This article is based on excerpts from the second edition of Patients Beyond Borders (2008), the flagship of a landmark series of consumer guides to international medical travel that have helped thousands of patients plan successful health journeys abroad. Healthy Travel Media, publisher of the guides, has become a global clearinghouse for useful information about medical and wellness travel.
The new phenomenon of medical tourism—or international health travel—has received a good deal of wide-eyed attention of late. While one newspaper or blog giddily touts the fun 'n sun side of treatment abroad, another issues dire Code Blue warnings about filthy hospitals, shady treatment practices, and procedures gone bad. As with most things in life, the truth lies somewhere in between.
In short, I've found the term "medical tourism" is something of a misnomer, often leading patients to emphasize the recreational more than the procedural in their quest for medical care abroad. Unlike much of the hype that surrounds contemporary health travel, Patients Beyond Borders focuses more on your health than on your travel preferences. Thus, throughout this book, you won't see many references to the terms "medical tourism" or "health tourism." In the same way business travelers don't normally consider themselves tourists, you'll begin to think more in terms of medical travel and health travel.
My research, including countless interviews, has convinced me: With diligence, perseverance, and good information, patients considering traveling abroad for treatment do indeed have legitimate, safe choices, not to mention an opportunity to save thousands of dollars over the same treatment in the United States. Hundreds of patients who have returned from successful treatment overseas provide overwhelmingly positive feedback. They persuaded me to write this impartial, scrutinizing guide to becoming an informed international patient. I designed this book to help readers reach their own conclusions about whether and when to seek treatment abroad.
So, why go abroad for medical care? Here are seven reasons.
1. Cost savings. Most people like to get the most for their dollar. The single biggest reason Americans travel to other countries for medical treatment is the opportunity to save money. Depending upon the country and type of treatment, uninsured and underinsured patients, as well as those seeking elective care, can realize 15 to 85 percent savings over the cost of treatment in the United States. Or, as one successful health traveler put it, "I took out my credit card instead of a second mortgage on my home." As baby boomers become senior boomers, costs of healthcare and prescriptions are devouring nearly 30 percent of retirement and preretirement incomes. With the word getting out about top-quality treatments at deep discounts overseas, informed patients are finding creative alternatives abroad. The costs listed in this table are for surgery (except as noted), including the hospital stay in a private, single-bed room. Airfare and lodging costs are governed by individual preferences. To compute a ballpark estimate of total costs, add $5,000 to the amounts shown in the table for you and a companion, figuring coach airfare and hotel rooms averaging $150 per night. For example, a hip replacement in Bangkok, Thailand, would cost about $18,000, for an estimated savings of at least $15,000 compared with the U.S. price. The estimates above are for treatments alone. Airfare, hospital stay (if any), and lodging vary considerably. Savings on dentistry become more dramatic when "big mouth-work" is required, involving several teeth or full restorations. Savings of $15,000 or more are common.
2. Better-quality care. Veteran health travelers know that facilities, instrumentation, and customer service in treatment centers abroad often equal or exceed those found in the United States. Governments of countries such as India and Thailand have poured billions of dollars into improving their healthcare systems, which are now aggressively catering to the international health traveler. VIP waiting lounges, deluxe hospital suites, and staffed recuperation resorts are common amenities, along with free transportation to and from airports, low-cost meal plans for companions, and discounted hotels affiliated with the hospital. Moreover, physicians and staff in treatment centers abroad are often far more accessible than their U.S. counterparts. "My surgeon gave me his cellphone number, and I spoke directly with him at least a dozen times during my stay," said David P., who traveled to Bangkok for a heart valve replacement.
3. Excluded treatments. Even the most robust health insurance plans exclude a variety of conditions and treatments. You, the policyholder, must pay these expenses out of pocket. Although health insurance policies vary according to the underwriter and individual, your plan probably excludes a variety of treatments, such as cosmetic surgeries, dental care, vision treatments, reproductive/infertility procedures, certain nonemergency cardiovascular and orthopedic surgeries, weight loss programs, substance abuse rehabilitation, and prosthetics—to name only a few. In addition, many policies place restrictions on prescriptions (some quite expensive), postoperative care, congenital disorders, and pre-existing conditions. Rich or cash-challenged, young or not-so-young, heavily or only lightly insured, folks who get sick or desire a treatment (even one recommended by their physician) often find their insurance won't cover it. Confronting increasingly expensive choices at home, nearly 40 percent of American health travelers hit the road for elective treatments. In countries such as Costa Rica, Singapore, Dubai, and Thailand, this trend has spawned entire industries, offering excellent treatment and ancillary facilities at costs far lower than U.S. prices.
4. Specialty treatments. Some procedures and prescriptions are simply not allowed in this country. Either Congress or the Food and Drug Administration has specifically disallowed a certain treatment, or perhaps it's still in the testing and clinical trials stage or was only recently approved. Such treatments are often offered abroad. One example is an orthopedic procedure known as hip resurfacing, a less expensive alternative to the traditional hip replacement still practiced in the United States. While this procedure has been performed for more than a decade throughout Europe and Asia, it was only recently approved in the United States, and its availability here remains spotty. Hundreds of forward-thinking Americans, many having suffered years of chronic pain, have found relief in India, where hip resurfacing techniques, materials, and instrumentation have been perfected, and the procedure is routine.
5. Shorter waiting periods. For decades, thousands of Canadian and British subscribers to universal, "free" healthcare plans have endured waits as long as two years for established procedures. "Some of us die before we get to the operating table," commented one exasperated patient, who journeyed to India for an open-heart procedure. Here in the United States, long waits are a growing problem, particularly among war veterans covered under the Veterans Administration Act, for whom long queues are becoming far too common. Some patients figure it's better to pay out of pocket to get out of pain or to halt a deteriorating condition than to suffer the anxiety and frustration of waiting for a far-future appointment and other medical uncertainties.
6. More "inpatient friendly." As U.S. health insurance companies apply increasing pressure on hospitals to process patients as quickly as possible, outpatient procedures are becoming the norm. Similarly, U.S. hospitals are under huge pressure to move inpatients out of those costly beds as soon as possible. Medical travelers will welcome the flexibility at the best hospitals abroad, where they are often aggressively encouraged to spend extra time in the hospital post-procedure. Patient-to-staff ratios are usually lower abroad, as are hospital-borne infection rates.
7. The lure of the new and different. Although traveling abroad for medical care can be challenging, many patients welcome the chance to blaze a trail, and they find the creature comforts often offered abroad a welcome relief from the sterile, impersonal hospital environments so often encountered in U.S. treatment centers. For others, simply being in a new and interesting culture lends distraction to an otherwise worrisome, tedious process. And getting away from the myriad obligations of home and professional life can yield healthful effects at a stressful time. What's more, travel—and particularly international travel—can be a life-changing experience. You might be humbled by the limousine ride from Indira Gandhi International Airport to a hotel in central New Delhi or struck by the simple, elegant graciousness of professionals and ordinary people in Thailand, or wowed by the sheer beauty of the mountain range outside a dental office window in Mexico. As one veteran medical traveler put it, "I brought back far more from this trip than a new set of teeth."