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Medical Tourism - Health care disrupter or fringe service?

by John W. Mitchell, Senior Correspondent | January 21, 2015
Primary Care
From the January 2015 issue of HealthCare Business News magazine

“Medical tourism could have been a disrupter — it was poised to be a disrupter,” she said in a recent interview while consulting in Greece on medical tourism. “But it hasn’t happened.” She attributes this to several factors, one of the biggest being the lack of medical or health care experience among those working in the field, which reveals itself in small details.

“For example, I just came back from the Athens airport visiting with managers and I learned that any patient traveling to Greece who needs a wheelchair must give 36 hours notice,” says Todd, who has both physician practice and hospital experience. According to Todd, the number of handicapped patients visiting Greece has increased from 7 to 12 percent in the past seven years for those who want to vacation at resorts near dialysis centers and other health services. But airport management there reports many medical tourism facilitators are not aware of the need for wheelchairs.

“I’ve seen medical facilitator certificate programs that have medical facilitators doing work that should only be performed by a registered nurse,” Todd says. “That’s not safe.”

Then there is the bigger problem of medical record privacy and the shoving match going on between the U.S. and the European Union. “The EU openly states that HIPAA does not meet their requirements for data privacy,” Todd notes. “Because of this dispute, U.S. insurance companies are reluctant to sign off on their patients going to the EU for care because they don’t want the liability related to privacy.”

To gain ground, medical tourism needs a good example. Todd said that she thinks South Korea has gone about setting up its medical tourism system well. According to Patients Beyond Borders (PBB), South Korea’s top three product lines for inbound medical tourists are cosmetic surgery, prostate cancer and cardiology treatment.

“The Koreans have set up an arbitration system for care and outcome disputes. They also require [registration by any] medical tourist facilitator who promotes them as a destination. What I like about that is they are regulating those outside the country who are marketing the country, which protects their brand.”

According to Forbes, in 2014, 1.25 million Americans traveled “outbound” to receive medical treatment. Patients Beyond Borders, which compiles an annual publication of industry and patient information, in 2013, lists the U.S. as the second largest single “inbound” destination (850,000 to 1.25 million) for medical tourists, behind Thailand (1.3 to 1.8 million). Cosmetic surgery is the most commonly listed specialty sought by medical tourists, with dental, cardiology, cancer/oncology and orthopedics topping the list of product lines. There is no doubt health care costs are significantly less outside the U.S. For example, according to PBB, heart bypass surgery in the U.S. is $88,000 compared to $20,800 in Malaysia, while a hip replacement runs $33,000 compared to $12,500 in Malaysia. Still, Todd said that most of the cross-border medical tourism occurring in the world is between countries outside of the U.S.

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