In other news: (sorry ah, long story but tare made me think of this recent article in our local rag.)
Taking a vacation to have an operation
Foreign medical care filling gap for some
By Ann Tatko-Peterson
MCT NEWS SERVICE
October 11, 2006
Once considered a niche for plastic surgery, medical tourism has expanded to include more necessary medical procedures and fill a gap for uninsured and underinsured Americans.
More than 500,000 Americans traveled out of the country last year for medical or dental work, according to the National Coalition on Health Care. In those numbers are cases of heart bypass surgeries, orthopedic surgeries and expensive dental treatments.
Soon, those cases of individuals seeking care may give way to corporate plans, as well.
In North Carolina, Carl Garrett, 60, became a test case in September for his company, Blue Ridge Paper Products, Inc. Garrett flew to New Delhi, India, to have gallstones removed and rotator cuff surgery at a savings of $50,000 for his company.
The surgeries would have cost Garrett $20,000 in the United States. Instead, he received $10,000 as a share of his company's savings.
This practice has been going on in other countries for years.
Canadians and Britons, frustrated with long waits because of nationalized health care plans, have used medical travel to have procedures done sooner. Asians long have traveled to countries within their region to reduce medical costs.
As U.S. health care costs have become prohibitive, Americans are joining the legions.
In 2005, 46.6 million Americans had no medical insurance and 120 million were without dental insurance, according to the Census Bureau.
Alain Enthoven, a senior fellow at the Center for Health Policy at Stanford University, noted that global health care is becoming an accepted alternative as U.S. health care “prices itself out of reach.”
Signs of that are already present:
Blue Cross Blue Shield Association has included Wockhardt Hospitals in India among its worldwide network of participating hospitals.
Insurer Health Net of California contracts with accredited Mexican clinics near the U.S. border.
United Group Programs in Florida, which caters to self-insured companies, offers options for obtaining medical care at Bumrungrad Hospital in Bangkok, Thailand.
West Virginia's state Legislature is considering a bill that would encourage state employees to have nonemergency medical surgeries overseas. These employees would fly first class, stay at four-star hotels to recuperate and receive cash bonuses for helping the state save thousands of dollars.
Starting next year, Blue Ridge Paper Products, which is self-insured, may offer its 2,000 employees and their dependents the same option it gave Garrett – a chance to receive less expensive medical care abroad.
Blue Ridge Products' corporate outsourcing may be just the beginning.
Dr. Arnold Milstein, medical director of the Pacific Business Group on Health, told a congressional hearing in June that several large U.S. employers have asked him to assess this option for possible inclusion in their health benefits plans.
In 2002, the United States spent $5,267 per capita for doctor visits, hospitalization and prescription medicine, according to a 2005 study of health care costs in 30 nations. That was almost $2,000 per capita more than Switzerland, the second-highest country.
Major health organizations and physicians' groups blame high costs on escalating malpractice insurance premiums and steep administrative expenses.
More than a dozen popular medical tourism destinations charge from 25 percent to 80 percent less, depending on the procedure, in their countries.
A hip or knee replacement surgery that would cost about $36,600 in the United States goes for as little as $4,000 in Malaysia. Heart valve surgery in India can be had for no more than $12,000, considerably less than the U.S. average of about $115,000.
In the past five years, five major companies have sprung up in the United States to help facilitate medical travel.
These companies research and evaluate overseas physicians, hospitals and clinics. They then arrange the medical treatment and, in most cases, the travel for prospective U.S. clients.
Three years ago, MedRetreat, with offices in Chicago and Washington, D.C., started its company by offering cosmetic procedures in two countries. It now provides an extensive network of hospitals and procedures, numbering in the hundreds, in eight countries.
El Salvador and China are set to join later this year. MedRetreat also hopes to begin outsourcing health care for U.S. companies before year's end, said managing director Patrick Marsek.
In his New Mexico private practice, Matthew Fontana saw patients denied insurance coverage for pre-existing conditions or because some procedures no longer were covered. Fontana joined medical travel provider Global Choice Healthcare in Albuquerque as vice president of client services because it offered care to those who were excluded.
Not everyone has championed medical tourism as a savior for uninsured Americans.
In June, Sen. Gordon Smith, R-Ore., called for a task force to study safety issues in medical travel. This followed a hearing on the subject by the Special Senate Committee on Aging.
Medical tourism companies are partnering mostly with hospitals receiving accreditation from the Joint Commission on International Accreditation of Healthcare Organizations, which also reviews U.S. hospitals. Started in 1999, the process involves on-site visits every three years from U.S. doctors, nurses and administrators.
That same protection has just begun for cosmetic surgery clinics and private practices.
While the American Board of Plastic Surgery long has been certifying U.S. doctors, the International Society of Aesthetic Plastic Surgery only recently signed with Surgery Facilities Resources, Inc., to offer an accreditation process for its members.
Cosmetic surgery still comprises 80 percent of medical travel, providers say. It also is teeming with sometimes problematic discount deals.
Australia's government recently issued a special travel advisory warning against medical tourism in Thailand. An increased number of Australian women experienced complications after having cosmetic surgery in uncertified clinics, primarily in Bangkok.
Complications have surfaced in the United States. From May 2003 to February 2004, there were 12 lab-confirmed cases of mycobacterial infections in American women who had cosmetic surgery in Santo Domingo, Dominican Republic.
Similar infections occurred from October 1996 to March 1998 for nine patients in Caracas, Venezuela.
Kevin Ciresi, a California plastic surgeon, sees going abroad as a reasonable choice if the surgeon is well-trained, reputable and provides adequate follow-up treatments. Ciresi cautions prospective patients to consider the potential for complications, out-of-pocket expenses associated with that and, in the absence of malpractice, the lack of legal redress.
“Plastic surgery is real surgery, too,” he said. “You have to believe the complications can be real and significant
