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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