By LINDA HEPLER, BSN, RN
Imagine gazing at the magnificent white marble face of the Taj Mahal after a hip resurfacing procedure performed in India. Or sipping Earl Gray tea in your private parlor at the luxury Raffles Hotel in Singapore following stem-cell therapy. These scenarios may seem far-fetched, yet for some 150,000 Americans who traveled abroad last year to combine sightseeing with state-of-the-art medical treatment, it is a reality.
Medical tourism, a phrase coined several years ago to describe the routine of traveling to other countries to combine vacation with medical procedures, is growing at the rate of 20 to 30 percent yearly. For developing countries, this phenomenon is a huge economic boost, an industry that will surely be more aggressively pursued in years to come. And for the 85 million Americans who are uninsured or underinsured, or for those who are simply dissatisfied with medical-care options at home, it’s a huge savings, with diagnosis and treatment for a variety of ailments available for a fraction of the cost as the same care given in the United States.
Consider hip replacement. Surgical cost in the U.S., including hospital stay, is approximately $43,000. Same surgery in India: $9,000. Whether it’s liposuction in Brazil, heart bypass surgery in Thailand, or restorative dental care in Mexico, the story is the same. Even adding airfare for yourself and a companion, hotel room for post-hospital stay — and a side trip — and you’re still way ahead. The difference between taking out a second mortgage, and simply taking out your MasterCard.
If you’re remembering a day when overseas travel conjured up frightening visions of becoming ill while away from home and falling prey to questionable medical practices and unsanitary conditions, you’re in for a big surprise. Countries like India, Thailand, and Singapore have invested billions of dollars into their healthcare systems, resulting in world-class medical facilities with modern technology and treatment that meets or even exceeds U.S. healthcare standards. In fact many hospitals and treatment centers abroad are accredited by the Joint Commission International, the global arm of our own Joint Commission on Accreditation of Healthcare Organizations, whose mission it is to develop impeccable medical standards of care and ensure that healthcare organizations comply with these standards.
As for amenities, it’s not unusual to see free travel to and from the airport, deluxe hospital suites, and postoperative stays at luxury yet discounted hotels, where treatment such as nursing care and physical therapy comes to you. Add to this that many hospitals abroad boast U.S.-trained and English-speaking medical staff that actually has time to listen to you and attend to your every need, and you’re apt to have a medical experience far less distasteful than some of those you’ve had at home.
Why is medical care abroad so much less expensive? There are those who believe that comprehensive health reform in the U.S. could result in competitive medical pricing — if only hospitals, physicians, insurance and drug companies weren’t so worried about their profits. There is no denying, though, that the U.S. spends more than any other country in the world on health care (without better overall health of its citizens), and more than half of this expenditure is on physician and hospital services. American doctors make about twice as much as do physicians in other countries, and hospital costs per day in the U.S. are on average as much as four times higher. Aggravating this is that increased consumer cost-sharing for these services as well as for insurance premiums results in under use of medical resources. That is, people are opting out of regular, preventive health care because they just can’t afford it. Serious preventable illness in an uninsured or underinsured population often ends in medical care that is left unpaid and absorbed by hospitals or government healthcare programs.
Then again, America is a litigious society, unlike countries such as India, where malpractice laws limit damage awards. Hospitals and physicians (or their liability carriers) in the United States pay out astronomical monetary awards for medical errors, resulting in higher costs for hospital liability insurance, physician malpractice coverage, and medical services — a vicious cycle indeed.
That said, medical travel is not without its problems. It’s hard to conceive of traveling halfway across the world to face a scary procedure away from the familiarity of home and family. And although postoperative complications following surgery abroad are no higher — and in some cases lower — than in the U.S., if you do experience a problem, you may find your home physician reluctant to treat you and your insurance company unwilling to pay for aftercare. You will also find your options for collecting damages as a result of medical error limited.
It takes a lot of hard work and patience to plan a safe and affordable medical trip. Enter Josef Woodman, a man who spent more than three years of research and travel to write Patients Beyond Borders, a comprehensive guide to world-class medical tourism. From how to find the right doctor and hospital to working with a travel agency and knowing what to pack, Woodman’s book gives a step-by-step explanation of the ins and outs of a safe and successful medical journey.
Woodman makes no bones about medical-travel planning being time consuming. On the average, he says, it takes about 40 to 100 hours of research. And if you’re not comfortable with the computer, you might reconsider. Almost all of the research you do, whether checking physician or hospital credentials or communicating with a travel agency, is best done online.
According to Woodman, who prefers the use of the phrase medical travel rather than medical tourism, a trip abroad for medical care should be thought of more as a business trip than a vacation. Anyone who has ever undergone surgery, he says, knows that postoperative discomfort and fatigue will most likely preclude much enthusiasm for sightseeing. And if you had in mind a recuperative lounge on the beach, you should know that sunlight is verboten for healing incisions. Take the money you’ve saved, Woodman suggests, and schedule a trip for later when you’re feeling better.
As for the future of medical travel, look for it to grow by leaps and bounds over the next few years, say economic experts like Milica Bookman, PhD, Professor of Economics at St. Joseph’s University in Philadelphia. Coauthor (with her daughter Karla) of Medical Tourism in Developing Countries, Bookman believes that medical tourism will eventually be embraced as a win-win situation for patients, employers, and insurance companies alike. While medical tourism is small in comparison to the overall consumption of medical services worldwide at present, she says, “It cannot be dismissed as either temporary or insignificant.”
Woodman agrees, but he doesn’t think it matters so much whether insurance companies decide to pay for medical services abroad — few are paying for this care now, and it’s a booming business used by the uninsured and underinsured, which is what counts the most. Although medical travel may not be for everybody, Woodman says: “Its all about choice. At least people have a choice.”
Ten Tips From Josef Woodman for Planning a Successful Medical Trip
Plan ahead. It takes time to research your options. Choose a health-travel planner (if using one), a physician, and a hospital. Plus, you get a better deal on airfare by booking early. Allow six months ideally for planning time.
Shop for the best deal. Don’t snap up the first option that comes along. Shop for the best quality and pricing in location, procedure, physician/surgeon, and hospital.
Check it out. Spend plenty of time checking out the credentials of your doctor, the hospital, and the travel- planning agency. Ask for references too.
Follow the $6,000 rule. If you aren’t saving at least $6,000 on your medical journey, it may not be worth traveling abroad for health care.
Choose a reliable companion. You should take a companion along for help and support before, during, and after your treatment or surgery. This should be someone whom you can trust and whose company you enjoy.
Scrutinize costs carefully. If working with a health-travel planner, make sure to look carefully at the costs quoted. Is it all-inclusive, or are there hidden costs?
Be realistic. You must be realistic about your expectations. Allow plenty of time abroad for recuperation. and don’t expect to do a lot of sightseeing.
Be prepared. Ask the travel planner, hospital, and surgeon what medical records or tests you need to bring with you to make things go as smoothly as possible.
Talk to your home physician. Whether or not your doctor agrees with your decision to travel abroad for medical care, he or she should be aware of your plan so that you can get proper follow up care at home.
Learn about your host country. Do your homework regarding currency, weather, food and water. and transportation so that there are no surprises to deal with while you’re under the weather.
For more information about medical tourism and Joseph Woodman’s Patients Without Borders, log on to www.patientsbeyondborders.com.
