Medical Tourism: Passport to Cheaper Health Care?

U.S. Health Care: Slicko or Sicko? continued...

The situation is so dire that in 2001, medical costs drove an estimated two million Americans into personal bankruptcy, even though 75 percent had medical insurance at the onset of their illnesses, report researchers at Harvard University.

In 2006, middle-class men and women who become medical tourists to avoid plunging into poverty were dubbed "America's new refugees" by the New EnglandJournal of Medicine. One such person is Howard Staab, an uninsured carpenter who testified last year before the U.S. Senate Special Committee on Aging. In 2004, Staab ventured to India for a mitral valve replacement that would have cost about $200,000 in his hometown of Durham, NC. At New Delhi's Escorts Heart Institute and Research Centre, the price was 96.6 percent less, or $6,700.

"The cost of health care is high, and people have started to vote with their feet. In time, there will be a lot of vacant American hospital beds," says Senator Gordon Smith (R-OR), former chairman of the Committee on Aging, who has enlisted the help of the Departments of State; Commerce; Health and Human Services; and Homeland Security to build a medical tourism task force. "But if Americans are going to travel for reasons of cost, they should have some assurance that the services they engage are legitimate, and not some snake oil abroad." Adds Kimberly Collins, the senator's spokesperson, "This is an industry ripe for fraud and abuse."

The Risks Patients Face

Surgery can go wrong, regardless of the country where it takes place, the hospital where it's performed, or the doctor holding the knife. And, of course, quality of care varies from hospital to hospital, just as it does in America. That's why it's essential for patients to minimize the risks as much as possible by making good choices - something that's difficult to do, say critics of medical tourism, in nations where the standard of care is inconsistent and qualitative measures are often vastly different from those in the States.

"One of the struggles is that there is no data," says Arnold Milstein, M.D., medical director of Pacific Business Group on Health, a nonprofit group that focuses on improving the quality of health care while controlling costs. "All you can say is that there is more uncertainty about quality with this form of care than there is with American care." Dr. Mahal agrees that overseas treatment can be unpredictable. "While the best hospital in New Delhi is on par with some of the best hospitals in the United States, if you start comparing an average hospital in New Delhi to an average one in America, you would find an enormous discrepancy," he says.

Many medical tourists understand that they're leaving the safety net of health-care standardization. "It was scary going abroad. But life is not risk free," says Patty Sanden, from North Bend, OR, who needed a hysterectomy this year and saved at least $13,000 by having it in San Jos¨¦, Costa Rica. She relied on the booking agency MTI to prescreen doctors. Her surgery went well and the hospital staff, she says, "treated me like a celebrity."

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