Medical Tourism - First Cochlear Implant for US Patients in India

HOUSTON, TEXAS -- Last Christmas was one of the most memorable one for the Yoder family in Burkesville, Kentucky. Their two children Dena Yoder and Ananias Yoder got a gift of their life which was made possible with the help of a local church community, Apollo hospital in India and their facilitator Quest MedTourism, the medical tourism company based in Texas. "This Christmas shall be very special for all of us," said smiling Sarah, mother of the two children.
Both now 10 years old Dena and 6 years old Ananias were born with hearing defects. "Hearing defects can be hereditary at times. It became pronounced in these two children, who could not hear or speak at all," says Dr Ameet Kishore, senior consultant surgeon at Apollo Hospital.
The high cost of the surgery made it impossible for the uninsured family to get the children treated in USA. They approached their neighborhood church for help. John Schmucker, a brother at the church, and two other committee members took this opportunity to help the family and raised funds for the surgery. "We had to look for a good hospital, which not just ensured a sure shot treatment but where the costs were also low," said Schmucker.

"We got in touch with Quest MedTourism which got us connected with the doctors at Apollo hospital. We were all a little nervous and had several queries, which were eventually sorted out by way of several three-way conversations with the family, Quest MedTourism case manager and the doctor at Apollo hospital," he added. After six months of deliberation, the Yoder family and Schmuckers decided to fly down to New Delhi. "After we met the doctor, we were sure our children's were in safe hands," said Sarah Yoder.

Average cost for Cochlear implant is US is approximately $70000 which does not include investigation and post surgery therapy cost. The two-week treatment in India cost the family approximately Rs 12 lakh (US $30000) per child which included accommodation cost as well. "The best price we were quoted in the US was $43500 per child, which did not include the investigation costs," said Enos Yoder. The cost difference, he said, would have been higher if the implant was cheaper. The cost of the implant they used was approximately $20000, which accounted for two-thirds of the total cost of the surgeries.

The surgery was done on December 1st, 2007 by Dr. Ameet Kishore at Apollo hospital in New Delhi, India. Yoder family was very satisfied by the services of the hospital and the doctors at Apollo hospital. Before flying back to the US the family visited Taj Mahal.

The Yoder children are undergoing the speech therapy at a local hospital in US. "The centre will charge me $250 per child for six months," said Enos. "It's a second life for them. They will have to start learning sounds from scratch," he adds. Six month after the surgery the children have started communicating as expected.

The whole process from getting in touch with the Apollo hospital to returning back to USA was managed by Quest MedTourism. Quest MedTourism destination case manager helped the family at every step during their stay in India. "I was very pleased with the Quest MedTourism services for my kids cochlear implant surgery. They were very prompt and efficient to make all arrangement for medical and lodging, also meeting with us every day to make sure all our needs was met," said Enos Yoder.

About Quest MedTourism (www.questmedtourism.com) Quest MedTourism is one of the USA's leading Medical Tourism service company, helping patients in their quest for affordable, high quality health care overseas. Quest MedTourism facilitates its client in finding cost effective medical treatments at various overseas hospitals, help them with completion of their traveling documents, departure from their home country, arrangements at the airport, hotel accommodation and tours.

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Hyderabad Hospitals to Focus on Medical Tourism

Hospitals in Hyderabad already welcome many foreign patients who want medical treatment abroad and are likely to attract many more in the future, an official has claimed.

Hyderabad is the capital city of the state of Andhra Pradesh in India and is already a popular location for conferences and meetings, boasts the nation's second largest film industry, and is a well-known sporting destination.

Increasingly, the city is also welcoming foreign tourists who are keen to benefit from its state-of-the-art hospitals and range of medical specialisations, including alternative medicines, TravelBizMonitor.com reports.

Sabyasachi Ghosh, director of Andhra Pradesh Tourism, told media representatives that work is underway to integrate medical institutes and tourism stakeholders.

He said: "Lots of international tourists are getting treatment at the corporate hospitals in Hyderabad and the demand is steadily increasing.

"Andhra Pradesh Tourism Development Corporation (APTDC) is the nodal centre to promote and operationalise medical tourism in Hyderabad."

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Medical Tourism May be a Temporary Boom

BY ELIZABETH BASSETT

It seems like a fairly straightforward question: Would an uninsured patient rather pay $130,000 for a heart bypass in the United States or pay about $10,000 for the same procedure in India, where the entire medical staff has been trained in the U.S. and the hospital meets standards set by the Joint Commission International?

Medical tourism is built on that question. Patients leave their home countries (or sometimes, in the U.S., their home states) and travel elsewhere for medical care. How widespread the practice is remains vague, since there is no international or national body that tracks Americans traveling for care, but anywhere from 50,000 to 500,000 may be seeking medical care elsewhere.

Despite the increasing number hype around medical tourism, it may be only a temporary boom that ultimately will serve to better health care delivery in the United States.

The trend seems to have started with cosmetic surgeries, which are generally not covered by insurance. Prospective patients looked for the best deals, and often could get procedures done abroad for a fraction of the price paid in the “Beverly Hills of the world,” said Dr. Harlan Levine, principal in Towers Perrin’s Care Management practice.

Despite growing numbers of medical tourists, scientific data about them and the outcomes of their care is still almost nonexistent, said Dr. Carlos Reyes-Ortiz, associate professor in the department of social and behavioral health at the UNT Health Science Center’s School of Public Health.

“We don’t have a lot of scientific information about that because that kind of business is related to tourists,” he said.

As more people consider medical tourism, more small startup businesses also are cropping up to help patients coordinate flights, transportation, hotels and hospital details. These medical tourism facilitators are a growing niche industry, but most of them do not have experience in the world of medicine, said Scott Edelstein, an attorney and partner at Squire, Sanders & Dempsey LLP.

Levine and Edelstein spoke at a seminar Sept. 17 hosted by the Dallas Regional Chamber. Edelstein also recently spoke at the medical tourism convention held in San Francisco by the World Medical Tourism and Global Health Conference.

More insurance companies are paying attention to medical traveling, Edelstein said, and some small companies or employer insurance programs are offering beneficiaries foreign options. The high quality of care received in hospitals abroad and the lower cost is enticing.

“I think the No. 1 driver of this is the economics of health care are very, very challenging right now,” Levine said.

Some have predicted that medical tourism will keep increasing indefinitely, but Edelstein and Levine said as the United States sees its patients go to other countries, it will become more competitive in an attempt to keep them at home.

That transparency will drive down prices, they said, and quality may also go up; Reyes-Ortiz said the quality of care at some foreign hospitals may be higher than care at some American hospitals.

“Some places may have lower fatality than some U.S. centers,” he said.
As American health centers and the health delivery system become more competitive, and as people realize that medical tourism is not lounging on a beach and then getting a surgery, medical tourism may actually die shortly after reaching its climax, Edelstein said.

“It’s a reaction or a symptom of the medical system we have the United States,” he said. “I don’t think it’s an answer.”

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Korea to Rise as Medical Tourism Center

By Han Suk-young

The domestic medical tourism was noted in the biggest medical tourism conference in the world, and Korea was distinguished as the new medical tourism center. The Korea Health Industry Development Institute (KHIDI, Chairman Kim Bup-wan) said that it participated in the World Medical Tourism Congress (WMTC) together with the Hanyang University Medical Center, Wooridul Hospital, Severance Hosptial, Kangnam St. Mary's Hospital, Ajou University Hosptial, and the Korea Tourism Organization. The WMTC was held in San Francisco, U.S. from September 9 to 12, and it was attended by 750 relevant visitors from all over the world. Korea was invited to the WMTC as a premier sponsor and received the best reviews.

President Ahn Yu-hun of the Council for Korea Medicine Overseas Promotion said, ¡°The trend of current medical markets in the world is the globalization of healthcare businesses. A global healthcare business should focus on providing the best quality medical services to patients in the world rather than just attracting tourists. The transparency of healthcare services and their qualities should be secured to advance global healthcare services.

During the conference, the U.S. medical insurance companies were busy developing insurance products by designating foreign medical institutions in order to reduce the high medical costs. They said that they would first consider partnerships with Korean medical institutions. They asked for the cooperation of the KHIDI for the joint development of insurance products and the education programs for insurers.

Besides, participating medical institutions, including the Severance, succeeded in making contracts with global medical insurance companies including Signa International and AIG International. Those medical institutions are also working on the finalization of the details to establish cooperative relationships with small/medium medical insurance companies and medical tourism agencies.

KHIDI Global Marketing Support Team Head Lee Young-ho confidently said, ¡°The conference was an opportunity to confirm the movement of the U.S. medical insurance companies, which is trying to lower healthcare costs by designating foreign medical institutions. Korea has more advanced medical technologies and experiences than other countries that were promoting medical tourism. Korea will be able to attract a considerable number of patients from the U.S. with active marketing.

Many relevant officials visited the Korean healthcare advertising center, and the Korean medical institutions successfully established cooperative networks. They would be able to attract U.S. patients through business with them. The Medical Tourism Association, which hosted the WMTC, will hold an international medical tourism conference in Korea in the first half of every year from 2009, following the business contract made in May with the KHIDI.

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Medical Tourism Represents a $2.1 Billion Business, Study Shows

The same economics that outsourced call centers and manufacturing jobs overseas may soon hit health care in a big way.

A recent Deloitte study forecasts that the number of people turning to "medical tourism" -- traveling internationally for medical care -- will increase from 750,000 to 6 million by 2010, an eightfold increase.

If the actual increase is even half that, one thing is clear: It will be insurers and employers driving the change, not individual workers.

Blue Cross and Blue Shield of South Carolina has already started down the medical tourism road, and employers in other parts of the country are showing growing curiosity, if not interest.

At the annual Pittsburgh Business Group on Health symposium earlier this month, local benefits managers heard how the Maine-based Hannaford Brothers grocery store chain this year began offering its workers the option to fly to Singapore for their knee replacements, while pocketing an extra $10,000. Because the surgery would be so much cheaper, the company also will pay for a spouse or loved one to accompany them.

The change "was designed to initiate a dialogue about quality and cost," said Chris Washburn, employee benefits supervisor for Hannaford, which is self-insured but uses Aetna as its vendor.

It's certainly started a conversation -- once the Hannaford program was publicized, the company started hearing from hospitals and health systems in the United States that said they could match or beat the Singapore prices. So far, no one from Hannaford has traveled to Singapore for an operation.

All this is not to say the Pittsburgh region is verging on a medical tourism boom.
While Mr. Washburn's presentation last week generated interest among local benefits managers, PBGH Executive Director Christine Whipple said she knew of no local company actively and seriously considering adding medical tourism to employee health benefits plans.
In line with Pittsburgh's historically conservative approach, she said, "They don't want to be leading edge, nor do they want to be far behind."

But as medical tourism becomes a global trend, the world may come to Pittsburgh. If the quality really is comparable, why not fly somewhere that will perform the same surgery for one-tenth the cost?

"The borders of health care have blurred. It is a very different world today than it was five years ago," said Dr. David Jaimovich, chief medical officer of Joint Commission International, which accredits international health systems and hospitals in similar fashion as its sister company, the Joint Commission on Healthcare Organizations, does in the United States.

JCI has given its stamp of approval to more than 250 hospitals in more than 30 countries, he said, and those institutions meet standards that "are very comparable to the U.S. domestic standards. There are many hospitals around the world that would put some of our [U.S.] hospitals to shame."

He expects that number of JCI-accredited hospitals to double by 2012.

At the same time, even accredited hospitals aren't worry free. As the Deloitte report points out, questions remain about follow-up care once a patient returns from overseas, and about who bears responsibility if something goes wrong. In most cases, the regulations and laws of the host country prevail.

"What a lot of folks would say is that the quality of care is highly variable," said Paul Keckley, executive director for Deloitte's Center for Health Solutions, which invested 1,900 hours analyzing the trend.

That does not mean that simple procedures, such as an uncomplicated shoulder surgery, could not be done safely at many centers in many countries, Dr. Keckley said. But he questions the wisdom of traveling overseas for, say, a hip replacement that carries a significant risk of infection or a deep vein thrombosis, when the patient faces a long flight home a few days later.
The Deloitte report estimates that medical tourism by Americans represents a $2.1 billion business. Part of that is a new industry of companies such as BridgeHealth International, which helps insurers, employers and individuals arrange medical travel plans. BridgeHealth advertises that it has "the most extensive provider network in the industry," with 25 hospitals in 10 countries.

The draw is easy to spot: A heart bypass procedure that costs $130,000 in the United States can be done for $18,500 in Singapore or $10,000 in India. A $40,000 knee replacement here is offered at one-fourth that cost in Thailand, all at accredited hospitals.

With health-care costs rising 8 percent to 9 percent domestically, it's the kind of savings that can make medical tourism sound very appealing.

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Medical Tourism Boost

by David Sexton

IT'S big business in Asia, and despite the fact thousands of Australians are taking part, medical tourism is still very much in its infancy in Australia.

But given its rapid growth, it's not surprising one of the the country's first forays into the multi-million dollar industry is attracting attention from tourism orgainsations.

Cairns Fertility Clinic expects to open its doors in March in a purpose built clinic in the Cairns Central Plaza building on the corner of McLeod and Apiln Sts on the edge of the city centre.

The clinic is being set up by West Australian IVF pioneer Dr John Yovich, his wife Jeanne and financial controller Doug Yek.

The difference between their new venture and their existing PIVET Medical Centre in Perth is that this will essentially be a one-stop for couples undergoing IVF treatment.

Not only will they undergo their IVF treatment in the clinic, they will also be able to stay in one of the five-star resort apartments above it.

And if they want to, the patients could even have cosmetic surgery work done during their stay in one of the associated medical businesses which will be co-located in the 12-storey building.
Mr Yek, who was in Cairns last week to monitor progress on the building, said the clinic was aiming for a 50 per cent Australian and 50 per cent international market. It is this international market that has the support of tourisnm organisations who see the potential of medical tourism.
Links have already been established in China and India where Mr Yek said the rising middle class wealthy would be the target market to come to Cairns for IVF treatment and a holiday in a tropical location at the same time.

"Medical tourism is big business in South-East Asia and hopefully this sets the benchmark in Australia and starts the ball rolling for other projects,'' Mr Yek said.

Recently Australian Tourism Export Council managing director Matt Hingerty pointed to medical and health tourism as an area that could be a market to put Australia back on the tourism map.

Mr Hingerty said predictions were for as many as six million Americans flying overseas for medical treatment by 2010.

Queensland Tourism Minister Desley Boyle is a major supporter of medical/health tourism. Ms Boyle said the IVF clinic "was a great opportunity" for government and industry to look seruiously at opportunities presented by medical and health tourism.

"In the early 1990s a group in Cairns looked at similar opportunities and did studies, but in the end it lost momentum,'' Ms Boyle said.

She said beyond the IVF and cosmetic procedure tourism, Cairns presented an ideal opportunity to provide mining companies throughout the country and Pacific basin with a destination for annual health checks for workers as well at the same time as their holidays.

"The reason I am so keen on this is it would more business for the town but it would also bring more private sector involvment in the city's health industry.''

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Controversial 'Stem Cell Tourism' Attracts Ailing AmericansTodd Finkelmeyer

To many scientists, those promoting what is sometimes referred to as "stem cell tourism" are nothing more than the 21st century's version of the snake oil salesman.

Fueled by sometimes desperate patients who are willing to travel the globe for cures, dozens of companies around the world are marketing injections of stem cells as life-changing treatments, or even cures, for everything from Parkinson's and Lou Gehrig's disease, to heart failure, spinal injuries and other tough-to-treat conditions.

"Medical tourism for stem cells is very controversial," said Bernard Siegel, executive director of the Genetics Policy Institute and the driving force behind the World Stem Cell Summit, which concluded its two-day run at the Alliant Energy Center's Exhibition Hall on Tuesday.

"If someone is a patient whom you know, a loved one who has an affliction for which there's no cure, should they travel if someone is offering stem cell treatment of some kind in Asia, central America or Europe?

"What if their physician confers with them and they find out there are some guidelines and informed consent, should we condemn that person for seeking a treatment or cure?

"Or what if the lab that's doing the procedure won't tell you what cells are being used and is charging $50,000 for an injection, is that fair? Should we condemn this as a scientific community? Should we seek to shut it down?

"This is really an important subject."
Although researchers across the United States are investigating stem cells and their potential use as treatment for many diseases, currently only blood stem cell transplants have proven beneficial to help treat blood disorders, such as leukemia and immune deficiencies.

Therefore, American patients seeking injections of stem cells from embryos, fetuses and umbilical cords must travel overseas for the controversial therapies because the Food and Drug Administration has yet to approve such treatments as safe and effective.

While it's nearly impossible to give an exact count, and based merely on claims made by these overseas stem cell companies, published reports indicate that at least a few thousand patients from the United States have traveled abroad to try these treatments. The going rate for these stem cell injections tends to run from $12,500 to $50,000.

The Web sites that generally promote these overseas stem cell therapies -- many of which advertise clinics in China, India, Mexico and the Ukraine -- mostly rely on patient testimonials as proof the treatments are safe and effective. Critics often say these Web sites have the feel of infomercials pushing the latest weight loss breakthrough.

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India Emerging as International Medical Tourism Hub

India continues to make rapid strides in medical tourism. Analysts view medical tourism as a most promising segment, but many areas of concern need to be addressed.

With its low cost advantage and emergence of several private players, it represents the fastest growing market, predicts "Asian Medical Tourism Analysis (2008-2012)," prepared by Research and Markets, an Irish firm.

Actually there is nothing strikingly new about the finding, experts say. India was touted as the global destination for health by the federal government back in 2003 itself.

Since then growing liberalization and entry of more and more private players, has meant that despite setbacks elsewhere in recent years, future seems sound for the health tourism sector.
The West is suffering by its own success. Public health expenditure is going through the roof. As the population ages and demands on healthcare increases, governments find it difficult to sustain the level of healthcare provided to citizens all along.

Besides, most developed countries are plagued by an acute shortage of medical personnel, of every category. To make matters worse, western economies are either turning stagnant or are declining. Consequently long waiting times are becoming an inevitable feature of the health scene, in Europe, particularly.

It is such challenges faced by the West that come as a boon for countries like India. According to the Research and Markets referred to earlier, India, Thailand, Singapore, Malaysia and Philippines could make the most of the difficult health scenario in the developed world.

The medical tourism market in India was estimated at $333 million in 2004. It is projected to reach $2.2 billion by 2012-14.

However, perceptions abroad over hygiene consciousness as also infrastructural constraints could spoil the party, it is feared.

The bulk of patients coming to India are from the SAARC region, from the Middle East, and Africa, though there is potential for exports to the West.

Chennai, capital of the southern Indian state of Tamil Nadu, is certainly in the forefront of health tourism.

Understandably so, for it was the Chennai-based Apollo Group that played a pioneering role in wooing foreign patients on the one hand and upgrading its own facilities on the other.

The time is not far off when we will be the Asian hub says Shamik Banerjee, Head of Corporate Communication, Apollo Group. The bustling metro boasts of a host of multi-specialty hospitals, he points out.

The group itself receives about 25,000 international patients every year, of which more than 3,000 come as medical tourists. Patients come from countries like Bangladesh, Maldives, Sri Lanka, Seychelles, Mauritius and Gulf countries.

The hospital has also tied up with over 10 international insurance companies and has its own health insurance company – Apollo DKV and has third party administrators (TPAs) abroad. In Japan, it has tied up with SOS International and Japan's Emergency Assistance to airlift sick patients and bring them to India for treatment. In Oman and Mauritius, Apollo has tie-ups with the Health Ministries.

Dr S Nirmala, who runs a maternity centre, says, Apollo Hospitals, MIOT Hospitals, Madras Medical Mission, Sankara Nethralaya, Sri Ramachandra University Hospital and Vijaya Hospital were the first to encourage this trend. Soon, other hospitals followed suit by tying up with travel agencies and organizing a network of home-stays.

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Medical Tourism Business Projected to Grow Eightfold by 2010

The number of people in the U.S. who plan to travel abroad for medical care, where the costs for various medical and surgical procedures often are comparatively lower, is projected to increase by eight times by 2010, according to a recent study by the Deloitte Center for Health Solutions, the Pittsburgh Post-Gazette reports.For the study, researchers spent about 1,900 hours analyzing the mechanics of medical tourism. The researchers estimated that the number of people who travel internationally for medical procedures will increase from 750,000 to six million over the next two years. The study also found that U.S. patients contribute an estimated $2.1 billion in business to the medical tourism industry.

The Joint Commission International, which accredits health systems and hospitals abroad, has certified more than 250 hospitals in 30 countries, according to David Jaimovich, JCI's chief medical officer. He said that he expects to see twice the number of JCI-approved hospitals by 2012.

Concerns
The study highlighted some of the common concerns with seeking health care abroad, such as post-operation care and who would bear the responsibility if a problem arises, according to the Post-Gazette. In such cases, the laws and regulations of the country where the procedure took place often would be enforced, the Post-Gazette reports.

Paul Keckley, executive director of the center, said, "What a lot of folks would say is that the quality of care is highly variable." However, Keckley said that it did not mean that the medical facilities abroad could not conduct simple and uncomplicated procedures. He said he still was concerned about the benefits of traveling overseas and returning on a long flight back to the U.S. just a few days after a procedure, with the risk of developing an infection, deep vein thrombosis or other problems.

Jaimovich said the hospitals have met standards that "are very comparable to the U.S. domestic standards," adding, "There are many hospitals around the world that would put some of our (U.S.) hospitals to shame." Jaimovich added, "The borders of health care have blurred," adding, "It is a very different world today than it was five years ago" (Twedt, Pittsburgh Post-Gazette, 9/23).

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