Globalizing health care through medical tourism.

• Author: Riczo, Steve
• Position: Medicine & Health

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THE U.S. ARGUABLY enjoys the best health care in the world. However, the system is marked by unsustainably high costs, making it unaffordable for millions. Unlike other industrialized nations that have universal health insurance coverage, the U.S. has 47,000,000 uninsured citizens and 25,000,000 who are underinsured. Approximately half of all small businesses do not offer health insurance to their employees because of the expense. Even the percentage of large employers that makes health insurance available has been declining in recent years while Federal and state governments maintain that health care costs are breaking their budgets and damaging the economy--a point that Pres. Barack Obama has made repeatedly. The number-one reason cited for personal bankruptcies in the U.S. today is medical expenses. Attempts by insurance companies and government to curb them have, by-and-large, not been successful due to a flawed payment system that encourages overutilization, fraud, abuse, and insufficient competition in local markets.

As a result, thousands of Americans travel overseas for less expensive medical and dental care. Medical tourism is an emerging industry and the term used to describe people around the world who travel to another country for their medical care. While individuals have traveled great distances to improve their health for thousands of years, the contemporary version of medical tourism more readily lends itself to widespread use due to the relative ease of travel today. Moreover, thanks to the Internet, a consumer in one country can learn about a hospital thousands of miles away and its physicians and the types of care they provide.

While high costs are the primary motivator for American medical tourists, others travel abroad for quicker accessibility to providers and quality of care. To illustrate the cost difference, a heart bypass surgery in a U.S. hospital easily can run in excess of $100,000, whereas the same procedure is $32,000 in Singapore, $24,000 in Thailand, and less than $12,000 in India. A hip replacement in the U.S. can be around $100,000, but $14,000 in Thailand and $9,000 in India. A $60,000 knee replacement in the U.S. would cost $11,000 in Costa Pica and $9,000 in Taiwan.

For anyone considering traveling overseas for medical care, a top priority should include a careful evaluation of alternatives. For instance, choosing a good hospital but not a physician to match could result in disaster. A hospital should have received its accreditation from an agency certified by the International Society for Quality in Healthcare (ISQua), which "accredits the accrediters" such as Joint Commission International (JCI), Accreditation Canada, Health Quality Service U.K., and others.

In addition to lower medical costs, quality of care is improving in many nations, and some hospitals overseas are going to extraordinary lengths to demonstrate that quality. These hospitals are offering their best-trained physicians to medical tourists and improving their facilities so that they can pass recognized accreditation standards. For instance, the gold standard for U.S. hospitals is receiving accreditation from the Joint Commission, which conducts reviews every three years. Hospitals work diligently on many quality aspects of their care, as they are well aware that the ramifications of failing a Joint Commission inspection are very significant. In recent years, the Joint Commission has developed an affiliate...