It should not surprise anyone that there is no mention of medical travel and tourism in the platform of either the Republican or Democratic parties. However, it’s lurking beneath the surface.

GOP candidate John McCain’s healthcare policies and positions would encourage Americans to take greater individual responsibility for their healthcare choices. Health benefits would no longer be treated as tax-free income; instead, individuals and families would get substantial tax credits for medical spending and would have tax-free health savings accounts.

Obama’s plan calls for most employers to either provide benefits or to pay into a national healthcare plan. He would create a National Health Insurance Exchange where insurers would sell coverage to small businesses and individuals. To participate, insurers would have to disclose costs and benefits of various plans and the percentage of premiums that go to patient care as opposed to administrative costs. The goal is to create a transparent market for health insurance that will improve quality, efficiency and value.

It is easy to see how medical travel would continue to grow under the administration of either man. Under McCain, consumers would presumably pay more attention to their own medical costs and might opt for care abroad. Under Obama, it is more likely that insurers bidding to be competitive with individuals and small businesses will look to provide innovative plans that keep costs down.

The odds are that you’re not going to be hearing either candidate out on the campaign stump extolling the virtues of outsourcing; more likely you’ll hear the opposite. But when all is said and done, there is nothing in the healthcare proposals of either party that is inimical to medical tourism.

A tip of the hat and a link to Amanda Hayes-Kibreab and Natasha Bellroth, who wrote a more extensive analysis:

How Would Obama and McCain’s Healthcare Proposals Impact Medical Travel?

The authors say McCain’s proposals are more friendly to medical tourism than are Obama’s. The only thing I’m sure of is that we probably don’t get to try both routes to healthcare reform.

Medical tourism seems likely to be part of the solution, either way.

Syndicated columnist Froma Harrop of The Providence Journal in Rhode Island writes about the “good and bad” of medical tourism in a piece that has appeared in newspapers from coast to coast over the past few days (including in The Seattle Times: Medicine through the back door.) Harrop fancies herself something of a pioneer as a medical tourist, having had Lasik ™ eye surgery in Toronto in 2000, paying about a quarter of what she would have in the United States, saving $3,000. She says that, at the time, “Canadian doctors had more experience with Lasik surgery than most of their American colleagues.”

I took 10 minutes to surf about the web and see what I could find out about traveling to Canada for eeye surgery now, in 2008. Disconcertingly, even in that small amount of time I could tell that it is very difficult to cut through the data smog I wrote about the other day. There is not a lot of concrete, objective information about getting Lasik in Canada that is immediately visible. Almost certainly, the cost difference between the U.S. and Canada has narrowed. A Canadian dollar was wotth only about 70 cents in U.S. money in 2000; today the currencies exchange at approximately 1:1.

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As of this morning, a Google search for “medical tourism” returns 1.8 million results. If a reader spent one minute on each page, for eight hours a day, it would take more than a decade to get to the end … and by that time there will probably be some more millions of results.

One of the mantras of medical tourism, as far as advice to people who are thinking about going overseas for healthcare, is “Do Your Homework.” Everyone says it. If you think I’m exaggerating — another Google search, this time for “medical tourism” and “Do Your Homework,” turns up 2,400 references. That’s a lot better than 1.8 million but it’s still a lot to go through for what is liable to be very much the same thing, over and over again, with the possibility that you aren’t going to find what you really want at all.

In the research biz, we call this data smog, a term probably coined and certainly popularized by David Shenk in 1997. As an author, I have learned to live with data smog. Once upon a time, people wrote books about particular subjects because not enough information was available about them. More often in the Internet age, books are written because too much information is available and someone hits on the good idea of winnowing it down. When I wrote Beauty from Afar in 2005-06, medical tourism was somewhere in between those two things and the book’s narrative was shaped accordingly. There are a lot of things in it that hardly anyone knew about, and also a lot about how to find medical information online. Today, there are books such as those in Joe Woodman’s Patients Beyond Borders series, which are more directory-like and represent more of an effort to bring good information out of the smog.

Part of what medical travel companies such as BridgeHealth International consciously do, part of what they bring to the table for consumers, is that they are soldiers in the war on data smog. They travel, accumulate good information, choose hospitals, facilities, surgeons and doctors on behalf of prospective patients; who in turn travel, undergo medical procedures, give valuable feedback on their own experiences.

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The Motley Fool’s reason for existing is “to educate, amuse and enrich.” The website has been dispatch breezy and sometimes irreverent financial advice to millions since about 1996. (It looked pretty different back then, too.) Late last week, Fool came out with its take on medical tourism:

Medical Vacations: The Retiree Health-Care Solution?

Despite the question mark, the Fool’s verdict was pretty one-sided.

The debate over U.S. health-care reform rages on. But why wait for someone else to dictate your future? You have many options — if you’re willing to take a vacation. If recovering from a medical procedure while lying on a palm-swept beach, relaxing by the hotel pool, or shopping for terrific bargains sounds good, then medical vacations may be exactly the right solution for you.

In other words — go for it. At The Bridge — and at BridgeHealth International — most folks cringe a little when life-saving or enhancing medical care is discussed in terms of being part of a vacation, but we’ll forgive Fool’s lightheartedness as long as patients recognize it for what it is.

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