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
