Can Medical Tourism Save Us From Obamacare?

3913JCI480 Can Medical Tourism Save Us From Obamacare?

Outside of the United States, going to another country for
medical care can lead to survival and recovery for patients
otherwise facing certain death or long waits for treatment at home.
Nigeria has no oncological care to speak of, so cancer-stricken
citizens are increasingly going abroad for modern care.
Battle-wounded Syrians are
getting life-saving surgeries in Turkish hospitals. Canadians
come to the U.S. to avoid
average wait times of four months for non-emergency
procedures.If the double whammy of Obamacare, which will be fully up and
running in 2014, and a rapidly aging population creates pronounced
health-care shortages, more and more Americans may soon start
looking abroad for fast, affordable, and effective treatments for
all sorts of medical problems.The global health-care industry is booming, which is creating
new opportunities for medical travelers to purchase everything from
discount dental work to state-of-the-art heart surgery. The
international accreditation agency known as Joint Commission
International evaluates the quality of hospitals around
the world. It has given its stamp of approval to
546 hospitals worldwide and the list is growing faster than
ever.Foreign governments and hospitals are staking big dollars on
promotion and infrastructure in an effort to burnish their
reputations as medical destinations. That enthusiasm was on display
last October at a medical tourism industry
conference in Miami, which drew participants from 90 countries.
Turkey, which paid close to $100,000 in exchange for prominent
branding at the conference, drew 500,000 foreign patients in 2011.
Medical tourists brought the country $3.5 billion in revenue in
2011, according to the head of the Turkish Healthcare
Travel Council, Emin Çakmak.Josef Woodman is the founder of Patients Beyond Borders
and the author of several guidebooks to the medical tourism
industry. He says foreign hospitals face more pressure to keep
their costs down than their U.S. counterparts because their
patients generally pay their bills out of pocket. And even highly
skilled doctors in most countries earn significantly less than in
the U.S. In India, heart-valve replacement surgery costs one-tenth
of what U.S. hospitals charge. A knee replacement in Thailand runs
about one-third of the U.S. price. In South Korea, gastric bypass
surgery can be had for half the U.S. price.The globalization of health care means
countries are specializing in certain kinds of care. Turkey excels
in pediatric cardiology. Singapore is a destination for oncological
care. Chinese heart patients needing top-notch angioplasty go to
Japan. Israel and Barbados excel in fertility treatment. Costa Rica
and Hungary have become dentistry destinations. Thailand excels in
a wide range of specialties thanks in part to its renowned Bumrungrad
International Hospital, which serves 400,000 foreign patients a
year.Port Charlotte, Florida-based orthopedist Sam Hess is part of a
group that’s working to open a full-service hospital on the
Caribbean island of St. Maarten. Hess says he’s grown tired of the
legal and bureaucratic headaches of practicing medicine in the U.S.
“I still love what I do, but the issues I have to deal with that
have nothing to do with patient care take a lot of wind out of my
sails,” explains Hess. “We have to assign more and more of our
staff to address insurance concerns and approvals. We order tests
we don’t need to cover ourselves legally.”Hess would also like the freedom to offer treatments that aren’t
legal yet in the U.S. Medical tourism offers doctors and patients a
way around the FDA’s often slow-moving approval process. Consider
an orthopedic procedure called Birmingham Hip Resurfacing that
gives younger patients an alternative to a total hip replacement.
It was invented by a British Surgeon in 1991, but the FDA didn’t
approve the technique until 2006. In the interim, patients flocked
to Chennai, India, to be treated by star surgeon Vijay Bose.Medical travelers don’t always make wise choices. Many seek out
bogus stem-cell treatments for disorders like autism, multiple
sclerosis, Down syndrome, and depression. Researchers anticipate
that one day stem cells will be used to treat a broad range of
diseases and conditions, but so far they’ve have been clinically
proven effective only for certain blood disorders.Harvard
Law professor I. Glenn Cohen, the author of
a new book about the globalization of health care, says the
stem-cell industry could be largely self-regulating if patients had
access to better information online. The scarcity of reliable
performance data is a major problem in the medical tourism
industry, according to Harvard Medical School Professor Sharon
Kleefield, who is working on developing better methods for
gathering information from foreign hospitals. There’s no ranking of
the best global hospitals by specialty, which Kleefield thinks
would go a long way towards convincing skittish U.S. employers and
insurance companies to partner with foreign health-care
providers.Most medical tourists traveling out of the U.S. are seeking
procedures that traditional health insurance companies don’t cover
– such as dental work, plastic surgery, and in vitro fertilization
(IVF). But that’s likely to change as health care becomes scarcer.
Obamacare, which will be fully enacted in 2014, increases the
demand for health care without doing much to grow the number of
doctors, nurses, and hospital beds necessary to meet that demand.
The aging of the baby boom generation (those born between 1946 and
1964) is already putting a strain on resources. By 2025, there will
be 64 million Americans over the age of 65. That’s almost double
the number at the start of the century.Some U.S. patients will follow in the footsteps of
the nearly
50,000 Canadians a year who forego their insurance
coverage and pay out of pocket for better and immediate treatment
abroad. Medical tourism may also flourish within the regulatory
confines of Obamacare. Southern Methodist
University’s Nathan Cortez argues in
an soon-to-be published essay that there’s nothing in the
Affordable Care Act that specifically prohibits insurance companies
from encouraging their clients to use foreign providers. It’s also
possible that insurance plans that utilize medical tourism could be
offered on the state-based insurance exchanges, although the U.S.
Department of Health and Human Services may choose to interpret the
law in ways that makes that difficult.Whatever the hurdles, the often-impeccable quality and low
prices available abroad will lead more patients to travel for
treatment in the coming years. “You’re going to see huge
competitive forces coming to bear on the U.S. health care system,”
says Josef Woodman of Patients Beyond Borders. “And god knows, we
need it.”Video shot, edited, narrated, and written by Jim Epstein.Approximately 4 minutes.Scroll down for downloadable versions and subscribe to Reason TV’s YouTube
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Can Medical Tourism Save Us From Obamacare?

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