Today’s New York Times has a fascinating look at how U.S. Sen. Edward Kennedy, D-MA, arrived at the decision to have surgery for a malignant brain tumor. Reading it, I was struck by the fact that, in many ways, Kennedy’s process was apparently much like that which is recommended to medical tourists and travelers. Initially, doctors and surgeons in Massachusetts suggested that the tumor, discovered May 20 after the senator suffered a seizure, was inoperable. Ultimately, Kennedy gathered opinions from leading experts from six or more medical institutions and chose to have surgery. He did not have it in Massachusetts, but rather flew to North Carolina for surgery at Duke University on June 2. According to The Times, “… whether the surgery was justified or not, that Mr. Kennedy had it at Duke embarrassed the Massachusetts General Hospital, a Harvard teaching institution.”

Further, from The Times:

“Several doctors not connected with Mr. Kennedy’s case said in interviews that they admired his resourcefulness in getting more opinions simultaneously. At the same time, these doctors said many average patients gained competent advice, without a command performance, by sending pertinent records to experts for their opinions.

“Many patients search the Internet for medical information and ask that their scans and other data be sent electronically or by overnight services.

“Then such patients visit, call or write the consultant.”

Read the rest of this entry »

I’ve been told time and time again that medical travel and tourism is under discussion at the highest policy-making levels of the U.S. government and have not doubted the assertion when I have heard it. Yet last week, I was briefly stumped when someone asked me for proof that medical tourism is important enough for Congress and the White House to be interested.

I pointed at hearings conducted by the United States Senate Special Committee on Aging in June 2006:

The Globalization of Health Care: Can Medical Tourism Reduce Health Care Costs?

… but my cynical correspondent pointed out that U.S. Senate committees conduct hearings all the time, perpetually gathering testimony on all manner of issues that they promptly forget about; and indeed, I had to acknowledge that there is to date no public sign of a government task force on medical tourism or any type of follow-up. The leadership of the Senate changed in late 2006 and committee staff has changed as well.

So I did a little more digging to back up my point and found that U.S. Health and Human Services Secretary Mike Leavitt has a very public curiosity about medical tourism and travel, and even discussed it on his own blog, as recently as April, after a trip to the Far East that included a stopover in Singapore. Of Singapore’s healthcare system, Leavitt had this to say:

“So, what about the quality you say? Aside from the statistics on life expectancy already cited, let me suggest we think about this. The Government of Singapore estimates that, in 2008, over 600,000 people, including many Americans, will engage in medical tourism. They will fly to Singapore to get their care at a fraction of the price. The Singaporean Government believes by 2012 the number will exceed a 1,000,000 people a year. In order to attract these people, they are transparent with both cost and quality outcomes. Patients have more information about care in Singapore than about care they would get from their local hospital. Hmmmm.”

Hmmmm, indeed.

During a trip to India in January, Leavitt blogged:

Read the rest of this entry »

How much can you say about medical tourism in less than three minutes? I found out Thursday that the answer is “more than I thought,” when the PBS Nightly Business Report managed to summarize recent events in the industry in … uh … two minutes and 48 seconds, by my clock.

An edited transcript of the segment is here:

“Bill of Health”-Medical Tourism

What did PBS think was important? Aetna’s deal with Hannaford Brothers to offer surgery in Singapore; Blue Cross Blue Shield of South Carolina setting up a subsidiary for medical travel; the American Medical Association announcing medical tourism guidelines; Intercontinental Hotel Group embracing medical travel in Latin America; etc.

Vic Lazzaro, CEO of BridgeHealth International, was among those PBS turned to for comment. The report didn’t break new ground, but it’s interesting that medical tourism has turned into the kind of story that large business news outlets — PBS, the cable news networks, major business magazines — feel they have to keep up with.

The United States healthcare system in 2008 gets an overall grade of 65 out of 100, according to a study relased late last week by the Commonwealth Fund’s Commission on a High Performance Health System. The U.S. ranked last among 19 nations surveyed in the number of deaths that may have been avoided with the proper care in 2002-2003, falling from 15th place in 1997-98.

I wince when I type sentences like that. Anyone familiar with my work knows that I’ve gone out of my way on more than one occasion to NOT say that healthcare in other countries is somehow “better” than that available in the U.S.  I note U.S. strengths in high-end care and technology and its leading role in medical research. I know overseas surgeons who have told me that, all other things being equal, they consider their peers in the United States to be the most advanced.

The problem is that all other things are not equal. The United States lags behind, badly, in the commission’s 37 different indicators of healthy lives, quality, access, efficiency and equity, compared to other countries.

Here’s some coverage of the study by major media:

• While the U.S. Spends Heavily on Health Care, a Study Faults the Quality (New York Times)
• U.S. health system scores a D in new report card (CBS Marketwatch)
• U.S. Health Care Still Ill, Survey Finds (HealthDay, Washington Post)

Read the rest of this entry »