A couple of years ago, a friend of mine
tore the meniscus cartilage in his right knee while playing soccer.
Like me, hes a freelance writer with basic health insurance.
The surgery he
needed would cost about $5,000, and he would pay much of that
before meeting his deductible. Unlike me, he spends several months
a year in India, where his wife studies the linguistics of a
little-known tribe in the Himalaya foothills.
Dan had his
operation at a sports medicine clinic in Austin, Texas. It went
very well. What Dan didnt know was that he could have had the
operation at Indraprastha Apollo Hospital in New Delhi and saved
himself a lot of money.
I just didnt know
that was an option then, he later told me. The regular hospitals in
India are beyond horrifying.
Indraprastha
Apollo, however, is a corporate hospital that serves private
customers rather than the general public. Its staffed with
first-rate specialists who could have treated Dan for about $1,300.
Thats a fortune for most Indians, but its a relative bargain in the
high-priced world of private health care to which most U.S.
citizens are accustomed.
Indeed,
escalating health care costs in the U.S. may be a boon for the
travel industry. Every year, thousands visit countries such as
India, Thailand, Singapore, Malaysia and South Africa for
everything from liposuction to liver transplants.
As many as 150,000 medical
tourists are reported to have visited India in 2002. The Indian
state of Maharashtra (home to Mumbai, aka Bombay) formed the
Medical Tourism Council (MTC) of Maharashtra earlier this
year.
The Singapore
Tourism Board estimates some 270,000 medical tourists are expected
to visit Singapore in 2004 and spend $500 million in Singapore
dollars (nearly $300 million U.S. dollars). Moreover, some
estimates suggest medical tourism could be a $2 billion business in
India by 2012.
A
question of cost
Cost, of course,
is what drives this growing segment of the travel
industry.
According to the
MTC and other sources, heart surgery at a private hospital in India
costs about one-fifth of what it does in the U.S. Even patients who
have the health insurance to pay for heart surgery find a need to
go overseas for cosmetic procedures, which usually are not covered
by insurance.
For instance,
when the rand was trading at a record low in 2001, South African
agents started selling scalpel and safari tours to adventure
travelers who also were interested in plastic surgery.
For Lorraine
Melvill, founder of Cape Town-based Surgeon and Safari, the trend
helped grow her company into a multimillion-dollar
business.
Surgeon and
Safari arranges cosmetic, plastic and reconstructive surgery,
dental procedures and other treatments as well as accommodations in
top hotels such as the Mount Nelson.
After
convalescing in luxury, customers can extend their stay in South
Africa with a visit to upscale game lodges in the countrys
best-known wildlife parks. In many cases, the cost of the entire
package is less than the cost of the surgery alone in the
U.S.
Similar packages
are available through companies in Thailand and
Malaysia.
While cost may be
what drives medical tourism, care is what makes it a bargain.
Doctors in South Africa, India and other developing countries often
study medicine in English, making it easy for them to communicate
with U.S. patients. Many of these doctors have done postgraduate
work in the U.S., Canada, U.K. or Australia.
Their facilities
are built with private money to international standards, but the
local cost of labor and raw materials are a fraction of what they
are in the U.S.
The result is a
growing group of first-world hospitals in third-world countries.
Indraprastha Apollo, for instance, claims a 98.5% success rate with
heart operations. Wockhardt Hospital in Bangalore, India, is
approved by U.S. insurance company Blue Cross Blue
Shield.
Concerns
for agents
Despite
attractive costs and quality of care, there are some concerns for
agents interested in selling medical tourism.
The first is
liability. Steve Levin, of travel agent-insurer the Berkely Group,
said, If the agency is not involved in the medicine side of such a
trip, well still insure them.
But if they take
money for the foreign doctors, then we wouldnt write it [the
errors-and-omissions policy] at all. You cant file a malpractice
suit against a foreign doctor, but you can sue the travel agent who
sent you to him.
So for now,
agents should stick to arranging flights, accommodations and
sightseeing and leave the medical procedures to local
operators.
That, of course,
sets up the second hurdle in selling medical tourism: If you cant
legally vouch for the local doctor, how do you convince clients to
travel halfway around the world to let someone theyve never met
perform surgery?
Theres no easy
answer for this, but the statistics and testimony of previous
medical tourists provide some support. The local hospital or clinic
should also provide information to answer all of the clients
questions and allay much of the fear.
Time,
money and need
Retiring baby
boomers, who have the time and money for travel and the need for
health care, are good candidates for medical tourism. Even young,
healthy, insured U.S. citizens (provided they like to travel) can
take advantage of quality, low-cost care offered in other
countries.
At Bumrungrad
Hospital in Bangkok, a patient in for a checkup might get a series
of blood tests, an electrocardiogram, an ultrasound and other exams
-- for less than $100.
As appealing as
quality, affordable health care may be, medical tourism is also
booming because its still tourism. It presents an opportunity to
justify the kind of long-distance foreign travel to which many
clients are hesitant to commit.
Or, to put it
simply, if youre flying halfway around the world, you might as well
see the sights while youre there.
To contact
the reporter who wrote this article, send e-mail to [email protected].