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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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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Medical travel and tourism continues to be poked and prodded in the U.S. media and, increasingly, the news is catching up with the most significant trend in the nascent industy.

And that is, that patients can go outside of the United States for high quality medical care at far lower costs than at home is becoming part of how businesses, insurers and consumers — together — are fighting to contain costs for needed healthcare. The May issue of Fast Company covers the topic and the issues it raises, in considerable depth, in an article headlined, simply, Medical Leave. The article is a snapshot of U.S. healthcare at a crossroads:

“The phrase “medical tourism” was once used to describe early retirees jetting in to Bangkok or Bangalore to have a little work done before recuperating on the beach. That image doesn’t jibe with the numbers today. As many as half a million Americans streamed abroad last year in search of affordable alternatives for hip replacements or prostate surgery. And they went not for the postsurgical tanning but for the savings: up to 90% off the going rates in the United States. They went because 47 million Americans lack insurance and can’t pay for surgery to fix a bad back or clogged arteries. Or because they have insurance but can’t begin to pay the soaring deductibles a major surgery entails. They’re fleeing a system that is by far the most expensive in the world and growing more so by the hour, with diminishing returns in quality of care.”

The FastCompany.com article makes it clear — U.S. businesses and insurers are integrating medical travel into healthcare offerings at whatever pace that consumers will accept — and as consumers learn more about healthcare outside the U.S., they accept or even embrace it.

That has also been the experience of Stephanie Sulger, BridgeHealth International vice president, who has been helping patients get the care they need at a cost they can afford for the past six years.

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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