Comments on: Have Medical Need, Will Travel

By: Linda Gorman

Linda Gorman — Thu, 12 Nov 2009 16:19:29 +0000

The medical travel thing is overrated. If you have to, you have to. But it is way better not to have to and much better to recuperate in one’s own bed with family and friend support systems.

US health care reform should set its sights on making US health care competitive with the rest of the world so that US citizens don’t have to travel.

US governments could lead off by doing away with price controls, making sure that subsidies go only to individual patients, treating all health care providers the same under law, and treating health care like any other business–no special taxes, rules, regulations, or competitive protections.

By: Devon Herrick

Devon Herrick — Thu, 12 Nov 2009 14:37:40 +0000

Steve,

You are wise to exercise a healthy skepticism about where you receive cardiac care. You should exercise the same skepticism domestically as you would if traveling abroad. A 2004 study of California found the cardiac mortality rate after surgery varied from 0% to 12%. The national and California state average is just under 3% (around 2.9%). Hospitals that treat international patient, such as Mayo, Cleveland Clinic, Johns Hopkins, typically have a cardiac mortality rate after surgery of between .5% to 1% (closer to .5%). Some of the best-known international facilities (Wockhardt, Bumrungrad, Fortis, Apollo) will have a similar cardiac mortality rate, but probably closer to 1%. Many of the surgeons were trained in the United States.

By: Larry C.

Larry C. — Thu, 12 Nov 2009 12:41:38 +0000

Steve,the key word here is “travel.” The patient who travels is regarded as the marginal patient to medical institutions. So they are willing to charge marginal cost to get the business. That means that the traveling patient can get a price well below the patient who lives next door. (At least in the US.)

Further, the traveling patient may be able to get a package price (for the same reason), whereas the local patient may not.

By: Steve Catoe

Steve Catoe — Thu, 12 Nov 2009 03:31:12 +0000

The report mentions medical tourism within the United States (Intrabound Medical Tourism) but other than a definition, it gives no details at all. Is that calculated?

I was born with a Congenital Heart Defect, and while I have traveled to some of the USA’s major medical centers for treatment and surgery (Johns Hopkins, University of Alabama at Birmingham, Emory University Hospital) I would be very hesitant to seek Cardiac Care offshore!

By: John R. Graham

John R. Graham — Wed, 11 Nov 2009 22:24:44 +0000

(For those who don’t pick up as fast as others: Sarcasm Alert!)

While the transaction prices of “medical tourism” might appear much lower than prices in the USA, these prices do not reflect the total cost of doing procedures overseas. To date, medical researchers have measured the cost of inputs and the cost of capital, but something has been lacking.

Thankfully, important research has just been published in JAMA that addresses this neglected cost. I speak, of course, of the carbon footprint.

Yes, researchers have actually estimated the carbon footprint of U.S. health care, and just published their estimates (http://tinyurl.com/yzgjs7r).

Until we get estimates from overseas hospitals, I don’t think the government should allow people to travel. Do we really want to heal the patient, but kill the planet?

(Can you believe that academic scholars actually wrote a paper on this?)

By: Devon Herrick

Devon Herrick — Wed, 11 Nov 2009 21:10:14 +0000

Two years ago when I wrote my study “Medical Tourism: Global Competition in Health Care,” I predicted that once it become commonplace for insured workers to be directed to low-cost, high-quality providers abroad, the next step would be selective contracting with domestic providers willing to compete on price. We are already seeing this market develop. In-country medical tourism is growing along with its out-country counterpart. It isn’t practical for all Americans to travel to India for surgery. But the threat of Americans seeking care abroad will prod some domestic providers to offer discounts much larger than they would under typical third-party reimbursement. Here is the link to my study: http://www.ncpa.org/pdfs/st304.pdf

By: Joe S.

Joe S. — Wed, 11 Nov 2009 21:04:57 +0000

I believe this is about to happen within the US. In fact a previous post by Linda Gorman showed that Canadians can come here and get package prices. The key is that the patient has to be willing to travel.

By: John Goodman

John Goodman — Wed, 11 Nov 2009 20:58:23 +0000

I spoke at the Healthcare Globalization Summit (Skip Brickley’s group) in Miami this morning and I think this is a market ready to really take off.

By: Ken

Ken — Wed, 11 Nov 2009 20:54:25 +0000

If employers would become more aggressive about financial rewards to emplyees who are willing to travel for their health care this market could explode.