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)

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Though blogs, or web logs, have been around for years — sometimes it seems like everyone has a blog –  the vast majority of Internet users have only a glancing knowledge of them. We thought it would be a good idea to explain, clearly and simply, what The Bridge blog is, who it is for, how to get around, how to use its features and how to participate.

The Bridge is a blog about medical travel and tourism, written and edited by experienced professionals. It is sponsored by BridgeHealth International, a medical travel company that provides services both to consumers looking to travel abroad for high-quality, lower-cost medical, health and dental care; and to businesses that seek to provide such services for employees or customers. BridgeHealth International has a web site, obviously. But it sponsors The Bridge as an information and discussion center that is less formal, more interactive and more flexible and current than its more focused corporate web site sibling.

Who is The Bridge for?

The Bridge is a blog for anyone with an interest in medical travel and the global availability of medical services for consumers and for businesses. In the left column, note our categories. They are general headings or sections for the articles that appear on the blog. There will be some overlap. In general, if a blog post or article fits in more than one category, it will be cross-filed so that readers are better able to find relevany information by browsing through the categories.

How do I navigate The Bridge?

The most recent five blog posts appear on the front page. Some longer articles are not complete on the front page; readers should click on “Read the rest of this entry” to go to the complete article. Older articles can be found by subject (browsing categories in the left hand column) or by date (browing the archives, underneath categories.) Readers can also search the full contents of The Bridge via the the box in the upper right on every page.

“Recent Posts,” on the right side displays the headlines of the five most recent articles, linked to the complete articles. The “Recent Comments” box lists the five most recent comments on articles and gives the author of each comment.

The News Ticker is updated in real time as a service of Google News, with five recent stories about medical travel from around the world. Clicking on a story will open it in a new tab in your browser. To return to The Bridge, simply select its tab in your browser.

“Top Links” are a list of sites chosen by the editor of The Bridge for the quality of information they provide about medical travel. They are not advertisers.

The Currency Converter at the bottom of the right column is provided as a convenience for readers. Exchange rates come from Yahoo Finance.

RSS Feeds and Social Networking

At the bottom of each post are links to some of the most popular social networking and bookmarking sites. If you are a subscriber to them, you can add The Bridge to your site or page by clicking on them. If you are unfamiliar with social bookmarking and wish to learn more, see this link at Wikipedia.

http://en.wikipedia.org/wiki/Social_bookmarking

RSS Feed links for The Bridge are at the bottom of the left column. These are links that readers can use to offer content from The Bridge on their own blogs, profiles or other web pages. We will add to and update these options as time goes on.

Registering and Subscribing to The Bridge

If you wish to participate fully in our discussions, customize an e-mail subscription to The Bridge or manage your own personal profile, you must be a subscribed and registered user. Click the “Subscribe” tab at the top of any page. You’ll be asked for your e-mail address and to select a user name. A password will be sent to you, allowing you to log in using the box near the top in the right hand column. Once logged in, that same box will show your user name and give you additional options.

The Bridge will never give out your e-mail address and you may unsubscribe at any time. Users control their own privacy.

Article Comments

Registered users may view comments on any article by clicking on “Comments” below that article. Registered users who are logged in may add their own comments on the comments page for any article. Registered users can choose to be notified of responses to any comments they may have.
All comments are subject to moderation as of May 15, 2008, which means that they must be approved by a moderator before they will appear on the site. We will try to moderate the blog in real time, but are not staffed 24/7. We hope to relax moderation for registered users as conversations and time goes on.

Unregistered users can also leave comments but they will always be subject to moderation.

Spam comments and comments of an overtly commercial nature are banned, at the discretion of the moderator.

Article Authors

We welcome article submissions from the public and from medical professionals and businesspeople with an involvement or interest in medical travel and tourism. Please submit queries to the moderator using the “Contact” link in the navigation at the top of any page.

Happy blogging, and I look forward to meeting you on The Bridge!

Jeff Schult, moderator and editor
May 10, 2008

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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