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:

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It took me a full day to decide whether or not the above headline worked for me at all. Undeniably, the European Commission, which has broad power over economic policy for most of Europe, is supporting transnational regulation for healthcare in the 27-member European Union (EU). (News link)

Almost immediately upon the announcement of the proposal, Britain’s National Health Service (NHS) was freaking out.

“Millions of patients will be able to travel abroad for free medical treatment within three years under European plans,” was the breathless lead in The Telegraph, which went on to say:

The new rules will allow patients to buy hospital, outpatient or dental treatment in any EU country and send the bill to the National Health Service.

Experts predicted that the rules could spark an exodus of patients from the NHS due to concerns about long waiting times and hospital superbugs.

Once adopted the new laws will give patients the right to claim back the cost of any medical procedure up to the amount it would have cost in their home country.

Further down in the article, the NHS had its say:

“… Health Secretary Alan Johnson is fighting for the right to make patients obtain NHS permission in advance for major operations.

The health department said: ‘We are absolutely committed to ensuring that the NHS retains the ability to decide what care it will fund.’

The proposal represents a potential boon to medical travel and tourism businesses and facilities in Eastern Europe especially, along with perhaps Portugal, Spain and those Western European countries that have lower costs than Great Britain — along with no waiting lists, for which the NHS is notorious. The reaction from India was also immediate — the EU proposal was called a “major setback” to Indian medical tourism, which has been courting NHS outsourcing for years now.

Can the NHS and Britain buck the Commission? Perhaps. The proposal isn’t set in stone. But there is a certain aura of inevitability about medical tourism in Europe …

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The decline of the value of the American dollar vs. other major world currencies has prompted more than one prospective medical tourist to ask me if “it is still worth it” to go out of the country for medical care. The very short answer is: “Yes, it is still worth it.” The dollar has not declined nearly enough to offset the enormous gap between prices for medical services in the United States and medical tourism destination countries.

But it is worth a closer look, because currency exchange rates do have an impact on costs of medical travel to and from different countries.

The dollar has declined sharply in the past two years against other major world currencies, which generally has the effect of making foreign goods and services more expensive for people who are spending dollars, whether in the U.S. or when they travel abroad. In a feature article in the New York Times on April 21, “If Only the Dollar Were Stronger,” Americans who are living overseas talked about how the fall of the dollar has eroded their buying power. Healthcare costs, the article said, has hit Americans who have retired overseas hard:

“Americans think that health care anywhere but in the U.S. is cheap,” said Daniel Prescher, publisher of International Living, a monthly magazine focused on living overseas. “Yes, it’s less expensive, but when you need it often as a resident in a foreign country, it’s something you still need to plan for as part of your budget.”

Note that this is rather a general statement, and that living abroad as a retiree who must pay out of pocket for regular health care is not at all the same as traveling abroad for one-time surgery or care. Specifically, much of the consternation about the falling dollar is about how it has fallen vis-à-vis the Euro, to record lows recently, with little prospect for recovery in the near term.

But the value of the dollar has not fallen as drastically vs. the currencies in medical tourism destination countries and, even where it has fallen, prices for medical services, surgery and dental treatment have remained at a drastic discount from those in the United States.

In Costa Rica, a prime destination for medical tourists, the dollar has been relatively steady against the colon. In fact, the dollar has risen in value vs. the colon for most of the last decade, and prices of medical services to tourists have remained quite stable. Real estate prices have ballooned in recent years in Costa Rica, but not the prices of dentistry and plastic surgery.

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Just a few years back, medical travel and tourism was the province of a small and select group of hospitals and medical facilities; and the United States was better known as a destination for international patients, not as a country from which patients went elsewhere for care.

Today, the infrastructure of medical travel and tourism is global. Consumers led the way and the medical and business communities have expanded to cater to the growing demand. In that context, BridgeHealth’s announcement of a global network of providers puts it at the leading edge of providing international care but patients in the U.S. shouldn’t be surprised. Providing for increased choice in destinations, facilities, surgeons, doctors and pricing is part of what medical travel *does*, as a phenomenon, as it grows.

– the moderator

DENVER - Responding to the growing demand among employers, health plans and other stakeholders for a comprehensive, “world-class” network of international healthcare centers of excellence, BridgeHealth International, Inc. (BridgeHealth) today unveiled its initial system of providers comprised of over 25 hospitals and 600 physicians, dentistsand health professionals in ten countries. With a focus on serving businesses and individuals for the delivery of international medical care, BridgeHealth developed its World-Class Provider Network™ to offer an extensive range of medical and dental procedures, a wide choice of hospitals and destinations, and options for accessing providers with experience, expertise and high standards of safety.

“The BridgeHealth network is the first-of-its kind in the industry, bringing to the marketplace a best-of-breed option for delivering high quality care and treatments to medical travelers,” says Victor Lazzaro, Jr., CEO of BridgeHealth. “Backed by decades of executive experience in healthcare delivery, BridgeHealth has assembled a network of breadth and depth, with a focus on promoting provider choice and offering a superior client experience. As the recognized leader and innovator in medical travel, we are committed to growing this international system while always maintaining the highest degrees of integrity and concern for quality.”

The BridgeHealth network represents the widest range of choices now available for medical travel, offering patients a vast array of options.

“Some Americans may choose to travel to exotic locations including Singapore or India while others may prefer to be closer to home and opt for Mexico or Panama,” continues Lazzaro. “We offer a broad menu of medical and dental procedures – meeting needs as varied as orthopedic procedures, cardiac surgeries, and bariatric operations. Our goal is to match patients with their location of choice, meet budget expectations, and arrange for the highest quality care available in a specific country. This is all made possible by assembling the most extensive network in the industry.”

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