Medical Tourism to India, All Expenses Paid
Lots of talk, not much action—until now. In January, Serigraph Inc., a West Bend, Wis., manufacturer, will become the first U.S. company of any size to embrace medical travel or medical tourism, offering employees the option of having certain nonemergency operations, such as joint replacement, in India. The company will pay all expenses, including travel and lodging for a companion. The incentive for employees is that they don't have to pay a deductible—typically $1,000 to $5,000—or the hospital copay, which would be 10 percent to 20 percent of the charges.
Last May, I went to India and Singapore to explore the trend of growing numbers of under- and uninsured Americans heading to both places and other foreign climes to take advantage of package prices for hip replacement, heart valve repair, spinal surgery, and other elective procedures that can be 80 percent less than the sums charged by U.S. hospitals. To cite one expensive example, heart bypass surgery can easily run up a $70,000 to $133,000 bill at a U.S. center, compared with an average of $7,000 at Indian hospitals catering to westerners. An uninsured patient I interviewed extensively in India paid a total of about $25,000 to have both hips and one knee replaced, including airfare and incidentals. He easily could have paid more than $125,000 at a U.S. hospital. And there are plenty of similar cases of huge price differences.
Perhaps 50,000 Americans currently go abroad for that kind of surgery. Hundreds of thousands of others go as actual medical tourists, combining cosmetic plastic surgery, extensive dental work, and other treatments with time spent sightseeing and lying on the beach in fun destinations like Mexico and Costa Rica.
Until now, however, the movement has largely been fueled by patients paying out of pocket. Health insurers and corporations have stayed on the sidelines, talking endlessly about whether to get involved and, if so, how. There's reason to be cautious. How can the quality of care abroad be guaranteed? What if an employee has a surgical complication after coming home?
But the potential savings for employers are too large to be ignored forever, and Serigraph, which has about 1,200 employees worldwide and slightly fewer than 1,000 in the United States, is taking the plunge. The pilot program will be administered by Anthem Blue Cross and Blue Shield of Wisconsin, an affiliate of WellPoint, the largest U.S. health insurer in numbers of members (and the originator of the Serigraph initiative). Employees needing the following procedures will be covered:
- Hip replacement or resurfacing
- Knee replacement
- Heart bypass surgery
- Heart valve repair or replacement
- Spinal fusion
- Prostate surgery
Employees will be treated at two Apollo Group hospitals, in Bangalore and New Delhi, both accredited by the Joint Commission International. An Anthem case manager will steer patients through the process, including managing medical complications should they occur.
Finally, a corporate pioneer. The Serigraph move will get a lot of attention. I'll be watching, and WellPoint, of course, will as well. "One reason we're doing this is to understand the extent that employees will choose this option," Lisa Latts, WellPoint vice president for programs in clinical excellence, told me. "They will do their own risk-benefit analysis."
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hospital costs
My father, now deceased, was at one time the principal auditor for all of the church-based hospitals of one of the U.S.s largest denominations. As such he visited and inspected all their accounts and other financial records.
He spent some time with my family in the Southwest. During one visit he had audited several hospitals over a three-state period and he was was quite down-hearted. Being an honest man, beyone any reproach, he was apalled at the careless spending of virtually all the hospitals he audited.
Instead of different hospitals in a metropolitan area each buying some items of great expense and then sharing the equipment among these hospitals, each hospital felt it necessary to purchase the same identical equipment. Each hospital had to have a helicopter or two, etc., resulting in tremendous costs to each. Why did they do that?
The facts were that the hospitals, all not-for-profit institutions, were making so much money that they were endangering this status. But rather than lower prices, they made unneeded purchases to remain qualified for the not-for-profit advantage.
Americans are, therefore, paying good money for all the fancy furnitures and decorations and dubious health practices so that they could continue these unsupported costs to the patients who had to pay for them.
This was considered extremely unconsciounable to my father, and his objections led to his early retirement at the age of 72.
When you read the tremendously expensive advertisements put out constantly by hospitals, you can bet that these are published in order to remain a "non-profit" organization.
Anne PME
Wellpoint has Medicaid contracts (billing) and billing/reimbursement contracts with hospitals. It would be interesting to know many legal and illegal aliens from India and other countries come to America and take advantage of our free care in emergency rooms or under these health insurer managed Medicaid programs. It astounds me that THOSE WITHOUT ANY LIABILITY,MEDICAL DEGREE OR MEDICAL LICENSE are now spinning medical tourism as the next big wave that will save our ailing health care system. Is this just another example of big business - in this case health insurers- using stockholder, policyholder and operating income (from doctors, pharmacists etc.) to provide themselves with financial bonuses and to promote outsourcing at the cost of high paying US JOBS!
Health insurers have already pushed pharmacies, inpatient and outpatient centers to purchase outsourced products like generic drugs, medical test kits, medical supplies etc. The AP recently reported that Wellpoint has offered money to doctors if they switch their patients from brand name drugs to more profitable foreign manufactured generic drugs.
How many times have health insurers failed to cut costs and improve our health care system...? Maybe if health insurers stopped paying over the top prices for spin doctors, lobbists and legal defense, they'd have enough money to pay for competent (and LICENSED) clinical care here in the US.
There is more data
Google's Gapminder Project at http://graphs.gapminder.org allows you to sift their huge databases (mostly UN reported data) and see what the reality is in the world in many ways and points of comparison adding further to Glenn Contrarian's sources.
Frontline also did a detailed study in depth of the specific differences of five countries and how they have structured UHC differently and what is the up and downside of each decision. In every case, the system is better by far than the US, but some work out better in some issues than others. Taiwan had a commission to look at everyone's experiment to plan their system, we have the advantage og all of those and Taiwan too.
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U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since they first appeared in 1990. His reporting on clinical medicine, from the latest cholesterol guidelines to robotic surgery, has been driven by the question: What does this mean to patients? And that is the perspective he brings to his observations and commentaries on the increasing number of programs by hospitals and other healthcare providers to improve care and patient safety.
