Medical tourism Definition
Medical Travel and Medical Tourism
Why are people traveling overseas for medical care?
Quality is essential when considering traveling overseas
Potential Destinations
Medical Travel is not for everyone
Health Insurance
Questions to ask when considering medical travel?
Medical Travel and Medical Tourism
While not yet main stream, traveling overseas for medical treatment is not new. In ancient Roman times documented cases of people traveling comparatively vast distances to locations of health were not uncommon. What is new is that the major reason Americans are traveling overseas is that the high cost of elective, non-acute medical procedures is making such procedures inaccessible at home in the US.
The ‘early movers’ in this industry are the uninsured, the underinsured or those who travel for procedures that are not usually covered by insurance. However with the uninsured in the USA hovering around 60 million that is no small market. Various reports put the number of medical travelers leaving the USA each year between the realistic figure of 85,000 (McKinsey report) to the more optimist figure of 750,000 (Deloitte). A recent report by Deloitte indicated that by the year 2017 between 12 and 15 million Americans will travel overseas for treatment. Even if the authors are wrong by 50% it still is a huge number of patients traveling abroad specifically for medical treatment.
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So Why Are People Traveling Overseas For Medical Care?
Again as a survey of 3000 US consumers indicates, if the price of the overseas package is less than 50% of the US procedure cost and the quality is as good as what can be accessed in the USA, then 39% of respondents said they would travel (Deloitte 2008). People are traveling to save money (medical travel) or are making minor procedures part of their vacation in a far away destination (medical tourism).
The difference in cost between the USA and New Zealand for example, is found in Table 1. New Zealand like the USA is an English speaking, first world country which has a cultural and medical alignment with the USA. Yet on average the same procedure performed in New Zealand private hospitals, by surgeons dually trained both in New Zealand and either the US or Europe is about 20-25% of the cost of the procedure in the USA. Even factoring in air travel, accommodation and contingency insurance (in case an adverse event) the cost of the package is around 30-40% the procedure cost alone in the USA.
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Quality Is Essential When Considering Traveling Overseas
Some quality indicators such as where the doctor trained or whether the hospital is accredited Internationally are relatively easy to find out. The International Society of Quality in Healthcare or ISQua accredits most first world medical systems, including the better known American Organization Joint Commission International (JCI). ISQua accredits all of its international agencies to the same standard and thus provides a level of reassurance about the standard of the hospitals that are awarded such accreditation.
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Potential Destinations:
The list of medical travel destinations is growing rapidly. In terms of overseas visitor numbers it is difficult to get a good estimate for each country.
Traditionally medical tourism has been large to destinations like India, Thailand, Singapore and Mexico. It is thought that the vast majority of the current medical visitors to these countries are from nearby regional countries or expatriates living in the USA returning to their country of origin. Newer destinations include New Zealand, Cost Rica, and Israel to name a few. A comparison of these destinations is found in Figure 4.
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Medical Travel Is Not For Everyone
Not everyone can take advantage of medical travel. Patients who have complicated cardiac history such as unstable angina or lung disorders that make air travel risky shouldn’t utilize medical travel. Patients with a variety of coexisting medical conditions also have to be careful. Due to the duration of treatment oncology treatment is also a doubtful candidate. The better medical travel destinations or facilitators prescreen all patients to make sure they are suitable to travel before accepting them as a potential patient.
The American Medical Association (AMA) has also issued guidelines with regards to medical travel which highlight the importance of choosing a procedure that is appropriate to travel abroad for, ensuring that it is appropriate for the patient to travel and lastly make sure that medical travel is voluntary and only ever offered as an option.
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Health Insurance
Deloitte, in predicting that millions of Americans would travel for health reasons, are probably factoring on an industry entering the fray that outside of government, has the biggest impact on health costs; Health Insurers.
To health insurers who are currently losing enrollments, medical travel looks good. Even with their ability to cut deals within the USA; saving over 70% per procedure in an environment where the quality is equally as good as the USA is unparalleled.
BUT WHAT WOULD BE ENTICING TO THE INSURED PATIENT? IT IS POSSIBLE FOR INSURERS TO OFFER A PRODUCT TO THEIR EXISTING CUSTOMERS THAT STILL SAVES THE INSURER OVER 50% AND ALSO ALLOWS THE CUSTOMER TO HAVE:
- Travel to the destination and have the required operation
- No deductible or co-payment charges
- Free Companion travel
- Dedicated recovery time (important in getting the best result from the surgery)
- Less erosion of the customers life time benefit.
- Use of the customers HSA or HRA accounts
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Questions To Ask When Considering Medical Travel?
When considering traveling overseas for medical care, make sure to ask yourself the following:
How easy is communication with the doctors and nurses of the destination hospital?
When dealing with health it is vital that you are not in the vulnerable position of not being understood or not understanding what the doctors and nurses are saying. Thus if you speak English travel to a country whose fi rst offi cial language is English.
How far do I need to travel? Is it a direct flight or multiple stop overs? Find out what happens when things go wrong?
In the majority of western first world country hospitals, the risk of complications is minimal but never zero. Adverse events happen even to healthy people. What contingency has the destination put in place to ensure that I am looked after if I have a complication and how much will it cost?
What is the total cost of the package?
Comparing treatment costs between the US and the medical destinations is meaningless as you need to factor in the cost of traveling there, accommodation, aftercare and transport. Always compare the package cost of the destination to the procedure cost in the USA.
Does the destination provide comprehensive aftercare post discharge from the hospital?
Some destinations provide daily physical therapy and nursing programs to your hotel as well as domiciliary aids to help with shopping and even dressing. Not having comprehensive aftercare can impact on the success of your procedure and recovery time.
While US based medical travel facilitators exist it is possible to work directly with the destination, you can go direct to the source.
How transparent is the medical destination?
Will they share surgical outcomes concerning their hospital for your procedure? How many operations has the surgeon you are seeing performed and what training has the surgeon undergone? Can you talk with Americans that have already been there?
Will I feel safe and comfortable traveling to the destination?
You must be able to completely trust the destination you are traveling to. Traveling and having a medical procedure makes one feel considerably more vulnerable than usual. You don’t want “a foreign experience’ but a destination that is safe, American friendly and conducive to aiding your recovery.
What are the potential hidden costs in the packages?
You don’t want any surprise costs when you travel there. Never assume, always ask what additional out of pocket expenses you can expect.
What is the main purpose of my travel?
While beautiful beaches and tourist attractions are enticing these should not outweigh the quality of care factor in deciding the destination. The time you spend at the destination may involve some must see tourist sites and experiences before the operation. After the operation you will be solely interested in getting better and getting home.
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