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Medical Tourism: An Expert Explains Healthcare Globalization Basics

What is medical tourism?

Medical tourism, at its simplest, is when people leave their country for another in pursuit of healthcare, whether a quest for faster treatments, for the sake of time-sensitive health issues, or for considerably cheaper state-of-the-art treatments, for the sake of their wallets, when some common surgeries and hospital stays in the U.S. can run in the tens of thousands.

Ruben Toral, founder of MedeGuide, an online international doctor directory featuring over 3,000 doctors in 10 countries, and former director of JCI-accredited Bumrungrad International Hospital in Thailand, a pioneer in medical tourism, spoke to SpaFinder staff earlier this month.  Toral’s affiliated hospital in Thailand operates similar to and is said to have the feel of a five-star hotel: Accommodations are more hotel-like than hospital-like, food options and boutiques within the facility are broad and international in scope and the overall atmosphere is more serene than frenetic, complemented by first-class medical care and service.

Toral says, for a time, the U.S. was the central medical tourism destination for Latin America, with institutions for superlative cancer care, like Johns Hopkins, the Mayo Clinic and Memorial Sloane Kettering.  In the wake of 9/11, both the U.S. and Europe placed visa restrictions on many travelers from the Middle East, thereby creating a shift that opened up other countries as hubs for medical tourism.
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Medical tourists are traveling for anything from chemotherapy to fertility to multiple cosmetic plastic surgeries − and at “third world prices,” Toral says.  Things like labor and malpractice are far less costly outside of the U.S., he explains, and the system is “less amorphous than the U.S.”: There is little ambiguity in costs, and medical bills are paid in cash.  Medical costs can run anywhere from 50 percent to 80 percent less expensive for comparable procedures than the U.S.

The tidal wave for Toral’s hospital, in particular, followed a story on 60 Minutes on CBS that aired in 2005 about medical tourism. The story spotlighted his hospital and a few American patients struggling with the cost of medical care.  One uninsured post-heart attack patient from Louisiana, grappling with the need for quintuple bypass surgery to live, as well as the hundred thousand-dollar plus cost, researched the hospital and found a U.S.-trained physician and had the surgery three days after his arrival in Thailand. He was able to avoid draining his life savings or finding himself unable to have the operation, essentially saving his life.


The outsourcing of healthcare, though up to an eighth of the cost for care in the U.S., is not currently embraced by U.S. insurers, national policy makers or the mainstream, despite the exploding numbers of uninsured or under-insured, Toral says. He speculates the resistance due to already built-in products and providers around U.S.-insured care, and insurers deem those who seek care abroad to be a small constituency.  On the contrary, Toral says. While the U.S. is not yet monitoring the volume or dollars spent by those who seek healthcare abroad, he is seeing the industry/market explode: In 2009, Bumrungrad, one of Southeast Asia’s largest private hospitals and founded in 1980, claims that international patients comprise about 42 percent of patient volume; about 30,000 patients a year come from North America.  Many countries are finding their specialty in the global healthcare market: Mexico for bariatric surgery, Costa Rica for dentistry, Barbados for in vitro fertilization and Brazil for plastic surgery and cancer treatment, he says.

Toral expects the globalization or outsourcing of healthcare to continue to flourish, as the U.S. no longer has a lock on quality care and Americans are paying more out-of-pocket for their healthcare than ever before. The convergence of the Internet is also a factor.  The uninsured are learning more about the alternative to outsource their healthcare and can readily find expert-trained care, many who are U.S.-educated.



Similar to medical tourism, which Toral called “a stepchild of tourism,” is wellness tourism, where visitors go abroad for comprehensive checkups, lifestyle modifications and detox programs. Patients are combining holiday and healthcare and the marketing opportunities are ripe, he says, as people are getting the message: “Come to Thailand to feel better.”  Both niches in tourism are fruitful as those who go typically stay longer and spend more than average tourists, and most importantly, they come back, Toral says.

What do you think? Will offshore medical care go mainstream and gain the acceptance of national policy makers, major insurers and employers?

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