Medical Tourism in America

by Zaid Safiullah

There has been a sharp increase in the cost of health care in the U.S. over the past few years. Many Americans have sought alternatives to expensive medical treatments by going outside of the country and, consequently, medical tourism has gained popularity, its market growing 25 percent annually. So what is medical tourism, and what factors contribute to a decision to seek treatment abroad?

Medical tourism, in the broadest sense, refers to seeking health services outside one’s native country. The most common health services sought after abroad are cosmetic surgeries, dental procedures, cardiovascular operations and fertility solutions. These procedures are quite costly in the U.S. and have large out-of-pocket costs for the patient even after insurance coverage. According to the Healthcare Blue Book, the average cost of a routine coronary bypass surgery is $70,000. The out-of-pocket expense can be upwards of tens of thousands of dollars depending on the insurance provider. This huge expense propels patients to seek similar services abroad. In addition, patients may seek international medicine for novel treatments not available domestically, such as stem cell therapy. The countries most visited by cost-driven and procedure-driven medical tourists include: Brazil, Costa Rica, India, Korea and Malaysia. While searching for a destination, the patient must consider insurance coverage, quality-of-care and the rights of an international patient.

The medical tourist industry has spurred the growth of international insurance firms whose coverage extends to medical institutions in Europe and the Far East. Several pre-existing insurance providers, such as Cigna and Blue Cross Blue Shield, now offer coverage of international medical services. As medical tourism grows, so will competition in the international insurance market, likely resulting in more complete coverage for those seeking international medical treatment.

The company Patients Beyond Borders provides a network of resources for medical tourists seeking a destination. They offer a search tool making it possible to search by medical treatment, specific procedure, institution, or country. They also provide testimonials for many of their treatment destinations. However, all of the options available to the tourist raise the question of quality: how do medical tourists know which tourist destination is right for them?

The answer can be found in a foreign medical institution’s international accreditation. The international accreditation standards were established by the U.S. Joint Committee International (JCI) in 1999. In order for an international hospital to receive accreditation by the JCI, they must satisfy a long list of patient-centered and management-centered requirements that are outlined in the JCI’s annual publication. These requirements and standards are quite similar to those required for accreditation by medical hospitals and institutions in the United States. This system of international accreditation helps ensure high quality-of-care for patients going abroad for treatment and allows the patient to make an informed decision based on a standard comparable to a U.S. hospital.

Like any domestic medical treatment, there are similar risks involved with foreign medical procedures. Risks of malpractice and surgical complications exist no matter the location of the procedure; however, methods of compensation in light of an unfortunate event differ. In the U.S., patients are lawfully allowed to sue their physician due to malpractice and are also protected by information privacy laws passed by Congress. The absence of universal patient rights is the toughest challenge advocates of medical tourism are faced with today, and can be a deterrent to patients seeking medical treatment abroad. For example, countries like Malaysia, Brazil, and India operate under a different set of patient rights legislation, preventing a medical tourist from receiving fair compensation for malpractice as they would in the U.S. Third-world countries, like India, do not have laws yet to hold physicians liable nor do they have regulation of patient information similar to the U.S. Health Insurance Portability and Accountability Act (HIPAA). This places a greater burden on medical tourists to make sure their destinations have patient-friendly health care laws.

The decision to seek international medical services is undoubtedly risky. One must weigh the affordability of a procedure, the quality of care offered by a foreign institution and limited patients’ rights. The expanding medical tourism industry has spurred the growth of international insurance, and a vast array of resources is now available that can help a patient make the most informed decision in a global context.