Re: Lower costs lure U.S. patients abroad for treatment

On Sat, 28 Mar 2009 16:18:57 -0400, Jim Higgins
<gordian238@xxxxxxxxxxx> wrote:

Lower costs lure U.S. patients abroad for treatment
http://www.cnn.com/2009/HEALTH/03/27/india.medical.travel/index.html

NEW DELHI, India (CNN) -- "I was a walking time bomb. I knew I had to
get on that plane if I wanted to be around to see my grandkids."

Sandra Giustina is a 61-year-old uninsured American. For three years she
saved her money in hopes of affording heart surgery to correct her
atrial fibrillation. "They [U.S. hospitals] told me it would be about
$175,000, and there was just no way could I come up with that," Giustina
said.

So, with a little digging online, she found several high quality
hospitals vying for her business, at a fraction of the U.S. cost. Within
a month, she was on a plane from her home in Las Vegas, Nevada, to New
Delhi, India. Surgeons at Max Hospital fixed her heart for "under
$10,000 total, including travel."

Giustina is just one of millions around the world journeying outside
their native land for medical treatment, a phenomenon known as "medical
tourism." Experts say the trend in global health care has just begun.
Next year alone, an estimated 6 million Americans will travel abroad for
surgery, according to a 2008 Deloitte study. "Medical care in countries
such as India, Thailand and Singapore can cost as little as 10 percent
of the cost of comparable care in the United States," the report found.

Companies such as Los Angeles-based Planet Hospital are creating a niche
in the service industry as medical travel planners. One guidebook says
that more than 200 have sprung up in the last few years. "We find the
best possible surgeons and deliver their service to patients safely,
affordably and immediately," said Rudy Rupak, president of Planet
Hospital. "No one should have to choose between an operation to save
their life or going bankrupt."

Planet Hospital, which works with international clients as well as
Americans, books patients' travel and arranges phone interviews with
potential surgeons. Patients are greeted by a company representative at
the airport in the country where they've chosen to be treated; a 24-hour
personal "patient concierge" is also provided, a level of service that's
standard among many of the top medical travel planning companies.
VideoWatch Dr. Sanjay Gupta meet some medical tourists »

"Our patient concierge was amazing," said Giustina. "He came to the
hospital every day, gave us his personal [telephone] number and after my
operation, he arranged private tours of India." Just two days post-op,
Giustina and her husband, Dino, toured local markets and landmarks
including the Presidential Palace and the Taj Mahal.

"I was able to fix my heart and tour India, which is something I thought
I'd never do."

Walk through a patient wing at Max Hospital in New Delhi on any given
day and you're likely to see people from around the world. In one visit,
CNN met patients from the United Kingdom, Nigeria, Jordan, Afghanistan
and the United States. They're alike in choosing surgery abroad, but
their reasons differ.

Many South Asians and Africans said they travel abroad because they do
not have access to care in their homeland.

Some Canadians and Europeans said they chose to travel aboard, despite
having national health plans, because they are tired of waiting --
sometimes years -- for treatment.

Patients from the Middle East said they come to India because the
technology as well as the staff is more advanced.

For most Americans CNN spoke to, it came down to finding the best value.
"If I could have afforded my procedure in the United States, I would
have taken it, but that was not my option," Giustina said. "I had to get
online and look for a Plan B." Read about hot destinations for medical
tourism

The private hospitals in India market themselves as having upscale
accommodations, Western-trained surgeons and state-of-the-art medical
equipment.

CNN spent time at Max Healthcare in New Delhi and saw operating rooms
similar to those in many U.S. hospitals. If fact, Max's neurosurgery
room had an inter-operative MRI scanner, which is technology hardly seen
at hospitals in the United States.

The lobby had marble floors, a book café, coffee station and a Subway
sandwich shop. The patient suites were equipped with flat screen TVs,
DVD players and Wi-Fi. This hospital also catered to families traveling
together. The suites had adjoining rooms with a kitchenette, coffee
maker and a sofa bed.

Max neurosurgeon Dr. Ajaya Jha said the hospital can provide
high-quality care at low prices because the staff work hard to cut
waste. VideoWatch Dr. Gupta visit an Indian spice market »

"I've seen hospitals in the U.S. where they open up something costing
$10,000 and say, 'Oh it's not working. OK, give me another one.' We
would never do that here. Even for 100 rupees (about $2) -- we would
say, "Do we need to open this suture? Do we need to open this gauze?' We
are very conscious of cost."

Hospital officials negotiate hard to keep costs low for high-tech
medical machinery and other supplies, Jha said. "In the U.S. people are
making careers out of carrying laptops and documenting things that are
not really useful in the long term for the patient."

The salary of a U.S. surgeon is five times that of a surgeon in India.
"We [surgeons in India] want to make a profit, but we don't want to
profiteer. We don't want squeeze people and I think American industries
should also think that way," Jha said.

Critics of medical tourism warn patients to be diligent when researching
treatment aboard. "I've found that industry voices tend to crowd out
those of us who are more cautious about the legal risks," said Nathan
Cortez, assistant law professor at Southern Methodist University, who is
conducting a case study investigating what legal recourse patients have
outside America.

Patients don't think about their legal vulnerabilities, Cortez said.
"Some countries limit patient access to medical records so they can't
really learn what happened during the surgery. And a lot of
practitioners in other countries just refuse to give you your medical
records. So people have to weigh the risk versus benefits."

While most tourism patients from America are uninsured, major U.S.
insurance companies are considering providing "medical tourism" coverage
to their customers. Several have already launched pilot programs.

"I think what's really important about medical tourism is that you make
the choice for what's right for you and what's important to them," said
a spokesman for U.S. health insurer WellPoint Inc.

Experts say that every patient considering traveling abroad for surgery
should inquire about postoperative care, legal rights and the safety
standards and certifications of the hospital. Foreign health care
providers should be willing to discuss the procedure and answer question
ahead of time.

"What really helped me feel good about the process was that my doctor in
the U.S. spoke to the cardiologist in India prior to my trip," said
Giustina. "They were so open about everything; I knew I'd be in good hands."

Just weeks from returning from abroad, Giustina says she has only one
regret, "I shouldn't have waited so long! I feel like a new person
again, no more pain."

Jim, if Obamacare wins, where are Canadians going to go? India?
.

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