Competition for American Healthcare

It’s no secret that the American healthcare system is a flawed and expensive institution. In 2014, following the passage of the Affordable Care Act, 33 million people remained uninsured (Smith and Medalia, 2015). That same year, the United States spent a total of 3 trillion dollars on healthcare and two years later, the state of healthcare still remained critical (Health Expenditures, 2016).

In 2016, the American Medical Association reported the retail prices of several procedures for uninsured patients: heart bypass surgery retailed for as much as $177,000; an angioplasty was up to $83,000; a spinal fusion was upwards of $91,000; and gastric bypass surgery was as much as $69,000 (Wurzel, 2008).

But when you look at the progression of healthcare costs overseas, you see a slight downward trend. Reports show that procedures performed overseas can cost less than 20% for the same procedure in the US. For example, in India, heart bypass surgery costs 10,000 US dollars; angioplasty is $11,000; a spinal fusion is $5,500; and a gastric bypass is $11,000. This drastic difference is the result of lower wages, cheaper medical supplies, less involvement by third-party payers, lower malpractice litigation costs, and less cost-shifting between covered patients to those without insurance (Wurzel, 2008).

It’s not just a discrepancy in cost, but also a discrepancy in availability that is also driving patients abroad for care. “Other nations may offer treatments or procedures illegal or unavailable in the U.S.” (McArdle, 2013). Assisted suicide, for example, is legal in Switzerland, the Netherlands, Luxembourg, and Canada, but only a few US states allow it (Suicide Laws, 2015). Stem cell therapy is also banned in the US, but “more than 200 hospitals in China offer stem cell therapies” (McArdle, 2013). Hip resurfacing is another procedure that patients pursue in other countries. Though it is an established alternative to hip replacement, “availability here remains spotty” at best (Woodman, 2008). International providers, on the other hand, have better “techniques, materials, and instrumentation . . . and the procedure is routine” (Woodman, 2008).

With a lower costs and a wider variety abroad, it is no surprise that Medical Tourism, traveling with the intention of seeking medical care, is on the rise.

To some, the idea of traveling abroad to receive medical care is still intimidating. While it is impossible to guarantee a safe outcome, patients can take steps to maximize their chances of receiving quality medical treatment overseas. Here are a few things that you should confirm with abroad providers in order to ensure a safe and satisfactory health care experience overseas:

  • Facilities should have accreditation from organizations such as Joint Commission International, DNV International Accreditation for Hospitals, or the International Society for Quality in Healthcare.
  • Providers should have accreditation from American Board of Medical Specialties, ACS, American Society of Plastic Surgeons, the International Society of Aesthetic Plastic Surgery, or an equivalent organization.
  • Avoid websites that attempt to sell you tourist packages, as they often do not list the licensure of the facility or provider (Gaines and Nguyen, 2015).

As with any healthcare decision, there are risks associated with medical tourism. In order to make the right choice, each patient must understand and weigh every potential scenario.

  • If you and your provider do not speak the same language, it can interfere with care.
  • Medication quality may be substandard in other countries.
  • “Resistant bacteria may be more common” in the country you choose.
  • “Flying after surgery can increase the risk for blood clots” (Medical Tourism, 2016).

First-hand accounts of medical tourism are varied. Freda and Tim Moon first learned of medical tourism when they were facing $6,000 worth of dental care. They both needed treatments, but could not afford it with their modest salaries. At the suggestion of friends, they decided travel to Thailand, where they enjoyed an exotic vacation and received discounted medical treatment. Throughout their recovery, they enjoyed fresh food, scenic beaches, and the warm sun. Even with travel costs, they spent far less than they would have in the US (Moon, 2017).

Stacey Cavaliere, however, was not so lucky. After losing 200 pounds, she sought body contouring in Costa Rica. She found her surgeon online, who offered three references and a smaller price tag. But when pre-operative tests revealed her to be anemic, the surgeon still proceeded with the surgery despite the risks. Then, during the operation, she suffered severe blood loss. Once she returned home, she developed a raging infection that required debridement and skin grafts (Casper, 2007).

But medical tourism does not just affect the patient. It affects the American health care system as well. When patients seek overseas treatment, it can potentially increase competition and, with that, efficiency of health care in the United States. Medical Tourism has the potential to provide patients with services that are lower in cost, higher in quality and of greater convenience. When faced with this sort of competition, American healthcare will have no choice but to improve quality and expand the services offered to patients (Herrick, 2007).

While it may light a fire under the American healthcare system, healthcare abroad can benefit from this trend. When Americans travel overseas for treatment, it helps fund local hospitals and creates additional skilled jobs (Johnston, Crooks, Snyder, & Kingsbury).

But with these benefits come some concerns. For those traveling abroad, continuity of care and a lack of follow-up care is a frequent occurrence. It can be detrimental to the outcome of the procedures and treatments provided and offset the original cost savings (Williams, 2011). Essentially, American patients who do not address complications once they return home can counteract any financial gain from overseas care.

Additionally, with this wave of ex-pat patients, there can be negative effects on the servicing country’s health care system. This influx of paying patients can draw providers towards private hospitals and away from the public healthcare sector and rural areas. This in turn can reduce access to healthcare for local populations and exacerbate already prevalent inequalities (Gayathri, n.d.).

Ultimately, medical tourism is on the rise. Thanks to competitive pricing and increasing insight, more patients are traveling afar for their care. Though it carries risks, patients can facilitate a positive endeavor. Choose your providers carefully, weigh the risks, and be prepared. This journey is yours, no matter where your health takes you.

Published by

Deanna Brownlee

Deanna Brownlee

My name is Deanna Brownlee, and I have an undiagnosed disease. For 10 years, my unidentified illness has yielded only futility and heartbreak. As much as it has stolen from me, however, writing has always remained by my side. I am truly honored to be part of the CrowdMed team.