Health Journalism 2008: Medical tourism – trend or aberration?

By Sarah Nail
The Sedalia Democrat

High costs and unavailability of certain treatments are sending droves of Americans overseas for medical procedures.

Jim Gutman, vice president and executive editor of Atlantic Information Services Inc., who moderated a session on medical tourism Saturday, said the practice once common for plastic surgery and joint replacement is growing in other areas.

The number of Americans who seek operations outside the U.S. is unknown, said Wouter Hoeberechts, chief executive officer of WorldMed Assist, a company that helps patients with their overseas medical arrangements. Some say 150,000 and others estimate up to 500,000. Hoeberechts said what he is certain of is the anticipated growth in the next 10 years.

"Long term proections are very big … $150 billion," he said. Hoeberechts said he doesn't think the trend will result in massive outsourcing, but will have niche appeal.

"I believe it is not an aberration, I believe it's here to stay," he said. The rising cost of health care in the United States is one of the driving factors in the trend of overseas operations. The savings is big, often as much as 80 percent, Hoeberechts said. A heart bypass for an uninsured American could cost $149,000 or $67,000 for insured, compared to $10,000 in India or $19,000 in Turkey. Others go abroad for procedures that are hard to find or unavailable in the U.S., such as hip resurfacing or disk nucleus replacements. Common procedures include those dealing with orthopedics, the spine, weight loss, cosmetics, cardiology and transplants.

Patients who seek overseas treatments may encounter difficulty transferring their existing medical records and receiving post-operation care in the U.S.

David Kibbe, M.D., senior adviser for the American Academy of Family Physicians, said technology will make transferring medical documents abroad easier. Kibbe said programs through Google, Microsoft and Intel are making the documents portable and liquidated. Documents in PDF formats are another option for transferring overseas.

Medical centers overseas are often more ready to use these electronic documents "than most of the hospitals in this country," Kibbe said.

BlueCross BlueShield of South Carolina started a separate company similar to WorldMed Assist called Companion Global Healthcare, which has an agreement with a network of U.S. doctors to provide post-operation care.

David Boucher, assistant vice president for health care services for the insurance company, is responsible for Companion.

"The whole aftercare process is part of the missing link here in the U.S.," he said.

Julius A. Karash, health care and business reporter for The Kansas City Star, said it was a challenge finding local patients willing to talk about their overseas procedure. One woman was afraid her insurance company would decline to pay for any complications that may arise from her bariatric surgery in Brazil.

Karash, who published a story in December on medical tourism, said he was struck by the consumer empowerment he discovered while reporting the issue. Americans are using the Internet to research medical procedures overseas.

Journalists should include tips for medical tourists and tell readers why this trend is happening, Karash said.

"This is a fun story to work on and it's a growing trend," Karash said. "There's going to be a lot more on this topic."