Consumer Directed Healthcare Abroad

Dr. Scherger is clinical professor of family medicine at UCSD. This article is from the Editor's Column, October 2007 issue of "San Diego Physician", published by the San Diego County Medical Society.

A NEW MEDICAL MAGAZINE arrived in the mail. Big deal. Then I took a look at it. Issue 1 of The International Medical Travel Journal. I was flabbergasted by what I found inside. I knew that places like India were attracting "medical tourists" from the United States for less expensive surgeries and other treatments. I was not prepared for what I found inside, and I would like to share with you a sampling of articles and current offerings.

Singapore aims to attract one million medical tourists by 2012 through the efforts of SingaporeMedicine, an initiative of the Economic Development Board of Singapore, Singapore Tourism Board, and International Enterprise Singapore. In 2005, the number of visitors who came to Singapore expressly for healthcare reached 370,000. A growing number of medical and surgical specialists offer a complete range of consultative and treatment procedures. Medical travel agents are standing by to help you.

Vietnam opened its first medical-travel resort, Medicoast, in February 2007 in the popular seaside town of Vung Tau. The resort offers pediatrics, obstetrics, eye surgery, orthopedics, nutrition advice, general surgery, and cosmetic dentistry.

Tourism officials in Thailand are optimistic the number of medical tourists will reach two million by 2011. The Thai medical-travel industry has several advantages: "First is the quality of doctors, second is price, and third is that patients do not have to wait to see a good doctor."

The South Korean government and private hospitals are collaborating to attract overseas patients. The priority target for international patients is Korea's advanced techniques in LASIK operations, Oriental-medicine treatment, plastic surgery, backbone surgery, artificial fertilization and implant treatments.

India and Taiwan are relaxing visa restrictions to help promote medical travel, and the options are extensive and rapidly growing.

Turning from Asia to Latin America, a recent San Diego Union Tribune reprinted a Miami Herald article about Americans traveling to Panama, Mexico, Costa Rica, Columbia, Argentina, and Chile. The article states that United Nations figures show that travel and tourism is now the world's largest industry at $4.4 trillion, more than defense, manufacturing, oil, and agriculture. Medical tourism is the hottest new sector in the travel industry.

This is not just about Americans traveling abroad for less expensive medical care. Annually, about 50,000 British patients travel out of the United Kingdom to escape long waiting lists and out of fear of contracting hospital infections. The most popular destinations are India, Hungary, and Turkey. In Germany, a new website is offering "e-auctions" for medical treatment: www.arzt-preisvergleich.de. The site asks patients to post how much they have been quoted for a treatment from one physician, allowing other physicians to offer to beat the price. When physicians compete, you win!

A new Irish Internet start-up www.revahealthnetwork.com describes itself as a matchmaking site for those interested in having medi-cal treatment in other countries.

If you want to avoid the Third World, try Switzerland. The five-star diagnostic center, The Diagnostic & Prevention Center (DaP) in St. Moritz, claims to be the first European medical resort of its kind. DaP offers a range of packages to suit each client's needs. Clients are expected to come from all areas of Europe, particularly Italy, Germany, and the United Kingdom. Like with Swiss banks, strict confidentiality of results will be maintained.

The list goes on: Bahrain, Dubai's Healthcare City, Israel, South Africa, and even (this will make you smile) Iran. Not to be totally outdone, the United Kingdom's largest private hospital, London Bridge Hospital, is getting into this.

Of course this type of activity has been going on in the United States for many years. Cleveland Clinic and Mayo Clinic have large international caseloads. New York hospitals advertise all over the world. I have witnessed the efforts of the University of California medical centers. But the problem in the United States is our prices for medical care. Despite the higher costs for almost everything in Europe, healthcare costs run about half that of the United States. In the Third World, pockets of excellence can operate at a small fraction of U.S. prices.

What about accreditation and liability? These issues are being covered. Our own Joint Commission now accredits international hospitals and facilities. Interestingly, India added Australian hospital accreditation as an option. The quality international centers make transparent their liability coverage, and patients can purchase their own policies to guarantee the results.

The days of rich Arabs coming to the United States and paying top dollar are coming to an end. The world is rapidly becoming flat for quality medical care. The private healthcare market in the United States facilitates Americans going abroad for care. With the rise of consumer-directed healthcare, and patients paying more of the costs, medical travel is likely to steadily increase unless we can be competitive at home. Health insurance plans in the United States are even beginning to cover medical travel since the costs are lower.

As our patients think about traveling abroad for care, we should seize the opportunity and become a destination for medical travel. Think of those HMO and PPO rates we accept. Many people in the world will pay much better.

jscherger@CUSD.edu