"If domestic hospitals actually had to compete with international hospitals the way American car companies have to compete with Toyota and Honda, they might be forced to become more efficient." ~New Yorker MagazineThis year, a few hundred thousand Americans will head to places like Costa Rica, Mexico, India and Thailand and not for the views of the Mayan ruins or ancient Buddhist temples, but rather for affordable medical care.
Yesterday's New Yorker features the story Club Med on James Surowiecki's Financial Page, discussing the increasingly commonplace practice of destination health care, in which US patients travel abroad for treatments as varied as root canals, metabolic surgery (for type 2 diabetes) and hip replacements.
Surowiecki opines that if costs for US healthcare continue to rise, and Obama care is overturned in the Supreme Court, this practice will become more and more common.
Destination health care is nothing new - Mayo Clinic is one of the earliest practitioners, attracting more than 80,000 medical travelers, or medical tourists, per year.
Now, international hospitals such as Bumrungrad Hospital in Bangkok and Angeles hospitals in Mexico are also major hubs for destination healthcare, treating hundreds of thousands of medical tourists every year.
“Ten years from now, we’ll all get on planes and fly somewhere to get treated.” ~NY Times
Other countries reporting annual medical travelers to their private hospitals numbering in the hundreds of thousands include the Philippines, Malaysia, India, Korea, and China; dental travel is common in Mexico and eastern Europe.
The attractions of destination healthcare are many: most significant, of course, is the value, i.e. medical care is much cheaper abroad, often less than half the out of pocket costs to insured patients in the US health system.
But cheap is perhaps not the best word, since the private hospitals catering to American medical travelers are often quite luxurious by US health care standards, with very low nurse:patient ratios, all private rooms, and the latest medical technology.
And as Surowiecki notes, the challenges to medical travel have virtually disappeared with the advent of destination health care facilitation services, including:
- employers providing destination health care options in employee benefits
- physican-founded organizations like Orbicare specializing in taking US stem cell, IVF and metabolic surgery patients to Latin AMerican destinations such as Spain, Argentina
- technology companies like Health Travel Guides providing patients with a global network of health are options and a free, full complement of concierge services to make the process easy
- medical device companies are choosing to bypass the FDA approval process and offering their products abroad, where Americans must follow for the latest technology
Cuts in Medicaid and Medicare might make the cost of US health care cost prohibitive to America's silver citizens, adding further to the growing ranks of medical travelers.
Health care has, to date, been insulated from the impact of globalization, but medical tourism might spell the end of that. Benefits of the practice go beyond savings to the patient, according to Surowiecki; more medical tourism increases free trade in medical services.
The US of course has a long history of breaking down barriers to free trade in manufacturing and service, exposing these industries to foreign competition and resulting in lower prices and higher quality goods and services to American consumers. The same, Surowiecki argues, would hold true for competition in health care.
Despite the technology explosion and social interfacing of the information age, medicine has stubbornly remained an anachronism - local and somewhat unconnected business. That would quickly change if patients could easily engage in domestic medical tourism (i.e. journeying to lower cost hospitals within the US), or if Medicare and Medicaid covered treatment in foreign hospitals, and/or if insurers decide to cut consumers in on the savings from treatment abroad.
Ironically, bringing the US health care system's costs into line might only be possible as the result of more Americans outsourcing their health care.
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