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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Most medical patients aren’t aware of their rights, other than generally. In the United States, particularly, they can be excused — patient rights vary depending on the state in which a person lives and what protections and recourse that may be offered by an insurer or HMO. Patient Bills of Rights passed both the U.S. Senate and the House of Representatives in 2002, but they were different versions and, ultimately, no bill was able to pass both bodies.

The President’s Advisory Commission on Consumer Protection and Quality adopted what amounted to a consumer bill of rights and responsibilities (note that with the rights come responsibilities) in 1998 which is, as the name of the commission suggests, only advisory in nature. Many, but not all, health plans and healthcare organizations formally subscribe to the principles in the commission’s final report. It is ten years old, and non-binding, but it is better than nothing.

Medical travel and tourism was barely heard of in the United States by 1998, and was not a consideration in the debate over a federal Patient Bill of Rights in 2001-2002. Medical tourism has only more recently come under scrutiny in Congress. Regarding their rights, medical tourists and travelers have mostly been told: “You’re on your own.”

So it’s good to see medical tourism companies grappling with the concept of patient rights and responsibilities, as BridgeHealth International has. The company today released “Clients’ and Traveling Patients’ Rights and Duties,” a statement that is meant to represent the company’s values as well as representing, broadly, the rights that a BridgeHealth client can expect when traveling overseas for medical care.

Reading through the document, it occurred to me that in it are embodied the rights that any patient should expect to have anywhere — not just when traveling abroad — but that several of the enumerated rights are not common in the United States. In particular, do patients have a timely, thorough and documented process for registering complaints? And do they always receive a detailed statement of account with an explanation of all expenses incurred during treatment? Perhaps both are routine in some facilities, but I think the perception is that neither is commonplace.

I’d love to hear what readers think. Is the BridgeHealth statement of rights and duties on the money? Does it go far enough? What, if anything, would you add to it?