Global Medical and Prescription Savings: A $100 Billion Opportunity for U.S. Healthcare

BY JOE WALLACE
DECEMBER 13, 2024

The U.S. healthcare system is lauded for its cutting-edge technology and innovation, but it is also notorious for its exorbitant costs. As policymakers grapple with ballooning Medicare and Medicaid expenditures, a potential solution lies in an unconventional approach: utilizing lower-cost medical procedures abroad and allowing Americans to source prescription medications internationally. By leveraging global healthcare efficiencies, the U.S. could realize significant savings while maintaining, or even improving, care quality. This article explores how such policies could save hundreds of billions of dollars annually and outlines the key actions necessary to achieve these savings.

The Case for Medical Travel: International Cost Comparisons

Medical tourism is not a new concept; thousands of Americans already travel abroad annually for surgeries and treatments at a fraction of U.S. prices. Consider the following cost comparisons:

• Hip Replacements: A procedure in the U.S. averages $120,000, whereas in Belgium or India, the same surgery costs between $12,000 and $20,000. For Medicare patients alone, which accounts for over 300,000 hip replacements annually, shifting just 20% of these surgeries overseas could save approximately $6 billion per year.
• Heart Bypass Surgery: This life-saving procedure costs $75,000 to $150,000 in the U.S., but as little as $20,000 in Thailand or Singapore. Medicare pays for around 200,000 of these annually. Redirecting 10% of these surgeries to accredited international hospitals could save $11 billion annually.
• Dental Implants: In Los Algodones, Mexico—known as “Molar City”—a single implant costs around $1,200 compared to $5,000 in the U.S. By promoting dental tourism for non-urgent procedures, Medicaid and Medicare Advantage programs could save $1 billion annually.

The combined potential savings from targeted international medical tourism programs could exceed $25 billion annually.

Prescription Medications: Bridging the Price Gap

The United States pays more for prescription drugs than any other country, primarily due to the lack of negotiation power and regulatory restrictions. Allowing Americans to purchase medications internationally, either through travel or online pharmacies, could produce enormous cost reductions:

• Generic Medications: A common cholesterol-lowering drug, atorvastatin, costs $10 for a month’s supply in India or Mexico but averages $30 in the U.S. With over 25 million Medicare beneficiaries on statins, shifting sourcing offshore could save $6 billion annually.
• Specialty Drugs: Insulin costs $98 per vial in the U.S., compared to $8 in Mexico. Given the 8 million Americans who use insulin, enabling offshore purchases could save $10 billion annually.
• Cancer Drugs: Specialty medications like Gleevec cost $6,200 per month in the U.S. but just $2,500 in Canada or the EU. Providing structured access to international pharmacies could save Medicare and Medicaid an additional $15 billion annually.

The total savings from adopting global prescription sourcing policies could approach $31 billion annually, and consumers could experience reduced out-of-pocket costs.

Estimated Aggregate Savings

Combining savings from international medical travel and prescription drug policies, the U.S. could achieve annual healthcare cost reductions approaching $56 billion. Expanding these initiatives to include other procedures and broadening participation could push the total savings closer to $100 billion per year.

Key Actions to Realize Savings

1. Expand Medicare and Medicaid Coverage for Medical Travel: Policymakers could pilot programs that cover international travel and procedures for elective surgeries, particularly for high-cost operations like joint replacements, organ transplants, and cardiac surgeries. Accreditation partnerships with top international hospitals would ensure safety and quality.
2. Create an International Prescription Market for Americans: Regulatory reforms should permit Americans to purchase medications from verified international pharmacies. Establishing an FDA-monitored global pharmacy network could provide assurance of drug safety while promoting competition.
3. Offer Tax Incentives for Private Insurers: Insurers could be incentivized to integrate international medical options into their plans. Tax credits could offset initial implementation costs, encouraging broader adoption.
4. Implement Digital Platforms for International Healthcare Navigation: User-friendly digital tools could connect patients with reputable overseas providers, estimate savings, and assist with logistics. For example, a Medicare app could list certified international hospitals, costs, and reimbursement processes.
5. Negotiate International Healthcare Agreements: The U.S. government could broker agreements with countries offering high-quality, affordable healthcare. These partnerships would streamline patient access and establish fixed pricing for procedures.
6. Establish International Insurance Pools: Medicare and Medicaid could create specialized pools to fund international procedures, using the savings from lower-cost surgeries and medications to reinvest in domestic healthcare programs.

Addressing Common Concerns

Critics of international healthcare initiatives often raise concerns about safety, continuity of care, and ethical considerations. These challenges can be mitigated through robust oversight and thoughtful implementation:

• Safety: Only internationally accredited hospitals and pharmacies, such as those certified by the Joint Commission International (JCI), would be eligible for participation.
• Continuity of Care: Patients would be connected with U.S.-based follow-up providers, ensuring seamless post-procedure care.
• Economic Impact: While some fear that domestic providers might lose revenue, savings could be reinvested to strengthen preventive care and address public health challenges.

Potential Benefits Beyond Cost Savings

The adoption of international healthcare options could yield ancillary benefits:

• Reduced Strain on U.S. Facilities: By offshoring elective procedures, domestic hospitals could prioritize emergency care and high-complexity cases.
• Improved Global Healthcare Relations: U.S. partnerships with international providers could enhance diplomatic and economic ties.
• Increased Consumer Choice: Americans would gain access to affordable, high-quality care options not available domestically.

Conclusion

The U.S. government is at a crossroads in addressing unsustainable healthcare costs. By embracing the efficiencies of international medical travel and global prescription markets, policymakers could save tens of billions annually while expanding access to affordable care. Implementing these policies would require thoughtful planning and robust oversight, but the potential benefits—both fiscal and social—are too significant to ignore. In an era where every dollar counts, sending “Granny to Belgium” for a hip replacement or allowing her to buy $8 prescriptions from Mexico isn’t just feasible; it’s a transformative solution for a strained healthcare system.