Relaaaaaaax. It’s not a true story. It’s not based on a true story. It’s a work of complete fiction by the master — perhaps the inventor — of the medical thriller genre, Robin Cook. “Foreign Body,” published Aug. 5, is bound to find an audience; Cook, 68, has written a string of bestsellers dating back to the 1970s. “Coma,” the original medical thriller, came out in 1977. It was the “gripping story of patients who check into a hospital for “minor” surgery-and never wake up again.” We’ve had variations on the theme ever since from Cook, a medical doctor. Books. Movies. TV Miniseries. Robin Cook is an industry.

That his latest book comes wrapped with a medical travel and tourism theme shouldn’t be surprising. Cook has always mined the latest headlines for his stories: Organ donation, genetic engineering, fertility treatment, in vitro fertilization and managed care have been a few of the topics that have previously provoked his flights of fancy. His last book, “Critical,” was a tale woven from some of America’s worst fears, and facts, about its own medical system — one in which business issues take precedence over quality of healthcare.

Medical tourism is a natural for Cook. That it has become big enough to attract his attention is testimony more to its popularity, success and safety than it is to its drawbacks and dangers, however. Medical tourism generally, and Indian medical tourism specifically, will continue to thrive, though I wouldn’t choose to read “Foreign Body” to pass the time while on a plane to Delhi for hip surgery any more than, once upon a time, I would have read “Jaws” while relaxing on a small sailing vessel off the shore of Cape Cod.

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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.

Sometimes, you can’t go it alone and get satisfaction. Individual consumers with complaints, however valid, are rarely a match for the sort of colossal indifference that a big corporation or government entity can routinely bring to bear on a problem.

And most medical tourists and travelers go it alone. I know I did, in 2004. I did my research. I talked to other people who had been overseas for healthcare. I vetted my doctor. And I went, and I had a great experience.

But what if something had gone wrong — if I had been unhappy with my treatment or had complications? I like and trust my doctors; I know they would have done everything they could to “make it right.” But I have no way of knowing what would have happened, really.

Earlier this week, the Washington Post ran a story about a patient, Betty Meisel of Portland, Oregon, who went to Thailand in 2005 for plastic surgery and had things go wrong. The hospital, perhaps the best-known destination for international patients, claimed three years later to have not received the email she says she sent back then regarding her terrible surgical outcomes. When contacted by a reporter in April, the hospital did write to Meisel and issued a refund.

Which didn’t make everything OK, of course, though it was something.

Years ago, stories like Betty’s were more the rule than the exception, when reporters wrote about medical tourism. This was not because the medical facilities and doctors overseas were bad, but because reporters didn’t know enough to place a single bad outcome in context. The “news value” would be the oddness of someone going overseas for surgery, and the media treated bad surgical outcomes almost with a “what else would you expect?” kind of demeanor. The media learned, over time, and stopped reporting the small percentage of bad results as the norm. Bumrungrad International, in fact, has a reported complication rate that any U.S. hospital would be proud to match.

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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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