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Healthcare tourism: Should specialists in the United States be worried?

Maryann Lambert

Maryann Lambert, Senior Health IT Consultant, CureMD

Countries across the world have been seeing an incredible increase in the number of patients traveling great lengths to receive medical treatment. Medical tourism, healthcare tourism, medical travel – no matter what you call it, it is on the rise.

The most common source of this phenomenon comes from affluent or upper middle-class individuals who are seeking for affordable alternatives to healthcare procedures. Many Israelis and Americans are traveling to Jordan for its ability to deliver state-of-the-art surgeries and treatments for as much as 80 percent cheaper than if the patient had received it in their home country. In fact, these trips have become such a part of the Jordanian medical industry that it has begun handing out medical tourism provider awards.

Dubai similarly has taken up the mantle of providing skilled but affordable services, with medical tourism revenues in the country projected to exceed $710 million by 2020. By the same period, India is expected to earn around $8 billion in medical tourism revenues. Mexico, Thailand, China – all around the world it is the same story.

But what are these cheap procedures costing American healthcare providers, if anything? Answering this question has been notoriously tough, and directly observing its effects have been tougher. The general consensus seems to be that most U.S. healthcare providers are too busy to worry about such things, but should they be?

Effects hard to measure

In a 2011 report for the Bulletin of the World Health Organization, Matthias Helble notes that the only easy thing to pin down about medical tourism is that it is growing. The practice has become so common that some U.S. Health Insurance providers, such as Access Baja, have even begun covering foreign procedures. Low co-pays and premiums are offered to all policyholders who receive treatment in Mexico.

A huge barrier to accurately describing the trend is that no one can seem to agree on how to frame it. “The absence of an internationally agreed definition and of a common methodology for data collection is one of the main reasons that we have limited statistics on medical travelers that are often not comparable across countries” explains Helble. “The methods applied by countries vary substantially.”

One of the easiest factors to note is the number of people being claimed to enter these countries who provide services. Unofficial accounts from Thailand claim that incoming foreign patient numbers have doubled from 630,000 in 2002 to well over 1.3 million in 2007. Jordan claims 120,000 foreign patients annually to the tune of $1 billion in yearly revenues.

As for the actual impacts on U.S. providers, one can only guess. “If a large number of patients travel abroad,” Helble conjectures, “it will probably heighten competition among private-sector health providers in the sending countries, which could bring prices down.” He then goes on to argue against this position: “On the other hand, since health-care centers are often fixed-cost institutions, they might be forced to increase prices to remain profitable.”

He similarly takes an either/or approach to how such trends might affect the workforce, saying “The growth of medical travel might trigger an expansion and modernization of health facilities in the receiving country, while it might cause a contraction in the sending countries.” This effect, he says, could ease the patient load on countries sending patients. “However,” he goes on “existing shortages may be exacerbated in these countries if health workers are attracted to receiving countries.”

Parsing through possibilities like these can yield little progress until more hard numbers can be had and measurable effects observed.

United States loses some patients to healthcare tourism, but gains plenty

Perhaps one of the biggest reasons that a measurable impact of medical tourism is hard to come by is that the United States regularly receives such visitors of their own. Reports by the Florida-Times Union discuss United Kingdom patients traveling to Florida to seek cancer treatment procedures unavailable on their side of the pond.

States like Florida actively court these patients. The Guardian comments on the same trend, noting that millions have been spent to stem the tide of an estimated exodus of $15 billion in revenues from the United States.

Associate professor at the University of Minnesota Leigh Turner, who was an editor of the book Risks and Challenges in Medical Tourism describes the typical marketing pitch. “They’d basically say: ‘Think of all the concerns you’d have if you go abroad for care; everything that can go wrong. Wouldn’t you feel better off staying in the United States?’”

Tactics like these can keep more dollars at home and even more coming in from abroad, but there is no denying the impact that a growing adoption of medical tourism will have if left unchecked. As questions of affordability rise, American healthcare providers are having to emphasize their technology, skill and quality of care as the key differentiators between their services and foreign ones, even as the tab for these services continues to climb.

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