Where Have All the Patients Gone?
by Jennifer Altavilla
Usually, surgery is no vacation. However, in recent years, Americans have begun to travel to exotic locations - South Africa, Argentina, Thailand, Brazil, Costa Rica, India, and Singapore - to have surgery. As the cost of insurance rises and the quality of care in U.S. hospitals declines, more and more U.S. citizens are looking abroad for medical care.
The low cost of surgery abroad is probably the most appealing aspect of the burgeoning practice called "medical tourism," where people often combine their surgery in a foreign country with extravagant vacations. Cosmetic surgery—which is not covered by insurance in the United States—costs between half or one-fifth abroad of what it costs in the United States. U-Daily, the University of Delaware’s online news source, reports that a $20,000 face lift costs only $1,250 in South Africa. In addition, major non-elective surgery costs 30-80% less in foreign countries. For example, as Walecia Konrad reports in the Fortune Small Business magazine article "Employees Make a Push for 'Medical Tourism,'" a coronary artery bypass surgery costing $75,000 in U.S. dollars costs only $11,400, including roundtrip airfare, at Fortis Mohali Hospital in India. For the approximately 47 million U.S. citizens who do not have health insurance, surgery abroad is the most attractive, and sometimes the only, option.
Surgery abroad is also the only option for some small business owners who cannot afford to give their employees adequate health insurance. Konrad writes that in an effort to cut costs by 10% per year and avoid a 20-30% rise in health insurance premiums, Steve Chavez, president of Albuquerque construction firm Integrate Control Systems, is promoting the practice of medical tourism to his 180 employees. The endorsement of medical tourism by employers has given rise to companies such as GlobalChoice healthcare, an Albuquerque firm started in 2005 by Ken Erickson, which connects U.S. employers to foreign doctors. GlobalChoice healthcare—which works with doctors in India, Mexico and Singapore— also arranges air travel, hotel accommodations, and sightseeing tours for the ailing employees.
The exchange rate, the low cost of labor, and lower malpractice insurance costs drive down the price of surgery abroad. However, lower costs do not equal lower quality as it is commonly assumed. In fact, the quality of doctors and post-surgical care in foreign hospitals is comparable—and often better— than the quality of American doctors and post-surgical care. As Tim Wallace, Vice-President of sales and marketing for Med Journeys, a New York City medical tourism agency, says in Neil Schlecht's article "Face Lift, Luxury Safari—Bargain Price," 80% of doctors practicing in internationally accredited hospitals are trained in the United States or United Kingdom.
The prevalence of United States-trained doctors abroad leads Americans to hospitals such a Bumrungrad Hospital in Thailand—both the number one international hospital in the world and also the hospital with the most foreign patients in the world. In addition to being staffed by 500 doctors, most of whom are trained in the United States or Europe, Bumrungrad is decorated like a 5-star hotel, complete with on-site boutiques and restaurants. Why would anyone want to stay at an understaffed, overpriced, and unattractive American hospital when they could be treated in an affordable, luxurious, world-class hospital abroad?
Although medical tourism will probably not significantly affect the finances of American hospitals, it has helped to unearth serious problems within the American medical system. As countries like Thailand build world-class hospitals and as India tries to become the "world destination for healthcare," as Anjali Kapoor Bissell, director of hospital group Apollo International, says in the article "Vacation, Adventure and Surgery," the United States is slowly being left behind. Superfluous medical lawsuits and subsequently high malpractice insurance costs are driving doctors out of practice or back to their home countries. Lack of universal health insurance prevents millions of Americans from receiving care from the doctors that are left. Ironically, the U.S., one of the richest countries in the world and the one in which many breakthrough medical advances are made, is shackled with a crumbling healthcare infrastructure. It is no wonder that Americans without insurance, or simply Americans who are dissatisfied with the healthcare system, are looking abroad for surgery. Medical tourism is a natural symptom of the disease that is the U.S. healthcare system.
