Get Health Care Elsewhere, We'll Pay You!

Medical Tourism- traveling out of the country for health care and procedures.

In a story that frankly surprised me a bit, The Wall Street Journal examined the fact that some health insurance now covers medical tourism.

Via M.P McQueen at The Wall Street Journal:

Now, a handful of plans are beginning to cover treatment overseas for heart surgery, hip and knee replacements and other major surgical procedures.

While medical tourism isn't expected to be a solution to the country's soaring health-care costs, the practice is intended to produce savings for insurers, employers and workers. Open-heart surgery, which can cost roughly $100,000 in the U.S., can be done at an internationally accredited hospital in India for just $8,500, for instance. Proponents note that many international hospitals are staffed with American and European-trained physicians. Many facilities also are accredited by an affiliate of the Joint Commission, a nonprofit group that is the main accrediting body for U.S. hospitals.

Some of these plans actually pay a bonus to those who elect to travel for their medicine. This is an astounding and innovative approach.

While issues such as a lack of legal recourse and the lack of follow up care plans are certainly concerns, it would seem that this idea has gained a lot of traction since I last wrote about it. The issue that I find unsettling is the lack of certainty regarding the safety and sterility of tissues and blood used in transplant-oriented procedures and surgeries.

Still, this is an interesting option and one still in its early stages. I would say it bears watching.

SOURCE: "Paying Workers to Go Abroad for Health Care" 09/30/08
photo courtesy of crucially used under its Creative Commons license

Fed Up Consumers Vote With Their Actions

High costs. Long lines. Horror stories about quality issues and errors in care. These are the things that come most easily to mind for the average American when the topic of health care comes up.

The last time I had to wait in the emergency room, I was there for 9 hours before I even got any pain killers. Since I was there due to an attack of kidney stones you may imagine how displeased I was. For those lucky enough not to have had experience with these vicious little mineral deposits, they are painful enough to leave you doubled over in agony unable to function. One friend of mine who has both given birth to twins and had kidney stones tells me the stones were more painful. Based on my experience, I can believe it.

The bill was extraordinary and even with insurance I am still paying it off four years later.

This makes it hardly surprising that two topics I have written about here on the Health Care Reform Now! blog are rearing their heads again as many Americans embrace them attempting to avoiding our own system's well documented pitfalls. I speak of medical tourism and the growing number of retail health clinics opening up in big box stores like Walgreens and Wal-Mart across the country.

Via Linda Johnson at SFGate:

The number of people heading abroad for "medical tourism" could jump tenfold in the next decade, to nearly 16 million Americans a year seeking cheaper knee and hip replacements, nose jobs, prostate and shoulder surgery, and even heart bypasses, according to a forecast by health care consultants at the Deloitte Center for Health Solutions.

Meanwhile, the number of retail clinics operating in pharmacies, big-box and discount stores and supermarkets has jumped from about 200 in 2006 to nearly 1,000 last month, according to a second report from the Deloitte center.

[...] The two reports show potential big savings for U.S. consumers - and probably their health insurers - would come at the cost of American hospitals and doctors losing billions of dollars a year in revenue.

"Significant numbers of people are willing to vote with their feet to try something different, whether it's retail clinics or medical tourism," said Paul Keckley, the center's executive director. "U.S. providers are having to pay attention."

Ms. Johnson focused her article more on the medical tourism aspects, examining the benefits, drawbacks, and some very interesting arrangements made with American hospitals for pre- and post-procedure care. Even so, she does cover the rise of medical clinics like the one in my local Walgreeens that are rapidly assuming an important place in the health care landscape.

SOURCE: "Americans look abroad to save on health care - Medical tourism could jump tenfold in next decade" 08/03/08
photo courtesy of eowin, used under its Creative Commons license

American Insurance Sends Patients to....Tijuana??

The cost of health care is a constant refrain these days. Just take a look at the wide variety of studies, news articles, and blog posts that are generated on the topic daily. Hardly surprising in an era where, as George C. Halvorson points out in his book Health Care Reform Now!, there are over 9,000 billing codes for procedures but not one for a cure.

Many solutions have been proposed, although the one embraced by a growing group of providers is novel: ship the patients to Mexico for treatment to cut costs.

Bloomberg's Thomas Black brings us the details as he reports from Monterrey, Mexico:

Yielding to pressure from employers, health insurers such as Health Net, Aetna Inc. and Blue Cross Blue Shield of South Carolina are offering cost savings to policy holders who take their ailing backs, hips and knees to foreign countries for non- emergency medical treatment. Mexico has emerged as a favored place for American medical tourists because of its proximity and U.S. insurer incentives.

Black reports about 180,000 Americans make a run for the border when they need health care each year, and spent approximately $2 billion with foreign providers last year while doing so. Why is this happening? Cost is the main factor, although Black's article reports some people stating they received better quality care in Mexico than in the United States.

A hip replacement in Mexico or Thailand costs $12,000 compared with $43,000 to $63,000 in the U.S., according to a study by Christus Health published last year. Angioplasty, in which a surgeon uses a tiny balloon to open a blocked coronary artery, costs $10,000 in Mexico, compared with $57,000 to $82,000 at an American hospital.

So that addresses the cost factor, how about that quality of care? Let's take a look at the case of Antonia Siguenza, who needed treatment for a cyst.

[In the U.S.] Her portion of the bill was $800, she said. When the incision failed to heal after several months and her U.S. doctor advised her to give it more time, she drove two and a half hours to get another opinion in Tijuana and elected to have a second procedure there.

Her cyst cleared up a few weeks after the surgery, she said.

Ana Andrade, vice president of Latino programs at Health Net says that approximately 20,000 customers have the Mexican coverage plan and also that they save roughly 40% on premiums by doing so.

While the pricing is vastly better across the border there are justifiable quality of care concerns. Follow-up care can be complicated to near impossibility, safety of the blood supply is sometimes suspect, and possible lack of legal options in the face of malpractice are valid concerns.

Black's article contains two pages of analysis as well as brief interviews with both patients and providers on this subject. He demonstrates the impact our inflated and inflating health care costs are having by demonstrating how many are opting to go outside of the American system because of finances.

SOURCE: "Mexico Gets Medical Tourists as Health Net Sends U.S. Patients " 03/26/08
photo courtesy of omar omar, used under this Creative Commons license