CABGs from India

I had briefly referred to medical tourism in an earlier post, speculating about how the nitty- gritties would work out.
I recently read a fabulous article by David E. Williams. from healthleadersmedia.com on the future of medical tourism from an American perspective.He makes five important predictions he feels will be relevant to the future of medical tourism. I shall reproduce some of his comments.

( Words in Italics from the original article. Rest, my inputs)

1) Medical tourism will cross over to the insured population in 2008: Insurers are beginning to get requests to cover medical tourism from multiple sources: employers and their benefits consultants, foreign hospitals and governments, medical tourism facilitators, and individual members who want to receive coverage overseas. There are important initial steps in this direction. For example, Blue Cross Blue Shield of South Carolina has added Bumrungrad Hospital in Thailand to its hospital network. Jaslok Hospital has tied up with Cigna.If you thought safety and standard of care were issues, the Joint Commission International has accredited over 100 foreign hospitals.

2) Mini-med plans and small employers--not big health plans and blue chip companies--will be the early adopters: Williams argues that though the big spenders will initialize the process, close to half of Americans work for organizations with under 200 workers. Only 60 percent of employers with fewer than 200 workers offered health insurance in 2006.Smaller employers look at insurance differently. Many are shifting to so-called "mini-med" or "limited benefit" plans that cover day-to-day expenses such as doctors' appointments, but not surgery. I wonder how they can commodify a medical service offered?Surgery, or a procedure is easier to. A $50,000 angioplasty in the United States costs less than $6,000 in Mohali, India, according to GlobalChoice Healthcare. Yes thats gains of around 42,000 counting airfare and stay.But with mundane spiels like the annual physical,or a pap test, will it be financially prudent to make a 10,000 km trip to Hyderabad?These would form the major bulk of doctor visits by employees and I don't think thats going to come to foreign shores.Unless you are driving from California to Mexico.I would reason that pathology or radiology would be major gainers here for obvious reasons.

3) Opposition to medical tourism by U.S. physicians will be modest: At the community level, over 25 percent of physicians in the United States are foreign-born. They are familiar with the level of professionalism and training in other countries. U.S. patients are also accustomed to getting their care from foreign physicians. He also draws attention to the fact that a shortage of physicians means the US physicians will be willing to share their work burden with their colleagues abroad.Well said, but the outsourcing juggernaut does whip jingoistic passions among the misinformedly sentimental. There might be patients who will refuse, this has to be factored in.

4) State governments will begin to embrace medical tourism by 2010: Rising healthcare expenses require states to shift funding from other programs or raise taxes, both of which are unpalatable. He gives the example of NY having half a million Dominicans. Santo Domingo, which has some excellent cardiac surgeons and low prices, is a 4-hour nonstop flight away. Why wouldn't New York at least explore the possibility?Possible. But you never know how politicians think.

5) The emergence of medical tourism won't have a major, direct impact on U.S. healthcare costs, but the secondary impact will be substantial: If every U.S. resident who could go abroad for treatment actually went, the savings on total medical costs would be about five percent. That's still a big number, especially compared to other initiatives that are available. But to look at it another way, if healthcare costs are increasing by 10 percent per year, taking full advantage of medical tourism only buys us about half a year.For a country like the US, with the most expensive health care system in the world( around $210billion!!) this might not translate into a very big gain, true.Considering that a major part of this expense is not a public spending, but out of the common man's pocket, the gains will accrue to demand supply equation that the provider and customer share. Queer are the dynamics of health care in this country, where fair market capitalism dictates that need supersedes want. Of course, no one is aiming for great shifts in any hard indicators of health care. (The US health care system does not figure in the first ten or twentys of the WHO list despite being the most expensive.) It would be ridiculously naive to expect anything more than a drop in the ocean. But for the person who feels the pinch most, a dollar saved is a dollar gained.