MedicalTourism-Guide

Polar Vision and Socialized Healthcare

peter — Thu, 11 Mar 2010 06:00:06 +0000

I’m sitting here in New Zealand feeling frustrated after reading Kinsey Gidick’s article True Tales about Healthcare Abroad. Nothing against Gidick, the article makes for an interesting read.

While the article does a great job of proving a point regarding the exorbitant cost of healthcare in the USA and the Medical Tourism alternatives available, Gidick, along with the vast majority of US media, polarizes the concept of socialized healthcare.

I’m referring to the section entitled “United Kingdom or Magic Kingdom”:

Dr. Evans disagrees. “I had a good friend of mine who lived on the west coast of England who was in his 80s and suffered from terrible chronic neuropathic pain,” he says. “After months of waiting, he was at last able to see a neurosurgeon who confirmed that he needed surgery to correct his problem. They put him down on the books for surgery 11 months out. Granted the surgery and all his care was free, but had he been in this country I could have picked up the phone and had him in a surgical suite in a week.”

Why is it that, regardless of whether they are ‘for’ or ‘against’ socialized healthcare, the US media insist on packaging a nations healthcare up in a nice tidy box that either has ‘socialized’ or ‘not socialized’ (or more correctly ‘American system’ or ‘Canadian system’) written on the front. The reality is that it is not this black and white.

Having lived and worked in the UK for a period of time, I’m in a fairly safe position to say that, much like New Zealand’s system, the chap Dr. Evans refers to had options, something that neither the US or the Canadian system would provide.

A quick Google of “private neurosurgeons UK” gives an abundance of competent surgeons. So had this patient been willing to pay he could have avoided the long wait he experienced.

Again through the powers of google it is pretty easy to confirm that there are elective insurance options available that would have covered this man for private surgery, again avoiding the wait lists.

He could have gone with the option he did…. Suffer the wait and receive free treatment.

Safe to say that even if Dr. Evan’s friend had chosen to pay, it would have been significantly cheaper than paying for the same care in the USA.

So why, when there are systems around that can offer so much choice, do the US media focus on perhaps the two least flexible systems around?

Source: The Medical Traveller

Study Finds Why Genealogical Tourism is Popular

peter — Mon, 08 Mar 2010 06:00:06 +0000

A University of Illinois travel expert has said that genealogical tourism is redefining leisure travel market.

U. of I. recreation, sport and tourism
Source: Latest Medical Tourism News

Medical Tourism – Putting the ‘CARE’ back in Healthcare

peter — Fri, 12 Feb 2010 06:00:07 +0000

Last week as I was seeing off yet another satisfied customer back home to relay the amazing experience to his friends, family and generally anyone who will listen, I thought back over our patient experiences to the common theme that “wows” each and every one of them… The Medical Tourism Care Factor.

While much is out there on Medical Tourism accreditation, quality outcomes, medical training etc, the importance of ‘care’ seems somewhat swept under the carpet. Don’t get me wrong, quality assurance markers are extremely important; but in my experience, in patient testimonials, they are not saying “Wow, the hospital is internationally accredited” or “The surgeon has one of the lowest post-op infection rates out”. However, it is pretty common to hear “the surgeon made me feel so comfortable”, “I felt like I was more than a number” or “The nurses were so attentive and caring”.

My suspicion as to why the care factor is not broadcast more widely is that it is beyond most Medical Tourists imagination. Remembering, that in many cases the starting point to seek treatment abroad is the disillusionment that they have experienced trying to access affordable care within their own health system. To tell someone in this situation that, not only will they receive excellent medical treatment at a lower cost, but they will also feel important and cared for while they are doing so, is like trying to explain Filet Mignon to someone who has only ever had burgers. While they know it is special, they can only really know the difference by experiencing it themselves.

This ‘Care Factor’ goes beyond one person to the whole experience; the call and guidance their facilitator gives them while they are deciding, the pre-operative experience with the surgeon, the hospital and nursing care, recuperative care, right through to the follow up once they return home. Get it right, and it is a recipe for health care success.

The Great Unknown – Is leaving home for healthcare really that scary?

Source: The Medical Traveller

Transplant Tourism – Friend or Foe

peter — Thu, 11 Feb 2010 06:00:11 +0000

Recent articles such as Transplant tourism poses ethical dilemma for US doctors and Majority of doctors skeptical of organ transplantation practices in China bring the issue of “Transplant Tourism” under the microscope.

At risk of quibbling over semantics, the name “Transplant Tourism” makes me shudder. When you are talking about surgery as major as a vital organ transplant, to trivialize it by the mere suggestion of beaches and palm trees is near criminal. I prefer the term Medical Travel over Medical Tourism, yet, I guess, Transplant Travel is not quite as catchy or sensationalist.

The process of traveling overseas for transplants is driven by desperation, let’s face it, for something like this, the ideal is to have it in an environment where you feel comfortable and can be assured that you have top-notch surgeons and facilities at your disposal, yet the sheer idea of “buying” an organ suggests that the regulations that you would normally desire around healthcare are absent in that “transplant tourism” destination. However, through inaccessibility of treatment, due to cost or wait times, patient’s are compelled to lower their standards of ethics, quality or both in order to regain their failing health.

Much is written about the evils of Medical Tourism and the impact on developing nation’s healthcare for its natives, this practice is yet another fine example of this. Who is missing out on an organ because someone wealthier from another nation can afford one?

It is these factors that would lead you to dust off your placards and join a movement to place a blanket ban on this phenomenon, however in many cases there is still room for Medical Travel in relation to transplants… well some of them anyway.

Live Donor Renal Transplant’s when carried out ethically are an option for those who have access to a live donor and can be more affordable when performed out of the USA. It is important for institutions and facilitators to screen donor’s, to avoid the “paid donor” trap however.

For example it is possible for patient’s to receive live donor renal transplants in leading New Zealand private hospitals for around one third of the cost in the US, including flights, accommodation (around 6 week stay) surgery and hospitalization for donor and recipient, drugs, aftercare and contingency insurance. Strict regulations around health care provision in New Zealand ensure that the procedure is carried out to a high standard and ethically, including checks to ensure that the live donor’s are known to the recipient and sourced ethically.

So, while the unscrupulous processes will no doubt continue with Transplant Tourism it is comforting to know that there are options for those who can’t access care at home, where they do not have to lower their standards in terms of quality and ethics.

Source: The Medical Traveller

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The changing fortunes of Medical Tourism

peter — Thu, 11 Feb 2010 06:00:11 +0000

Much has been written about the ebb and flow of opportunities around Medical Tourism as an attractive option for Americans seeking cheaper health care outside their own borders. From predictions of stellar growth by Deloitte in its 2008 report on the Medical Tourism market in the US, to significant downward revisions of forecasts due to the economic environment; authored by Deloitte in the 2009 installment.

Opinion generally around the fortunes of Medical Tourism are polarized, ranging from examples like; USA Today picking medical tourism in the USA to be one of the top 10 trends during 2010, to an article by Keith Pollard “Treatment Abroad” that points to medical tourism remaining in the margins for the foreseeable future. http://www.imtjonline.com/articles/2010/the-outlook-for-medical-tourism-30034/

Apart from feeling the need to reach for a bottle of Prozac and a stiff Gin after reading parts of Keith Pollard’s article, the issue I have with his opinion, is that it implies that Medical Tourism was originally prophesied as a Holy Grail, mainstream, overnight solution to the current issues facing the US health care landscape. In reality, Medical Tourism is a channel option within the business mix and will always be so. As such, being in the margins is probably a sound footing from which to continue to build on a beachhead industry, moving it towards a longer term goal of wider understanding and acceptance within the US health care landscape. As trite as it may sound, Rome wasn’t built in a day, or for that matter, a year.

Of greater interest, and proving that a week can be a long time in politics, was the election of Republican candidate Scott Brown to the US Senate. In doing so ending the 47 year stronghold by the Democrats in Massachusetts by the late Senator Kennedy, and preventing the Democrats from passing major reforms through the Senate unimpeded. A key reform Health care now appears stalled as the Republicans, with new found power, push back in response to, what appears to be, resounding public opinion. Watch this space, as it now appears that the already watered down health care reforms will be further watered down and in the process perhaps further opening the way for opportunities in Medical Tourism… watch this space.

Boutique Medicine – American style or New Zealand?

Source: The Medical Traveller

How Companies are Changing Healthcare Costs

Medical Tourism – Cottonwood man travels to New Zealand for Surgery

peter — Thu, 11 Feb 2010 06:00:11 +0000

Philip Wrights recent article in the Verde Independent explains the experience of Ben Wordinger, a self insured man from Arizona, and the difficulty he had accessing medical care in the USA.

This shows one of many drivers behind people accessing Medical Tourism out of the USA.

Of interesting note is his comment on his preference for an English speaking destination. When accessing medical care overseas many people find that cultural similarities such as this are an important factor in their decision on a destination.

10 Handy Tips for Hip Replacement Surgery Overseas

Source: The Medical Traveller

Boutique Medicine – American style or New Zealand?

peter — Thu, 11 Feb 2010 06:00:10 +0000

Apart from the cost one of the major differences between the majority of US healthcare and medical tourism destinations appears to be the personalized service one receives.

For example, the private healthcare offered in places such as New Zealand is the boutique option. You can choose your hospital, doctor and the day of treatment but you have to pay. In contrast, the public healthcare system in New Zealand is government funded and hence there is no charge for its use by individuals. Indeed the same doctors work in both systems. The real difference is in the waiting time, and choice of doctors.

Contrasting this with the US health system where a recent article cites an example of the same medical clinic having two entrances: one for the insured clients and one for the self- pay. The self pay got the boutique service; to see a doctor and the higher charge. The insured patient got the diagnostic test but very little more and their insurance paid (a reduced rate).

It appears more and more Americans are walking away from insurance and wanting to make their own decisions with added benefits that feel to them that they are receiving fair value for their own non-insured, self pay health dollar. In this environment of consumer driven healthcare, medical travel must be an option.

Americans now have a boutique option of medical care in their own country where increasingly the customer not the insurer pays. Since the customer can not negotiate substantial discounts, (like the insurers) they pay … a lot.

Hence to travel overseas for easy access to the same level of service, a single invoice (if not more personalized), for 25% the cost of the boutique service in the US, with no bureaucratic minefield or unexpected bills starts to sound attractive.

Defensive Medicine – Why Americans Pay More

Source: The Medical Traveller

10 Handy Tips for Hip Replacement Surgery Overseas

peter — Thu, 11 Feb 2010 06:00:10 +0000

A few tips for those heading abroad for Hip Replacement surgery (THJR). These are a combination of what I tell our clients coming to New Zealand for surgery, what they tell me, and what our surgeons and physical therapists advise.

1. Choosing accommodation

If you are not using a medical travel facilitator to book your accommodation (or even if you are in some cases) make sure that your accommodation is suitable for someone who is having hip replacement surgery. You need to make sure that you don’t have to navigate flights of stairs on crutches or that you don’t have to step into a bathtub to have a shower. Also bear in mind that low seating is not appropriate for people with recent hip replacements – especially if you are tall.

2. Airports

Ask your facilitator or travel agent to request wheelchair transfers for you in transit. While you may not think you need a wheelchair, sometimes it is a long walk between terminals and you may need some assistance with luggage etc.

3. Bring a knapsack

It makes life on crutches so much easier.

4. Bring slip on shoes

Unless you have a very patient traveling companion, you may struggle with laces.

5. Bring Skirts or loose fitting trousers

It will make life easier and be more comfortable than tight fitting clothing after surgery.

6. Talk to your surgeon

Arrange a telephone call before traveling to your destination. Find out what you can expect afterward in terms of recovery and mobility. Find out how long before you can get your wound wet (different surgeons have different perspectives on this). Then plan any additional travel with this in mind.

7. In flight DVT prevention.

This is important both before and after surgery. Drink plenty of water, avoid alcohol, make sure to get up and walk regularly on the flight. Talk to your surgeon about preventative measures for the flight home.

8. Recuperative Care.

This is VERY important. For our New Zealand clients we provide exercise equipment in the hotel rooms so that our physical therapists can work out a regime that gives you optimum results for your surgery and recovery. Be concerned if your overseas provider makes no mention of it.

9. Don’t skimp on the pain medication.

While you don’t want to overdo it either, being in pain can interfere with your post operative recuperation and physical therapy regime. Make sure your doctor explains clearly when and how you should take any prescribed pain medication.

10. Find out what sort of implant.

Will be used in your surgery. Implants can vary greatly in both price and quality. The general rule is you get what you pay for. Make sure you are comfortable and confident that you are getting a reputable brand of implant and that it is appropriate to your needs. Talk to your surgeon about the different types and what is best for you.

Note that these are suggestions only and should not replace any advice given to you by your health professional

Have you had or are you considering having hip replacement surgery either at home or abroad?

How do you decide on a hospital or surgeon?

Do you have any questions?

Do you have any tips for others?

Please leave a comment below. I’d love to hear from you.

Source: The Medical Traveller

Medical Tourism – Cottonwood man travels to New Zealand for Surgery

Coping with and without Health Insurance

peter — Thu, 11 Feb 2010 06:00:09 +0000

This recent article in the New York Times clearly highlights the disconnect between consumers and the US health system. These individual stories not only highlight the personal issues that these people face, but the economic concern that these people should be recognized as presenting to the US economy. These are stories about people in their economic prime who instead of being able live life and focus the contributions they can make to their families, communities and the wider economy through their work, worry more about the risks and complications of living with or without Health Insurance, knowing that they are probably quite literally one medical incident away from potential financial disaster.

The New York Times introduces the story as follows and I quote.

“Much of the debate about health care reform focuses on people who don’t have insurance. But as Karen Barrow explores during the latest Patient Voices series, even people with insurance coverage are struggling with bills, confusing policies and red tape.

Six men and women share their experiences with health coverage and insurance issues. You’ll meet Tasha Huebner, 41, who found dealing with the insurance company worse than dealing with breast cancer. “With insurance, it was always a big surprise, what are they going to deny next?” she says.

Once she called her insurance company to find out why a $5,000 surgery bill had been denied. She was told it was because she had one too many nurses in the operating room during her surgery. “At that point I hung up on my insurance representative that I was talking to,” she says. “I didn’t even know what to do with that.”

Zoraida Reyes, 46, is a small business owner who was forced to cut health insurance, including her own. “I work six days a week, and I can’t afford insurance,” she says. “You can imagine the people who have a lot less than me, they’re probably worse off.”

And there’s Carl Arrington, 58, who lost his health insurance after his Internet company closed. Instead of paying for health insurance, he decided to invest in his health, changing his diet and exercising more. “If you’re in your 50s or 60s and you don’t have medical insurance and you don’t get it through your employer, it’s going to cost you two or three thousand dollars a month. With that kind of money I could see a doctor every week.”

Adrienne Schroeder, 31, has high-deductible health insurance through her husband’s job but is saddled with medical debt as a result of four pregnancies in six years, including two that ended in miscarriages. “Since we have insurance we should not be worried about having a baby or having a miscarriage and be stressed about how long it takes to pay it off,” she says. “Our daughter is near 18 months, and we’re nowhere near paying off these hospital bills.

The majority of the people in this story are representative of a Medical Traveler demographic that are coming to New Zealand in gradually increasing numbers for non-urgent or elective medical procedures as an alternative to the high cost of care in the US.

Source: The Medical Traveller

Defensive Medicine – Why Americans Pay More

peter — Thu, 11 Feb 2010 06:00:09 +0000

When considering travelling abroad for medical care a fundamental question is why is the destination I am travelling to able to provide healthcare at significantly less cost than America? The answer is two fold.

Firstly from a historical perspective most of the destinations offered in the past have been third world countries which have built hospitals not to service their own population , who in many cases can not afford them. but to cater for the local wealthy and overseas patients, yet leverage a local economy offering cheaper labour and materials.

However with the advent of first world countries like New Zealand, Belgium, Ireland and Germany offering their themselves as destinations one asks how can they provide such high quality care at significantly less cost than the US system? How can cardiac surgery in New Zealand cost 25% of the same surgery in the USA, even though both sets of surgeons are US trained?

One fundamental difference is the widespread practice of defensive medicine throughout the US system, illustrated in the recent article Costs of Defensive Medicine

A 2005 study of 824 doctors in Pennsylvania by Havard School of Public Health and Columbia Law School found 93% reported practicing defensive medicine

Driven by the financial need not to be wrong doctors in America it seems over treat and over diagnose. Operations it seems are performed that are both unnecessary and wasteful, let alone an unnecessary risk to the patient. Screeds of CTs and MRIs are done because the punishment of missing something is far greater than the satisfaction of having the confidence to say to the patient ”Even though we could do this test in my opinion you don’t need it”.

In other first world countries it is perceived that doing that unnecessary test is a risk to the patient. In America it is perceived that not doing the test is a significant risk to the doctor.

In Atul Gawande’s erudite commentary of the state of the US healthCare system- The Cost Conundrum we hear that

Spending on doctors, hospitals, drugs and the like now consumes more than one of every six dollars we earn, The financial burden has damaged the global competitiveness of American businesses and banrupted millions of families, even those with insurance

Well to use a wellknown American saying ” Houston we have a problem….” and to an outside observer…it seems to be a big one.

The issue is that other first world healthcare sytems are not really cheap; its just that Americas healthcare system is really and truly massively expensive. The dramatically high prices American consumers are paying is for not higher quality procedures but for a wasteful system.

Other English speaking first world countries offer just as good quality healthcare as the USA; in some instances due to the co-ordination of aftercare, the access to the surgeon for the patient, they offer a better more personalized healthcare experience.

Its just at a cheaper price.

Boutique Medicine – American style or New Zealand?

Source: The Medical Traveller