Hey Buddy, Can I Catch A Lift To India For My Health Care?
September 30th, 2008
Last year we visited an Indian hospital that engaged in medical tourism. Fascinating place and visit.
Today’s Wall Street Journal [subscription required] had a great article on this very subject (Paying Workers To Go Abroad For Health Care).
Short summary:
In an effort to control rising costs, a small but growing number of insurers and employers are giving people the option of seeking treatment in countries like India.
I predict said trend will continue and more and more firms will do this.
Check out the article.
Have any of you worked for or do any of you work for firms that have plugged into medical tourism to help cut costs? If so, what has been your experience?
If not, if/when that day comes, won’t this trip help you make a better/more informed decision re: the viability of going this route for you individually and/or for you as a manager of your firm trying to educate your employees on this option?
16 Comments Add your own
1. Alex Thornton | December 21st, 2009 at 8:36 pm
The first thing that came to mind on traveling to India for cheaper health care was the fact the insured people have now incentive to travel abroad. The article confirmed this. If you have insurance, you just pay up to the annual limit. Regardless if the cost is $100,000 or $8,500, the insurance company will pay the majority of the cost. Spiting the savings between the patient and insurance company is an interesting idea.
I would probably wait a number of years for others to test out this new system. And of course, I would conduct a lot of research before hand.
2. Lindsay Leaver | January 9th, 2010 at 9:07 pm
I think it is great, and I think it is a rising trend. The cost of procedures in America has become absurd. If you can get the same/better standard of care in another country, it makes perfect sense to me to go there and do it. Just another form of globalization.
One of the countries that is popular for this, but not in the article is Mexico. For us on the West Coast it is close and easy to get to, and it actually offers clean hospitals and educated doctors. A few years back I had an accident while surfing in Mexico. Let’s call it a rock-to-the-face situation. I went to the local hospital expecting to find cockroaches and dirt, but I was WAY off. I had a short wait time, a clean room, a doctor who spoke English, xrays, shots, and medication. They sent me away patched up and perfectly satisfied. It was far superior to the level of care I have received in American emergency rooms.
A fixed knee and a trip to an exotic place… I say do it!
See the Daily Show’s take on Mexican Healthcare…
http://www.thedailyshow.com/watch/mon-november-30-2009/american-refugees-seek-health-care-in-mexico
3. Phil Hamer | January 23rd, 2010 at 2:26 pm
I had a lung operation in Singapore where I was hospitalized for 11 days, stayed in a private room with a view and a refrigerator, had daily X-rays and you name it. The entire medical bill coming out was $2000. I felt I got much better care than I would have got at home.
I also got two fillings and a teeth cleaning in China. The dentist used more sophisticated equipment than I had seen in America and spoke English well. It cost me $20! The amount I usually have to pay as penalty for missing an appointment here in the states.
Unfortunately emergencies do happen and insurance is a necessary evil in this country, otherwise I would skip insurance all together and just use my premiums to travel.
4. Tim Lynds | January 23rd, 2010 at 4:43 pm
While I completely agree that US health care procedures are overpriced, I would approach the idea of having a major medical procedure performed in a foreign country with caution. The article does a good job of outlining some of the possible downsides of medical tourism. The two downsides that put me off the most are the possible lack of ability to respond to complications and the difficulty or lack of recourse in the event of malpractice.
The first downside is a huge turn off for me. If someone is going to cut my chest open and play with my heart (not in the emotional way), I want that person to have the resources available to appropriately and quickly respond to any possible contingency. If the hospital has the equipment and supplies and the doctors have the most current knowhow, then more power to them.
The second downside bothers me because there is no real penalty for negligence or other malpractice. Sure there are a lot of good people who are doctors who would always do their absolute best because their conscious would weigh on them if they made a mistake, but there are also the other types of people. Either way, doctors are human and humans are destined to make mistakes. Medical mistakes can take away a person’s livelihood and cause huge financial and personal hardships for them. In the US these hardships can be at least somewhat relieved by lawsuit settlements.
A third downside that is much less of a concern for me but is still important to address, was mentioned in the article by Stan Johnson, the union director. Stan makes a good point that if medical tourism becomes a common option in many health care plans, it may eventually become the rule of insurance companies. Insurance companies are businesses and just like other types of businesses they are guided by the bottom line. Why wouldn’t they eventually force customers to travel to get procedures at a fraction of the cost? I personally do not want to be forced to fly 9000 miles one way to India to get a procedure done. I prefer immediate bed rest at home after a procedure rather than a 20 hour flight.
5. Erika Bylund | February 18th, 2010 at 7:46 pm
If I was an employer, I would not encourage my employees to obtain invasive medical surgery abroad to save money for my company. It is absolutely not worth the long term follow up, health, and legal risks. Even the U.S. still has problems (although sporadic) maintaining “clean” blood and tissue supplies. If we still have “slip-ups” like this, what can we expect in developing countries? Furthermore, many countries that can perform these types of discounted surgeries often have regulating and government agencies that suffer from bribery and corruption. Knowing that that’s even a possibility makes me very nervous, especially when it’s compounded by the fact that viral infections like HIV and Hep-C are higher in such countries. No thanks. Call me paranoid, but when it comes to healthcare, there’s no amount of money worth the short-cut. This isn’t a commodity we’re talking about- it’s life.
However, I know many people who have had successful plastic surgery operations in Costa Rica. My father-in-law gets all of his dental work done in Mexico for a fraction of the price by dentists educated in American dental schools, and he’s very satisfied.
6. Jay Ponto | February 19th, 2010 at 3:13 pm
As an oddball MBA who will be entering a health professions school next year (dental), I find this subject very interesting. I would very much like to analyze this topic further.
I can say with confidence that no dentist in the US will charge as little as $20 for two fillings and a cleaning. Typically, a cleaning alone will AT LEAST cost $60 (if you don’t have insurance to cover it). I’d be curious to know where that dentist got his equipment. The cost for equipment is monumental, as are the costs of attending any dental (or other health professional) school in the US. When you take into account overhead including rent, supplies, staff, and utilities, it is inconceivable for me to imagine how health care (in this case dental) could possibly be THAT inexpensive, even in China. Government subsidizing must come in somewhere. Additionally, there is definitely something I’m missing…
7. William Ary | February 21st, 2010 at 8:12 pm
People will do whatever they have to do in order to save money on things that they need to get done, even healthcare. I think its just another sign of globalization. I don’t worry about the quality of the care in a country, rather I worry about the standards of the doctor and the practice itself. If that proves satisfactory when audited in some way by an unbiased third party, I have no complaints going there for my healthcare. My mom does this kind of stuff all the time in Mexico.
8. Kirk Story | February 23rd, 2010 at 10:34 pm
I am not personally adverse to the notion of cheaper health care. Hence, I don’t subscribe to the insurance lobby. However, there appears to be some inherent flaws in outsourcing health care. As Tim paraphrased, ‘if this becomes the norm for US health care companies… it’s game over.’ We have seen, and many of us have personally experienced insurance companies manipulating obligations to the most profitable outcome possible. I can not imagine my grandmother climbing aboard a Horizon Air commuter in route to India. No thanks. Are we really this uncompetitive, or has our health care system been robbed by the rigged-market opportunists?
9. Michael Minasian | March 5th, 2010 at 4:50 pm
I think this is a very interesting question. I don’t see myself ever outsourcing my own health care. I don’t have any inherent problems with it, I just think the hassle and risks are not worth it. I was actually somewhat in favor of the idea in general, but Tim made a very good point. I did not consider the issue of follow up care. Even if a procedure is done correctly, there can be complications. I think that the extra costs, and probably lack of communication between the many parties involved will probably lead to more cost in the long run for my care. It is not an issue of trust or standards with foreign hospitals, but there are so many other factors, logistical and otherwise in play. Airfare, Visa, passport, blood/tissue transfusions etc. For certain people, under the right circumstances I think it is a positive. I don’t think it is for me. Perhaps my view will change once I make the long trip to a country like India?
10. Danielle Steussy | March 7th, 2010 at 12:49 pm
While I was reading this article I was immediately reminded of that Jon Stewart segment a while ago. Thank you, Lindsay, for posting that!
If countries like China and India are offering medical procedures for a fraction of the price of the care received in the United States, that only shows just how absurd insurance and medical costs are here. Despite the absurdity, ultimately it may be less costly to be taken care of domestically rather than being shipped out to another country for a procedure. Like everyone has already pointed out, follow-up care could be a big issue and travel alone could be incredibly costly. I think we need to start focusing on driving down our own costs here in the United States in order to incentivize companies to stay local. Until then, outsourcing health care is not a bad option if it continues to be safe and sanitary and is less costly in all dimensions compared to the US system.
11. Chase Janvrin | March 7th, 2010 at 7:36 pm
I agree with the hesitation that some of the others have expressed. Although I don’t necessarily doubt the ability, skill, technology, and prices of doctors and medical facilities in some other countries, I would be very nervous because of the lack of personal support I would have. Having a dental cleaning or filling done is one thing, but having invasive surgery when IF something does go wrong, it might be really wrong. I wouldn’t want to be there without my family and friends to lean on. I’ve (unfortunately) have had surgery several times, including eye surgery in Canada. That one instance there were complications, and this routine procedure turned into a nightmare, while I had to depend on the hotel staff where I was staying to help me. Even if it costs more, I’ll be staying state side thank you.
12. Catherine Kristensen | March 8th, 2010 at 5:16 pm
I found the article very interesting, but I was surprised to see that it left out a key industry - infertility. I worked in the infertility industry for 6 years and one of our biggest competitors was “medical tourism” - at least for our American clients. On the flip-side, “medical tourism” was one of our key revenue generators as citizens of countries with very strict guidelines traveled to the US to take advantage of our lax regulations.
Many clients opted to seek services abroad for a fraction of the cost. I am sure that the medical facility screening/monitoring fees and surgery costs are a lot lower, but I can’t wrap my mind around the prescription costs. Drugs are one of the largest expenses during fertility treatments (i.e. IVF) and I don’t understand how foreign countries are able to keep those expenses down - are they using knock-off FSH injections? Is the HCG legit? Or are Americans bringing their own drugs abroad with them?
Beyond the reduced cost, I think one of the main appeals of “reproductive tourism” (as its called) is the guaranteed confidentiality. Many patients are very private about their fertility needs and know that confidentiality can be maintained when there are no chances of running into their foreign nurse, doctor or egg donor at the grocery store! I assume this mindset would likely carry over to those receiving liposuction and breast enhancements as well…
13. Jordan Wente | March 10th, 2010 at 11:02 am
It doesn’t seem practical to me. It may be cheaper to travel abroad for medical procedures but is it safe? I don’t mean are the hospitals safe, but is it safe to put the stress on your body from traveling after having a major procedure. There is a lot to be said about the effects of stress on your health. It just doesn’t seem like a good idea to Introduce more stressors during the recovery process. I would also think wouldn’t be practical because a lot of health issues require immediate attention or prolonged treatment. I can’t see how these issues would be addressed by going abroad for treatment.
I would also see the possibility of this backfiring if the trend continues. If medical tourism continues and demand in other countries will increase which could lead to price increases as well. How are the prices that low? What are the doctor’s incentives to give the highest quality care possible? Isn’t one of the reasons medical care is so expensive has to do with incentives and the ability to pay off the expenses of medical school and be compensated for the time and effort put in. I agree its outrageously priced but I think some of it is necessary. It may be cheaper for the employer but I do not think going abroad for treatment will help solve some of the basic issues in the health care system.
14. Chris Phippen | March 12th, 2010 at 1:16 pm
I think its great that this is an option for a growing number of people. It is new, different and offers exciting implications. That said, I personally wouldn’t be caught… dead… nevermind, the point is I wouldn’t embrace this option for myself or my family. I agree with Erika and others above, the risks for bloodborne pathogens and aftercare treatment, follow-ups, etc are just too big a gamble when it comes to my health. As a manager, I would not encourage this option but would be happy to provide it as long as the employees were made aware of the risks involved. It would be up to them to weigh the cost savings with the associated risks.
As for the question asked at the end of the blog, I have not undergone any surgeries abroad or worked for any firms thus far that offer such an option. I absolutely believe that after this trip, no one in my organization will be better able to make an informed decision on and educate employees on this type of option for the company.
15. Vitus Holzner | March 19th, 2010 at 12:55 am
And another example from my home country: A major medical expense for us Germans is dental care. If a patient chooses to get the best available material for her dentures the co-payment can easily go up to $3000 - $5000. Compared to costs patients incur here in the US this amount seems ridiculously low but for patients who are used to a (almost) zero out-of-pocket expense system this really hurts.
Since German insurance companies are obligated to pay for treatment in all European member states a vivid medical tourism evolved over the last few years. I know quite a few people who had their teeth fixed in for example Poland or Bulgaria. Despite the additional cost for travel and accommodation they still saved a chunk of change. The European regulatory framework protects patients from malpractice no matter where in the EU they seek treatment.
I see medical tourism as a two bladed sword. The upside is clearly the potential for cost savings. On the other hand I share Kirks fears that insurance companies could mandate where I have a certain procedure done. I mean in the US HMOs already dictate which doctors their members can use and I don’t think it’s too for of a stretch seeing this expanded to doctors and hospitals in other countries.
A great PBS documentary on how five capitalist democracies — the United Kingdom, Japan, Germany, Taiwan and Switzerland — deliver health care, and what the United States might learn from their successes and their failures. I called Sick around the world and is available online.
16. Jeff | April 1st, 2010 at 7:46 am
I think if there is a bad actor to be identified in the situation that’s causing people to get procedures done off-shore it can be blamed on one bad actor… Insurance Companies.
They are similar to stock brokers….they get paid for the transactions whether you win or lose. Insurance companies get paid for insurance by the doctors for medical malpractice and liability, they get paid by patients for their health insurance premiums. They can look at their actuarial tables, apply a modicum of statistics and decide what price you will pay. They will not lose. They are somewhat interested in overseas procedures because they see a profit in it….Their job is not health care, it’s increasing shareholder value. Right?
If I were to decide on where to have a surgical procedure performed on me that in the US would cost $100K, but in Thailand, $10K, but in addition to accredited hospital, new equipment, skilled doctors, my own room, 2 weeks of R&R in warm weather…what would I do? I don’t think it takes too much thinking to come to a conclusion.
If the spokesman for the American Academy of Orthopedic Surgeons warns against the practice because of blood pathogens, but “We don’t have data…” the only thing he’s doing is propagating fear mongering. If he doesn’t have data, he shouldn’t be saying anything.
If you want to see horror stories on medical procedures gone bad, you don’t have to go any further than Hollywood.
Note: I tried to post this comment 3 times on the 19th, but the system wouldn’t take it.
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