Most medical patients aren’t aware of their rights, other than generally. In the United States, particularly, they can be excused — patient rights vary depending on the state in which a person lives and what protections and recourse that may be offered by an insurer or HMO. Patient Bills of Rights passed both the U.S. Senate and the House of Representatives in 2002, but they were different versions and, ultimately, no bill was able to pass both bodies.

The President’s Advisory Commission on Consumer Protection and Quality adopted what amounted to a consumer bill of rights and responsibilities (note that with the rights come responsibilities) in 1998 which is, as the name of the commission suggests, only advisory in nature. Many, but not all, health plans and healthcare organizations formally subscribe to the principles in the commission’s final report. It is ten years old, and non-binding, but it is better than nothing.

Medical travel and tourism was barely heard of in the United States by 1998, and was not a consideration in the debate over a federal Patient Bill of Rights in 2001-2002. Medical tourism has only more recently come under scrutiny in Congress. Regarding their rights, medical tourists and travelers have mostly been told: “You’re on your own.”

So it’s good to see medical tourism companies grappling with the concept of patient rights and responsibilities, as BridgeHealth International has. The company today released “Clients’ and Traveling Patients’ Rights and Duties,” a statement that is meant to represent the company’s values as well as representing, broadly, the rights that a BridgeHealth client can expect when traveling overseas for medical care.

Reading through the document, it occurred to me that in it are embodied the rights that any patient should expect to have anywhere — not just when traveling abroad — but that several of the enumerated rights are not common in the United States. In particular, do patients have a timely, thorough and documented process for registering complaints? And do they always receive a detailed statement of account with an explanation of all expenses incurred during treatment? Perhaps both are routine in some facilities, but I think the perception is that neither is commonplace.

I’d love to hear what readers think. Is the BridgeHealth statement of rights and duties on the money? Does it go far enough? What, if anything, would you add to it?

There is a lot of educated guessing in business and in the media about what motivates medical travelers. I call it “educated guessing” because the evidence available is largely anecdotal — there are no broad-based, scientific surveys of medical travelers. There isn’t even a generally agreed upon definition of what a medical tourist *is.* Are you a medical tourist if you live in San Diego, Calif., and take the trolley and a cab to your dentist in Tijuana, Mexico? I’d say yes … but others, in an effort, perhaps, to better define a market for medical services to which insurers and employers can relate, only count those who travel much further, and for medical care, procedures and surgery that might be (or is) insurable.

I bring all this up because it can get very confusing to try to figure out what matters to medical tourists when there are different definitions of what a medical tourist is. A recent McKinsey Quarterly study, Mapping the Market for Medical Travel, says “only 9 percent of the (medical) travelers seek lower costs for medically necessary procedures …”

That statement is taken somewhat out of context from a report that we’ll be talking about more in coming days and weeks. Most people in the United States with knowledge of medical travel agree that cost is a paramount factor in a decision to seek surgery or other medical care overseas. And the McKinsey article acknowledges that “US patients make up 99 percent of the people in this group.”

So … again, what motivates medical travelers depends on what a medical traveler is, and which ones you’re talking to. As a guide to helping potential medical travelers decide what is important to them, BridgeHealth has released a list of ten key value criteria for choosing a medical travel company. A patient’s motivations, reasonably, can be mapped to the list:

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Erik Steele, D.O., a physician in Bangor, Maine is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region. He has a terrific article in the Bangor Daily news, headlined, “Consider medical tourism a warning.” in which he discusses the recent news that Hannaford Bros., a supermarket chain with 27,000 employees, is offering a medical travel option as part of employee benefits. The story, initially reported out of Maine, was picked up by the Associated Press and made national news. (Link here.)

Says Dr. Steele:

“Rather than curse Hannaford for its self-interested decision, we would do well to see Hannaford as a corporate canary chirping frantically about the deteriorating conditions brought on by high health care costs in the coal mine of American business. Its action is a warning of things to come. If unheeded, it will not be Hannaford’s action that has brought about the ruin of some hospitals, but the failure of health care and other leaders in this country to listen to the canary.”

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Vic Lazzaro, BridgeHealth International Inc.’s CEO, was featured recently on the EBA Raw Bar, which is the regular podcast of Employee Benefit Adviser. The Raw Bar features “daily in-depth interviews and discussions with the leading employee benefits minds of our time,” and I’ve no doubt Vic is a little amused to be described as among such company. But that’s what happens when you’re ahead of the curve.

In the interview, he describes the role a strong network plays in creating confidence in care abroad and sheds light on the provider selection process. You can listen below — just click the arrow to play the sound file.