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    As U.S. Healthcare Costs Rise, Medical Tourism Booms

    By Jennifer Huddleston, staff writer     

    While medical tourism, the practice of going abroad to obtain medical care, has recently made headlines, it’s not an entirely new development. According to the American Medical Association (AMA), 150,000 Americans went abroad for healthcare in 2006. Of those, more than half underwent medically necessary procedures. [1]

    Many patients opt to receive medical treatment abroad for a number of reasons. In May, global consulting firm McKinsey & Co. reported that more than 70 percent of the patients it studied traveled in order to receive higher-quality care or to get the most advanced technology available.

    While some Americans leave the country to undergo procedures not covered by their insurance, such as cosmetic surgery or fertility treatments, others opt for foreign healthcare because of its lower cost.
    [3] But Americans and bargain hunters aren’t the only ones traveling to receive medical care—patients from countries with socialized medicine often go abroad to avoid long waiting times for procedures. [4]

    Now some patients’ insurance companies are even covering part of the bill.

    “You’re beginning to see the point now that it’s changing from a market primarily of individuals without coverage or insurance to a circumstance in which this is going to be adopted by U.S. health insurance plans to extend to a much larger U.S. population,” said Dr. Arnold Milstein, chief physician for Mercer Health & Benefits, an international healthcare consulting agency, and medical director for Pacific Business Group on Health.

    McKinsey & Co. estimates that between 500,000 and 700,000 Americans might seek surgery abroad next year if insurance companies begin covering foreign medical care. If that should happen, the savings on the procedures performed on those patients could be as high as $20 billion per year.

    Countries offering procedures at a fraction of the cost of those in the U.S. include Costa Rica, India, Korea, Singapore and Thailand.
    [8] Take, for example, the drastic differences in cost for the following procedures:

    • Heart surgery
      • in U.S. = $30,000
      • in India = $6,000 [9]
    • Bone marrow transplant
      • in U.S. = $250,000
      • in India = $26,000 [10]
    • Heartvalve replacement
      • in U.S. = $160,000
      • in India = $9,000 [11]
    • Hip replacement
      • in U.S. = $43,000
      • in Singapore = $9,200 [12]
    • Hysterectomy
      • in U.S. = $20,000
      • in Costa Rica = $4,000 [13]

    But critics of medical tourism have reasonable concerns about the trend’s growing popularity, including ensuring quality of care. It’s important to note that the Joint Commission International certifies approximately 170 hospitals and medical centers worldwide, and many hospitals popular with medical tourists staff physicians who have been trained and certified in the U.S. [14] Take, for example, Thailand’s Bumrungrad Hospital: It’s the world’s No. 1 international hospital and offers state-of-the-art technology and treatments that cost about one-eighth of what they do in the U.S. [15]

    Despite the availability of high-quality care outside the U.S., the problem lies in assuring access to qualified physicians. While hospitals and facilities abroad can receive accreditation from reputable sources, it’s not guaranteed that the specific physicians and nurses who treat a patient are properly trained and certified. Further, one of the factors in the lower cost of healthcare abroad is the limited legal recourse available outside the U.S.

    “It’s unclear at this time whether the risks outweigh the benefits,” said Dr. J. James Rohack, an AMA board member.

    It is important for those considering medical tourism to make sure that it’s medically safe for them to travel. Prior to traveling, patients should also research the treatments they will receive, the country to which they are traveling, the hospitals in which they will stay and the physicians who will be treating them. Patients should also work with their doctors at home in order to obtain any necessary records and paperwork and to schedule follow-up care for when they return.

    In an effort to ensure the safety of patients considering going abroad for medical treatment, the AMA approved new guidelines regarding medical tourism on June 16, 2008. To download the AMA’s complete list of guidelines, click
      here . [19]

    [1] Newsome, Brian. “Patients with Passports.” The Gazette. July 13, 2008.
    [2]  Ibid.
    [3] “Vacation, Adventure and Surgery?” Sept. 4, 2005.
    [4] Newsome, Brian. “Patients with Passports.” The Gazette. July 13, 2008.
    [5] Aleccia, JoNel. “Hip Surgery in India? Insurance May Pay.” June 30, 2008.
    [6]  Ibid.
    [7]  Ibid.
    [8]  Ibid.
    [9] “Booming Indian Medical Tourism.” MSN Life & Style. April 28, 2008.
    [10]  Ibid.
    [11] Newsome, Brian. “Patients with Passports.” The Gazette. July 13, 2008.
    [12]  Ibid.
    [13]  Ibid.
    [14] Aleccia, JoNel. “Hip Surgery in India? Insurance May Pay.” June 30, 2008.
    [15] “Vacation, Adventure and Surgery?” Sept. 4, 2005.
    [16] Caplan, Arthur. “Opinion: Medical Road Trips Not Worth the Cost.” June 30, 2008.
    [17] Aleccia, JoNel. “Hip Surgery in India? Insurance May Pay.” June 30, 2008.
    [18] Newsome, Brian. “Patients with Passports.” The Gazette. July 13, 2008.
    [19] American Medical Association. “AMA Provides First Ever Guidance on Medical Tourism.” June 16, 2008.

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