By
Roy M. Arnold, MD
With the uncertain state of affairs of medical insurance, many may believe that there are bargains on medical treatment to be found abroad. While it is true that certain elective surgical procedures can be obtained in foreign countries for a fraction of the cost of the same procedures in the US, a healthy serving of “Buyer Beware†is in order. While many of the hospitals in other countries are high quality and staffed with physicians trained in the US or Europe, there are some that aren’t.
According to the website Patients Beyond Borders (http://www.patientsbeyondborders.com/) the top destinations for medical tourism are Brazil, Costa Rica, India, Korea, Malaysia, Mexico, Singapore, Taiwan, Thailand, and Turkey.
The top reasons for medical tourism are:Â Cosmetic surgery, Dentistry (general, restorative, cosmetic,)Â Â Cardiovascular (angioplasty, CABG, transplants,) Orthopedics (joint and spine; sports medicine,) Cancer (often high-acuity or last resort,) Reproductive (fertility, women’s health,) Weight loss (LAP-BAND, gastric bypass,) and scans, tests, health screenings and second opinions.
Most sources estimate that 700-900,000 US residents will travel outside the country for medical reasons per year.
The Centers for Disease Control and Prevention (CDC) offers advice on a few questions to ask when considering a trip abroad for medical treatment. First is the hospital accredited by Joint Commission International? The Joint Commission on Accreditation of Healthcare Organizations accredits hospital in the US and a branch of that organization offers accreditation to hospitals in other countries. The JCI website lists accredited hospitals by country at http://www.jointcommissioninternational.org/JCI-Accredited-Organizations/
Second, bear in mind that certain practices taken for granted in the US like sterilization or reuse of needles or instruments, screening of blood donors, or the purity of prescription drugs may not be as strictly enforced in foreign countries as in the US.
Third, ensure that if you don’t speak the local language, the facility will provide interpreters to assist you.
Fourth, make certain that you have a complete listing of prices for all procedures you expect to have performed in advance with a statement of all charges anticipated.
Next, obtain copies of your US medical records including the lab and other studies done related to the condition for which you are obtaining the care and any allergies you may have. Prepare copies of all your prescriptions and a list of all the medicines you take, including their brand names, their generic names, manufacturers, and dosages. Get copies of all your foreign medical records before you return home.
Make certain that you communicate your intention to travel for medical reasons to your treating provider locally and arrange for follow-up after you return from abroad.
Inquire of your health insurance company as to what if any insurance coverage would be available in the event of complications that might arise after your return to the US. Health insurers may vary widely in their coverage of such procedures.
Many of the medical tourism destinations are also popular destinations for vacations as well. Before planning “vacation” activities, such as sunbathing, drinking alcohol, swimming, or taking long tours, find out if those activities are permitted after surgery.
Finally, don’t rush into any elective medical procedure. Investigate the country and facility you are considering visiting and shop around. Know exactly what you are looking for and how much you’ll have to pay. Verify the credentials and accreditation of the providers and facility you have chosen. Consult with the local providers who have been treating you and make certain your follow up care has been arranged.
Thanks Dr. Arnold. Just a comment:
People need to keep in mind that charges for many procedures can vary across locations in the United States also. I remember a few years ago in our Indianapolis dental office a staff member’s parent could receive care in our office on a complex case and pay air fare round trip for much less than she could have the same work done in her home state (AZ). Keep in mind that we did not give the patient a discount. She believed that in addition to a substantial savings, her bonus was to get to visit with her family locally while staying to have the work done.
I think it is very important to remember that price is a factor but should not be the only consideration for deciding who provides your care and where that care is provided. Your relationship with your health professional, your access to wide spread support in case of problems or an emergency, and long term follow-up availability are hard to place a dollar amount on until you hit the wall or have a problem from out of the blue. It is possible to receive good care in other countries but I believe that there are more unknowns attached.
The mother-daughter I recently read about who went to Tijuana to get gastric bypass surgery kinda amazed me.
I thought Tijuana was where you went immediately after your divorce to get crabs.
If I ever need gastric bypass, I’m going to Toronto where the drugs flow free, not Tijuana where the lead does the same.
Good public educational comment Doc. Thanks!
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