Notes on Patients Beyond Borders (Medical Tourism Book)
Why people do medical tourism, 10 questions to ask your doctor, the top destination countries, budgeting, checklists, do's and don'ts
This week’s post contains some of my highlights from Patients Beyond Borders (Amazon affiliate link), a book on medical tourism.
Bold emphasis is mine. Some sections left blank intentionally. All credit to author Josef Woodman. Read the book. Do your own research. None of this is medical advice or a medical guide.
Table of Contents
Introduction
(Testimonial) The $20 billion-a-year global medical-tourism market finally has a guidebook of its own. With medical tourism now growing at 15 percent annually ... this tome couldn’t be more timely.
In seeking additional data on medical travel, I found no reliable source of information. It seemed everybody had something to sell or a political axe to grind.
At the time of this writing, at least 50 countries cater to the international health traveler, with some 24 million patients worldwide visiting hospitals and clinics each year in countries other than their own.
...estimated 125 million Americans without dental coverage.
In 2019, nearly two million Americans packed their bags and headed overseas for just about every imaginable type of medical treatment: restorative dentistry in Mexico, hair transplant surgery in Turkey, heart valve replacements in Thailand, hip resurfacing in India, proton therapy in Korea, fertility treatments in Israel, facelifts in Hungary.
A good rule of thumb is the $6,000 rule: If your US specialist quotes you a price of $6,000 or more for a treatment, chances are good that one or more foreign countries can offer you the same procedure and quality for less, even including your travel and lodging expenses. If your US quote is less than $6,000, you’re probably better off having your treatment at home.
Why do people do medical tourism
Cost savings
The single biggest reason Americans travel to other countries for medical treatment is the opportunity to save money.
As Millennials and Gen Xers become senior boomers and as baby boomers live even longer than expected, costs of healthcare and prescriptions now devour nearly 30 percent of retirement and pre-retirement incomes.
Average savings comparison as of October 2018.
Better quality care
750,000 Indonesians travel to Malaysia and Singapore annually for access to general care as well as more complex treatments not yet available to the country’s 270 million citizens.
Improved patient experience
Government and private stakeholders in countries such as Mexico, Costa Rica, India, Malaysia, and Thailand have poured billions of dollars into improving their healthcare systems, which are now aggressively catering to the international health traveler. VIP waiting lounges, deluxe hospital suites, and recuperation resorts are common amenities, along with free transportation to and from airports, low-cost meal plans for companions, and discounted hotels affiliated with the hospital.
“My surgeon gave me his mobile phone number, and I spoke directly with him at least a dozen times during my stay,”
Excluded treatments
Although health insurance policies vary according to the underwriter and individual, your plan probably excludes an array of treatments, such as cosmetic surgeries, dental care, vision treatments, reproductive/infertility procedures, some non-emergency cardiovascular and orthopedic surgeries, weight loss programs, substance abuse rehabilitation, and prosthetics, to name only a few.
Uninsured and under-insured
Forty-six million uninsured Americans transmogrified into around 80 million under-insured as employers and entrenched stakeholders struggled and schemed to pare expenses and preserve margins through increased premiums, higher co-pays, more exclusions and a host of other gotchas.
Specialty and experimental treatments
Shorter waiting periods
Affordable prescription drugs
Savvy patients are heading to the border towns of Mexico, or to Turkey or Thailand, where reputable in-country pharmacies offer exactly the same products for 60-90% discounts off US prices.
More inpatient friendly
The lure of the new and different
Part One - How to Become a Savvy, Informed Medical Traveler
Chapter 1 — What Am I Getting Into? Some Quick Answers for Savvy Health Travelers
Is Healthcare Overseas Safe?
If Healthcare in Other Countries Is So Good, How Can It Be So Cheap?
This question is best answered by another question: Why is US healthcare so expensive? High facilities costs, unpaid hospital bills totaling billions of dollars, high-priced medical education, costly research, and excessive malpractice litigation all add up to exorbitant prices for healthcare in the US.
This is evidenced by the fact that the US ranks around 43 among all advanced-economy nations measured by life expectancy. US healthcare spending hovers at nearly 18 percent of our gross national product (GDP). Compare life expectancy with nations such as Singapore (rank: #3); South Korea (rank: #11); and the Czech Republic (rank: #33), all spend less than 10 percent of GDP on healthcare.
How Much Can I Save?
Patients who travel to India for complex heart bypass surgeries will typically save more than USD$50,000 over the price in the US. People traveling to Costa Rica for reconstructive dentistry or extensive breast and abdominal cosmetic surgery can save $10,000 or more.
Is it safe to travel overseas?
…of the tens of millions who have visited international hospitals for medical treatment in the last five years, not one patient has come to harm as a result of political or social unrest.
What medical treatments are available abroad?
How do I know where to travel for treatment?
Can someone go with me?
What if they don't speak my language?
How realistic is the "vacation" part of the trip?
Think of your medical journey more as a business trip than a leisure junket.
Will my health insurance cover my overseas medical expenses?
Can I sue?
Can I use a foreign provider in a US court?
US courts have jurisdiction over foreign enterprises only if they have sufficient connections with the US.
a judgment is only as good as its enforceability, and a US court cannot compel action, such as payment, in a foreign jurisdiction.
Can I use a foreign provider in its country?
Legal rights may be significantly different than they are in the US.
Can I use a US medical travel company?
Most commentators agree that establishing the liability of a medical travel company for the negligent acts of a foreign provider is difficult under current law. Theories of liability require a close connection between the medical travel company and the foreign provider, a connection that generally does not exist with the present business model of most medical travel companies. All of which points to a low likelihood of success in court.
In conclusion
However, the medical traveler need not bear all the risk, and remedies may take non-legal forms. For example, foreign providers may offer a corrective procedure if a problem occurs, or medical travel insurance can offer the promise of remuneration for bad outcomes.
Can I finance my treatment?
What if complications arise after I return home?
Chapter 2 — Planning and Budgeting Your Health Travel Journey
Three months before treatment is good. Six months ahead is great. One month is not so good.
Ten Must-Ask Questions for Your Physician Candidate
What are your credentials?
How many patients do you see each month?
To what associations do you belong?
How many patients have you treated who have had my condition?
What are the fees for your initial consultation?
May I call you on your mobile phone before, during, or after treatment?
What medical and personal health records do you need to assess my condition and treatment needs?
Do you practice alone or with others in a clinic or hospital?
(For surgery) Who holds the knife during my procedure?
(For surgery) Are you the physician who oversees my entire treatment?
Sample Budget Planner
Chapter 3 — The Twelvefold Path to Enlightened Health Travel Planning
Confirm Your Treatment Options
Narrow Your Destinations For Big Surgeries, Think Big
Consider Engaging a Health Travel Agent
Choose a Reliable, Fun Companion
Find Dr. Right
Get to Know Your Hospital or Clinic
Follow Up on Credentials
Gather Your Medical Records
Plan Your Recuperation and Recovery
Create Your Health Travel Vacation
Book Air Travel and Accommodations
Triple-Check Details and Documents
Chapter 4 — While You're There
Read the book!
Chapter 5 — Home Again, Home Again
Read the book!
Chapter 6 — Dos and Don'ts for the smart health traveler
Dos
Do plan ahead
Do be sure about your diagnosis and treatment preference
Do research your in-country doctor thoroughly
Do get it in writing
Do insist on your native tongue
Do learn a little about your destination
Do inform your local doctors before you leave
Do befriend staff
Do comply with doctor's orders
Do get all your paperwork before leaving the country
Do trust your intuition
Don'ts
Don't rely completely on the internet for your research
Don't schedule your trip too tightly
Don't forget to alert your bank and credit card company
Don't skimp on lodging
Don't stay too far from your treatment center
Don't return home too soon
Don't be too adventurous with local cuisine
Don't ever settle for second best in treatment options
Chapter 7 — Checklists for a Successful Health Journey
Part Two — The Most Traveled Healthcare Destinations
Chapter 8 — Destinations
Read the book for more depth!
Brazil
The Caribbean
Costa Rica
Czech Republic
Hungary
India
Israel
Malaysia
Mexico
Singapore
South Africa
South Korea
Taiwan
Thailand
Turkey
United Arab Emirates
United States
Chapter 9 — Additional Resources and References
International Accreditation
Online Resources
Publications and periodicals
Limits of Liability and Disclaimer of Warranty
The disclaimer from Patients Beyond Borders applies to the highlights I’ve written in this post, which come directly from the book.
This book is intended as a reference guide, not as a medical guide or manual for self- diagnosis or self-treatment. While the intent of Patients Beyond Borders is to provide useful and informative data, neither the author nor any other party affiliated with this book renders or recommends the use of specific hospitals, clinics, professional services (including physicians and surgeons), third-party agencies, or any other source cited throughout this book.
Patients Beyond Borders should not be used as a substitute for advice from a medical professional. The author and publisher expressly disclaim responsibility for any adverse effects that might arise from the information found in Patients Beyond Borders. Readers who suspect they may have a specific medical problem should consult a physician about any suggestions made in this book.
Hospitals, clinics, or any other treatment institution or third party cited throughout Patients Beyond Borders are responsible for all treatment provided to patients, including, but not limited to, surgical, medical, wellness, beauty, and all related queries, opinions, and complications. The author, publisher, or any other party affiliated with this book is not responsible for same, including any emergency, complication, or medical requirement of whatsoever nature arising from the patient’s treatment due to the patient’s present or past illness or to the side effects of drugs or lack of adequate treatment. All pre-treatments, treatments, and post-treatments are the absolute responsibility of the hospital, clinic, or any other treating institution, and/or the treating physician.
This is not a guide to medical diagnosis and treatment. It does not provide medical advice on specific treatments or caregiver referrals. Your condition, diagnosis, treatment options, and travel preferences are unique.
Your job is to:
consult with your local doctors to ensure you’ve reached a satisfactory diagnosis and recommended course of treatment
decide, based on your research and the material featured in this book, whether you wish to travel abroad for treatment
select a travel destination, treatment center, and physician based on the information you find in this book and elsewhere
Conclusion
That’s all folks!