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Outsourcing Medicine: The Expanding Field of Medical Tourism

Medical Tourism

In a country where 62% of all bankruptcies are the result of skyrocketing healthcare bills, it’s clear that the U.S. has a healthcare expenses problem [1]. Combine that with some of the worst mortality rates in the developed world, and you start to understand how Americans are in a lose-lose situation when it comes to healthcare options. In contrast, countries like India, China and Thailand offer healthcare procedures of the same caliber of the United States at up to one tenth of the cost. With that in mind, it shouldn’t come as a surprise that medical tourism is on the rise.

Medical tourism is the process of traveling to another country for medical procedures that may not be offered in one’s home country or are too expensive in the country an individual resides in. The concept of traveling for healthcare initially began as a way for people from less developed countries to receive medical treatment that was not yet available in their own countries by traveling to more developed countries. Now, however, people from more developed countries like the United States are actually traveling to less developed countries for medical procedures [2]. In these less developed countries, people are able to have medical procedures done at a fraction of the cost it would have taken back home, and often they receive better patient care than they would at home. In addition, patients find it attractive that many of these countries offer procedures that have not yet been approved by the FDA.

Medical tourism offers many people an alternative to their healthcare plan’s coverage, especially for those individuals who find that their conventional healthcare options aren’t the most effective or rational. For those who do not have health insurance, it allows for a much less expensive option than traditional healthcare. In fact, medical procedures in countries such as India, Thailand, and South America, are a fraction of the cost of medical procedures in the United States. For instance, while open heart surgery would cost up to $150,000 in the United States, it ranges from only $10,000 in Iran. Cosmetic surgeries in Costa Rica are normally a third of the cost that they are in the United States [3], and procedures in India can be as low as 10% of the cost of procedures in the United States [2].

Price, however, is not the only factor increasing the demand for medical tourism. A demand for anonymity also drives people to look for healthcare abroad. For example, people can go to a foreign country under the guise of a vacation, undergo cosmetic or sexual reassignment surgery, and then return to their home country with no one the wiser. Medical tourism also allows people the option of having surgeries and medical practices that aren’t approved in their home country.

In India, people are offered the option of having a hip resurfacing surgery instead of a hip replacement surgery. Hip resurfacing surgery, which has not yet been approved by the FDA, allows for a shorter recovery period than hip replacement surgery as well as increased mobility compared to traditional hip replacement [4].

Medical tourism also provides a faster option for undergoing medical procedures than in the United States. In cases where waiting lists for certain procedures are rather long, it is often much quicker (and in many cases, cheaper) to go to a foreign country and get the procedure done there. Often wait times for certain surgeries can be up to eighteen months in a home country, while the same surgery in India or Thailand could be completed within a week and the patient would be home within two weeks [2].

As medical tourism is still a new trend, it does have its drawbacks. If any complications from the procedure arise after the patient has returned to their home country there is little they can do. There are no laws or regulations concerning international medical procedures, and in effect, those who do partake in medical tourism do so at their own risk. If medical malpractice occurs in the foreign country that an individual has decided to have the procedure in, they would have to try the case in that foreign country, a process that is often long and laborious [5]. To make matters worse, many patients are asked to sign liability forms that prevent them from being able to take foreign clinics to court. The procedures in foreign countries aren’t as strictly mandated, and while this allows them to offer procedures that are not offered in other countries, it also means that there is less of a concern for patient safety.

Though going abroad for medical procedures has its drawbacks, it is mostly beneficial for those coming in from other countries to have procedures done. Yet, the development of medical tourism has had an adverse impact on lower income families that are native to the countries providing services for medical tourism. While medical facilities are targeting their business to foreigners, medical care for those who actually reside in the country are being put on back burners. In the case of India, medical facilities are being expanded and the government is putting even more money into the medical tourism sector, and at the same time they are ignoring the lack of medical facilities in remote regions of the country [3,6]. So while medical tourism might be helping the economy of less developed countries grow it has a negative impact on the native population of the region.

In China, India, and Moldova, to get organs for organ transplantation, people are reimbursed for giving up their organs. While people are not actually paid for their organs, they are reimbursed for expenses that they incur as well as for loss of earnings as a result of the surgery. This then results in poor people giving up their organs so that they can receive money. Yet while aspects of medical tourism are unethical with respect to the individuals native to these foreign countries, this doesn’t seem to be slowing the growth of medical tourism.

President Obama’s healthcare plans, however, may dramatically change the market for medical tourism. Since the healthcare bill requires that a majority of Americans have insurance by 2014, this seems to predict a fall in medical tourism as a whole. If more Americans have insurance, then it seems logical to conclude that less Americans will have to turn to foreign countries for medical procedures that they cannot afford otherwise. However, the situation isn’t as simple as that. A shift to government sponsored healthcare could also lead to a further increase in wait times for medical procedures. As a result, the demand for medical tourism could remain high, as foreign healthcare services would be much more prompt than procedures in the U.S. [7]. This seems like a reasonable conclusion to make, as it is the current situation in countries like Canada and the UK, who do have government sponsored healthcare [2].

Over the last few years, medical tourism has been steadily rising. In 2008, 540,000 Americans traveled abroad for medical procedures. In 2009, that number rose to 648,000, and in 2010 it was 878,000. It is expected to rise to 1,300,000 individuals by this year [7]. This shows a steady rise for the demand for global healthcare, and it is unlikely that a health care reform will drastically change those numbers. When both insured and uninsured Americans were surveyed on whether they would consider going abroad for medical treatment if it was recommended to them by a doctor, 28% of the uninsured individuals said they wouldn’t consider it, compared to 22% of the insured individuals [7]. This shows that though cheaper healthcare might be one of the key reasons that individuals go to foreign countries for medical procedures, it is not the only reason, and the advent of more insured individuals may not result in a fall in the numbers of medical tourism.

The growth of medical tourism parallels globalization across the world. As globalization becomes a more common phenomenon, it becomes increasingly clear that no profession is nationally exclusive. Not only do American companies not have to hire American workers, but Americans can also choose not to use American healthcare. The balance of the world is shifting in a way that is equalizing all nations, and this change is going to occur in all fields of work.

References

1. Cussen MP. Top Five Reasons Why People Go Bankrupt. Forbes. 2010 Mar. 25.

2. Horowitz MD, Rosensweig JA, Jones CA. Medical Tourism: Globalization of the Healthcare Marketplace. Medscape J. Med. 2007 Nov. 13; 9(4):33.

3. Connel J. Medical Tourism: Sea, Sand, Sun, Surgery. Tourism Manag. 2005 Nov. 29; 27:1093-1100.

4. Leung R. Vacation, Adventure And Surgery?. CBS News. 2005 Sept. 4.

5. Mirrer-Singer P. Medical Malpractice Overseas: The Legal Uncertainty Surrounding Medical Tourism. Law Contemp Probl. 2007 Aug. 8; 70: 211-32.

6. Gray HH, Poland CS. Medical Tourism:Crossing Borders to Access Healthcare. Kennedy Inst Ethics J. 2008;18(2):193-201.

7. Baran M. Medical tourism pros consider impact of healthcare reform. Travel Weekly. 2011 Jan. 25.

This article was originally published in The Science in Society Review at the University of California at San Diego by The Triple Helix Inc. Follow The Triple Helix Online on Twitter. Join us on Facebook

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Discussion

4 comments for “Outsourcing Medicine: The Expanding Field of Medical Tourism”

  • http://www.patientsbeyondborders.com Josef Woodman

    Excellent overview, one of the best I’ve seen on the subject.

    We at Patients Beyond Borders share your assessment that US healthcare reform is not likely to slow the growth of US-outbound medical tourism. In addition to the long waits you cite, the plight of the “under-insured” will dramatically intensify in the face of limited universal healthcare resources.

    US is the tip of the iceberg. Where medical tourism is a new and rising phenomenon for Americans, US-outbound represents less than 20% of worldwide patient flows. For example, some 400,000 Indonesians travel to Singapore and Malaysia for care each year. Thailand sees nearly a million cross-border medical tourists annually. Expect pan-Asian flows to increase over the next decade as 2.5 billion enter the middle class and seek access to quality care.

  • http://smileplanners.com/ Matt Kelleher

    There is also the market for dental tourism. The US health care bill does not address dental care. Dental will continue to rise especially for procedures such as All-on-4 (4 dental implants and full bridge) and All-on-6 dental implants, which can cost upwards of 60,000 USD for full mouth reconstruction with dental implants in the US. At Smile Planners Dental Holidays, we see dental costs – like these – driving the demand for dental tourism to locations such as India and Thailand where the cost savings at significant – especially for the most expensive dental treatments. The fact is that dental tourism enables people from around the world to receive dental treatments that they otherwise would or could not, due to financial considerations.

  • Roy

    i have read your article Really Nice one.because Now a days not only big companies like Adobe, Microsoft are doing software and product development in India at their development center. But now many other small to medium scale companies have started software and product development and started entering into outsourcing software product development. It is considered that, increase in business will be around 100% in offshore outsourcing product development.

    Virtual Assistant from India for £299 pm,

  • Anonymous

    Great post , Thank you for writing so well on such a difficult but important subject. It was really helpful to solve my confusion,

    General and Cosmetic Dentistry