Medical Tourism - recent article

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Barefootgirl
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Medical Tourism - recent article

Post by Barefootgirl »

Came across this recent Forbes article. Have any of you travelled internationally for medical services? if so, would you do so again?

http://www.forbes.com/sites/reenitadas/ ... pacemaker/

BFG
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adamthesmythe
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Re: Medical Tourism - recent article

Post by adamthesmythe »

I hope I can maintain medical insurance so that this will not be necessary.

The article did not discuss the most legitimate (and troubling) reason for medical tourism- lack of good medical insurance.
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ram
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Re: Medical Tourism - recent article

Post by ram »

adamthesmythe wrote:I hope I can maintain medical insurance so that this will not be necessary.

The article did not discuss the most legitimate (and troubling) reason for medical tourism- lack of good medical insurance.
I am insured but by choice have a high deductible plan. Yet my family does get medical care overseas as it is cheaper. Many places outside US provide excellent medical care at a much lower cost than US. However I believe that medical training in the US is the best in the world and if I require some types of very complex medical care I will get it within US irrespective of cost. (I am a physician)
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Re: Medical Tourism - recent article

Post by camden »

Before replying, I would like to make it clear that what I am about to say is anecdotal and certainly not a scientific, statistically significant sample, and that I am equally aware that high quality medicine can certainly be found outside the U.S.

I would be extremely careful. At the medical center at which I practice, I have seen a number of absolute postoperative disasters in patients who went to Mexico for financial reasons for gastric bypass weight loss surgery, for example. Do your homework carefully. Then do it again.
Paul78
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Re: Medical Tourism - recent article

Post by Paul78 »

ram wrote:
adamthesmythe wrote:I hope I can maintain medical insurance so that this will not be necessary.

The article did not discuss the most legitimate (and troubling) reason for medical tourism- lack of good medical insurance.
I am insured but by choice have a high deductible plan. Yet my family does get medical care overseas as it is cheaper. Many places outside US provide excellent medical care at a much lower cost than US. However I believe that medical training in the US is the best in the world and if I require some types of very complex medical care I will get it within US irrespective of cost. (I am a physician)

Yes obviously you can get great care in other countries but this is YOUR life you are talking about. I have to believe, on average, you can get better care (especially for advanced/complex treatment) in America. If that cost more money who cares. If I have to get open heart surgery down the line I am not gonna say "can we do this in XXXX countries so I can pay 1/3 the amount" I would want the BEST possible care I can afford. That does not mean surgeons/MDs can no screw up in America (they do) but you have to play the odds.

If you have no choice (ie $$$ wise) but to go somewhere else that is one thing. But to do it to save money sounds foolish to me.
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Re: Medical Tourism - recent article

Post by Barefootgirl »

ram, I'm wondering if you have any thoughts on the list of 14 "top" destinations provided by Forbes in the article? Agree, disagree, other locations worth noting?

Thanks!
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Re: Medical Tourism - recent article

Post by Barefootgirl »

I would not be surprised to hear of anyone getting negative results from cosmetic surgery or surgery performed to try to correct an issue like obesity - regardless of where the surgery was performed. After all, we live in a country where people have massive quantities of silicone injected into their buttocks (and elsewhere) for no good reason...and apparently, no shortage of people willing to take their money to do it for them.

Interestingly, on many expat forums, Americans (mostly older Americans) report receiving excellent (and far less expensive) healthcare outside the US.

They have indicated that if they were diagnosed with something rare, complicated or terminal, they would come home. That leaves a lot of room for other services.

BFG
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Re: Medical Tourism - recent article

Post by jebmke »

Barefootgirl wrote:Interestingly, on many expat forums, Americans (mostly older Americans) report receiving excellent (and far less expensive) healthcare outside the US.
We lived in Belgium (one of those listed in the article) for nearly 4 years and we were very satisfied with the medical care we received. Interestingly, nobody ever asked us if we were insured locally or not - they treated us the same as the citizens. We did have identity cards but I was paid through the US so my insurance was in the US. The providers just took us in and charged us the usual rates. I think I paid 12 euros for a visit to an ophthalmologist. No forms, no fuss. My spouse was being treated continuously by a specialist for a chronic condition for the last two years we were there.
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Re: Medical Tourism - recent article

Post by coalcracker »

Barefootgirl wrote:I would not be surprised to hear of anyone getting negative results from cosmetic surgery or surgery performed to try to correct an issue like obesity - regardless of where the surgery was performed. After all, we live in a country where people have massive quantities of silicone injected into their buttocks (and elsewhere) for no good reason...and apparently, no shortage of people willing to take their money to do it for them.

Interestingly, on many expat forums, Americans (mostly older Americans) report receiving excellent (and far less expensive) healthcare outside the US.

They have indicated that if they were diagnosed with something rare, complicated or terminal, they would come home. That leaves a lot of room for other services.

BFG
Full disclosure: I am a physician, but have minimal knowledge or experience with medical tourism.

I think many patients confuse "excellent healthcare" with "excellent customer service." I can tell you from personal experience with friends and family members, that whenever I hear about how "great" a healthcare experience was, it was almost always referring to how nice the staff was, how clean and beautiful the facilities were, how there was a chocolate on their pillow in the recovery room after surgery, etc.

These features undoubtedtly improve the patient experience, but have almost nothing to do with the appropriateness or quality of the care/tests/procedures that the patient is receiving. Unfortunately, there is not a great way in my opinion for a patient to obtain this information. I would think it is even more difficult to obtain in a foreign country.

Sure, there may be patient testimonials and anecdotal evidence you can read online, but take it all with a grain of salt. I would have serious reservations about getting a major medical procedure abroad.
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Re: Medical Tourism - recent article

Post by jebmke »

Barefootgirl wrote:They have indicated that if they were diagnosed with something rare, complicated or terminal, they would come home.
On the other hand, wrt terminal illness, there are some countries where you have options that are not legal in the US.
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Barefootgirl
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Re: Medical Tourism - recent article

Post by Barefootgirl »

Interestingly, in major publications like the NY Times, etc. - one often reads that many physicians abroad are trained in the US (since presumably, the medical schools here are superior) and yet, at the same time, many foreign born physicians practicing in the US are foreign-trained, so there seems to be a lot of cross-pollination.

Where would other countries lag most, if not due to trained personnel - access to technology?

BFG
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Re: Medical Tourism - recent article

Post by adamthesmythe »

> there are some countries where you have options that are not legal in the US.

If you mean what I think (assisted suicide): more accurately, not legal in all states in the US.
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Re: Medical Tourism - recent article

Post by TheGreyingDuke »

coalcracker wrote:I think many patients confuse "excellent healthcare" with "excellent customer service." I can tell you from personal experience with friends and family members, that whenever I hear about how "great" a healthcare experience was, it was almost always referring to how nice the staff was, how clean and beautiful the facilities were, how there was a chocolate on their pillow in the recovery room after surgery, etc.

These features undoubtedly improve the patient experience, but have almost nothing to do with the appropriateness or quality of the care/tests/procedures that the patient is receiving. Unfortunately, there is not a great way in my opinion for a patient to obtain this information. I would think it is even more difficult to obtain in a foreign country.
So true, and thus all the spending on facilities that look like boutiques (at least in the communities with $$) Patients testimonials are not useful in assessing quality.
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Re: Medical Tourism - recent article

Post by kksmom »

coalcracker wrote: Full disclosure: I am a physician, but have minimal knowledge or experience with medical tourism.

I think many patients confuse "excellent healthcare" with "excellent customer service." I can tell you from personal experience with friends and family members, that whenever I hear about how "great" a healthcare experience was, it was almost always referring to how nice the staff was, how clean and beautiful the facilities were, how there was a chocolate on their pillow in the recovery room after surgery, etc.

These features undoubtedtly improve the patient experience, but have almost nothing to do with the appropriateness or quality of the care/tests/procedures that the patient is receiving. Unfortunately, there is not a great way in my opinion for a patient to obtain this information. I would think it is even more difficult to obtain in a foreign country.

Sure, there may be patient testimonials and anecdotal evidence you can read online, but take it all with a grain of salt. I would have serious reservations about getting a major medical procedure abroad.
You mean like HCAHPS :twisted:
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Re: Medical Tourism - recent article

Post by KlangFool »

Folks,

I did full blood test in both Malaysia and USA multiple times. It was a lot cheaper and more comprehensive in Malaysia without insurance versus what I get in USA with insurance. Most of the additional things in the Malaysia comprehensive test for is OPTIONAL and COST EXTRA in USA.

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Re: Medical Tourism - recent article

Post by kramer »

You can check if a hospital abroad has been certified to American standards of the JCI by going to this page:

http://www.jointcommissioninternational ... nizations/

I can tell you that in the Philippines, which does not have a good reputation for medical care, the best hospitals are a cut below an American hospital (even though they are JCI-certified). Also, it is hard to tell if your particular specialist is highly qualified and competent even though many of the specialists do meet these criteria. The quality of care in the Philippines falls drastically outside of these three to five top tier hospitals. I think some of the horror stories you hear about medical tourism are people cutting corners and not going to the top hospitals in their destination country abroad.

Destinations like Thailand and Singapore seem to have top flight reputations. Studies done of surgeons in India found they had better outcomes than their US counterparts, and this was attributed to the fact that they did the surgeries much more often. My experience is that diagnosis can be the difficult part.

I listened to a talk given by the American CEO of Bumrungrad Hospital in Bangkok, possibly the hospital with the best reputation for medical tourism in the world. He said that patients from less developed countries come there for quality of care, patients from developed countries with government health systems come there for access to care, and American patients come for lower prices.
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Re: Medical Tourism - recent article

Post by desiderium »

adamthesmythe wrote:> there are some countries where you have options that are not legal in the US.

If you mean what I think (assisted suicide): more accurately, not legal in all states in the US.
Washington and Oregon have death with dignity laws that permit people with terminal illness to obtain a prescription for a lethal dose of a barbiturate. Unlike the Netherlands there is no assistance--the physician supplies a prescription only. Also it is not suicide based on specific statute. However, this provision is not open to tourists, only legal residents of these states
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Re: Medical Tourism - recent article

Post by Barefootgirl »

He said that patients from less developed countries come there for quality of care, patients from developed countries with government health systems come there for access to care, and American patients come for lower prices.

That says a lot.

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Re: Medical Tourism - recent article

Post by VictoriaF »

desiderium wrote:
adamthesmythe wrote:> there are some countries where you have options that are not legal in the US.

If you mean what I think (assisted suicide): more accurately, not legal in all states in the US.
Washington and Oregon have death with dignity laws that permit people with terminal illness to obtain a prescription for a lethal dose of a barbiturate. Unlike the Netherlands there is no assistance--the physician supplies a prescription only. Also it is not suicide based on specific statute. However, this provision is not open to tourists, only legal residents of these states
Wikipedia on Euthanasia wrote:Jurisdictions where euthanasia or assisted suicide is legal include the Netherlands, Belgium, Luxembourg, Switzerland, Estonia, Albania, the US states of Washington, Oregon and Montana, and, starting in 2015, the Canadian Province of Quebec.
Switzerland accepts euthanasia tourists, unlike The Netherlands.

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Re: Medical Tourism - recent article

Post by VictoriaF »

kramer wrote:You can check if a hospital abroad has been certified to American standards of the JCI by going to this page:

http://www.jointcommissioninternational ... nizations/

I can tell you that in the Philippines, which does not have a good reputation for medical care, the best hospitals are a cut below an American hospital (even though they are JCI-certified). Also, it is hard to tell if your particular specialist is highly qualified and competent even though many of the specialists do meet these criteria. The quality of care in the Philippines falls drastically outside of these three to five top tier hospitals. I think some of the horror stories you hear about medical tourism are people cutting corners and not going to the top hospitals in their destination country abroad.

Destinations like Thailand and Singapore seem to have top flight reputations. Studies done of surgeons in India found they had better outcomes than their US counterparts, and this was attributed to the fact that they did the surgeries much more often. My experience is that diagnosis can be the difficult part.

I listened to a talk given by the American CEO of Bumrungrad Hospital in Bangkok, possibly the hospital with the best reputation for medical tourism in the world. He said that patients from less developed countries come there for quality of care, patients from developed countries with government health systems come there for access to care, and American patients come for lower prices.
Thank you, kramer,

It comes down to the usual conundrum that one can't simultaneously minimize time, minimize cost and maximize quality. A prudent approach is to use the Pareto principle, e.g., apply 20% of the selection effort ("time"), that is, research only top-flight destinations, to get 80% of the results ("quality"). Likewise, one can use the top destinations, such as Thailand and Singapore, where 20% of the US cost may provide 80% of the US quality--and not try to reduce cost further.

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Re: Medical Tourism - recent article

Post by noyopacific »

The USA is ranked 38th in quality of medical care but is still tops in the cost of medical care.
http://en.wikipedia.org/wiki/World_Heal ... ms_in_2000
My wife (a physician) and I have gone to Mexico for some expensive dental work and our dentist says the work is good.
A friend who is a registered nurse went to India for Bariatric (weight loss) surgery and had excellent results.
We researched for providers that had positive recommendations and qualifications. Even if you are having medical procedures done in the USA, it is a good idea to check the references and records of your physicians and hospitals.
The information contained herein, while not guaranteed by us, has been obtained from from sources which have not in the past proved particularly reliable.
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Re: Medical Tourism - recent article

Post by Alex Frakt »

Locked. Medical questions are off topic here. So are general comment threads, questions have to be about your personal situation.
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