valve replacement with bypass that would cost $140,000 in the United States can be had for about $25,000 at Bangkok’s prestigious Bumrungrad International Hospital, which treated some 64,ooo Americans last year.  A hip replacement running $57,000 here costs around $10,200 at New Delhi’s Apollo Medical Centre, another popular venue for medical tourists.

The key behind contemporary medical travel is the build-out of high-quality international hospitals, mostly in Southeast Asia and India,: Woodman says.  “You have to be very careful which hospital you go to.  But the best have very high standards.  They’re competing with or engaging in partnerships with the Mayo Clinics, the Johns Hopkinses, the Harvards.”

Traveling overseas for surgery should never be considered a vacation, no matter how posh the accommodations or exotic the locale, Woodman and other experts caution.  Long flights, coupled with culture shock, make it an unrealistic option for many.

The American Medical Association has not taken a position on medical tourism, but AMA board chair Dr. Edward Langston acknowledges that “it is growing and will grow larger because of real issues of people having either no insurance coverage or coverage that is limited.

“We have concerns and issues surrounding medical tourism, yet we certainly understand why it is occurring,” he says. 

“Like anything new, it’s buyer beware.  There are liability issues, issues of redress, of critical post-operative care.  Continuity of care is always an issue, but it’s always an issue here, too.”

 Langston notes that about 175 hospitals worldwide, including the one where King was treated, have been accredited by the Joint Commission International.  The JCI stamp of approval is considered a benchmark for meeting universal quality standards in health-care delivery.

 Is Medical Tourism Right For You?

There’s more than just finances to consider before packing your bags and heading off to a foreign country for surgery you couldn’t afford back home.  Josef Woodman offers extensive guidelines and chicklists in “Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Travel” (Healthy Travel Media, 406 pages, $22.95;  www.patientsbeyondborders.com.  Among key questions to consider before outsourcing your health care:

 Are you healthy enough to travel?

•  Are you psychologically prepared? Novice travelers should think twice about going abroad for medical care because of the culture shock.
•  Is the payoff worth it? If your U.S. specialist quotes a price of $6,000 or more for treatment, chances are good that one or more foreign hospitals can offer the same procedure and quality for less, including travel and lodging, Woodman says in his book.
•  Are you willing to do your homework? Finding the right doctor and the right hospital, lining up aftercare back home and making complex travel arrangements is a lot of work. Medical travel agencies such as MedRetereat (www.medretreat.com) can help, but it’s up to patients to initiate communication, expedite transfer of medical records and more.