Medical Tourism: Passport to Cheaper Health Care?

U.S. Health Care: Slicko or Sicko?

No one knows exactly how many Americans have traveled overseas for operations. Excluding cosmetic surgery and dental patients and counting just those seeking essential medical procedures, companies in the business of sending patients abroad estimate an annual total of only about 10,000. "It's simply not as big as it's often reported to be, but it's growing every year," says Patrick Marsek, managing director of MedRetreat, a Chicago-based booking agency that sent 200 patients overseas in 2005 and expects to send 650 in 2007. Other booking companies (often called medical concierges) report similar growth: New York-based Medical Tours International (MTI) arranged care for 60 Americans when it opened in 2002; they project at least 900 clients for 2007. California-based Planet Hospital says this year's number will be 1,200, up from 500 in 2006. Seeing this increased interest, some health insurers have begun selling packages to Americans who want to go abroad for health care.

To leave their country, in some cases for the first time, and undergo surgery halfway around the world, people need to be motivated - and the dollar savings of medical tourism (also known as surgical off-shoring) are persuasively large. In the U.S., heart bypass surgery is $113,000 and up for the operation alone; in Thailand, only $11,000. A hysterectomy, about $20,000 here, costs around $3,000 in Malaysia. And a Knee Replacement that would run around $48,000 here is $8,500 in India.

Price cuts that enormous might appeal to anyone, but for Americans without health insurance (the number is more than 45 million, reports the U.S. Census Bureau), lower costs can mean the difference between life and death. Researchers at the Institute of Medicine found that more than 18,000 U.S. citizens die every year because they don't have insurance. The National Coalition on Health Care (NCHC), a nonprofit group whose mission is to improve America's health system, estimates that there are also 35 to 40 million other Americans who are either underinsured, like Bennett, or have coverage that doesn't address the reality of their medical needs. Even people with good coverage can end up out of luck if health-plan administrators deny claims, alleging that the treatment isn't "medically necessary." That was dramatized this year in Michael Moore's film Sicko, as was the problem of escalating premiums, which have doubled in the last six years. Many employees are now forced to turn down coverage because they can't afford to pay their share. "Our system is not caring for people the way it should," says Scott Rubinstein, M.D., associate clinical professor of orthopedics at the University of Illinois School of Medicine in Chicago, who has provided follow-up care for medical tourists when they've returned home.

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