Critics of health care reform often point to desperate Canadians who head south for surgery to escape waiting lists

But a bigger trend points in the opposite direction: Americans heading overseas to escape the exorbitant cost of U.S. care.

Medical Tourism - Top Quality Care At A Discount

Medical tourism is on growth.

Former Mill Valley resident John Freeman, 61, now living in Reno, needed a coronary bypass.

He had dropped his catastrophic insurance coverage because the $320 monthly premium was eroding his retirement savings and the $5,000 deductible left him with big bills.

Facing a $100,000-plus operation, he thought he had two choices: “submit or die.”

A friend pointed him to the third option with a medical facilitator which lined him up with a heart surgeon in Turkey. The all-inclusive cost: $18,000.

He had the surgery last spring and “unreservedly” recommends the care.

U.S. doctors refused to give him a price. “They would almost be proud of it,” Freeman said. “They would say, ‘That’s not my department, I do operations. I don’t have any idea how much anything costs.’ Even the nurse would get mad at me and say, ‘You want me to connect you with the billing department?’

But for Freeman, cost mattered. “For people who can’t pay, somehow the government won’t let them die. But if you’re like me in that awkward middle, where you have a little money saved, they’ll take it all.”

Once a cottage industry, medical tourism may be on the cusp of a big expansion as governments from India to Singapore are investing in state-of-the-art hospitals, vying for a global market.

Deloitte Consulting estimated that 750,000 U.S. residents went abroad for care last year. The firm thinks that number will rise to 1.6 million by 2012, with patients getting discounts of up to 90 percent on procedures from liver transplants to hip resurfacing.

Uninsured patients like Freeman make up the bulk of those now venturing abroad. But big insurers have started pilot projects, and a reinsurer for businesses, Swiss Re, is now offering overseas coverage. A Northern California casino and a Maine supermarket chain now offer the option to employees.

Lack of transparency in U.S. Healthcare

A key draw for overseas care is transparency – in price and quality – and U.S. providers’ lack of transparency.

Anesthesiologist Keith Smith, a managing partner of the Surgery Center of Oklahoma, is an exception.

His center performs as many as 700 procedures a month in Oklahoma City. Smith does a lot of business with Canadians but even more business with Americans he thinks are getting a rotten deal.

Smith started posting his prices online when he saw he could beat rates in India, Costa Rica, and other popular medical destinations. He said his center’s rates for surgeries are up to 90 percent cheaper than nearby nonprofit hospitals.

Competing hospitals “are not going to publish their prices online because it would be meaningless,” he said. Hospitals offer discounts to insured patients “so the uninsured patient is going to wonder why they’re not getting the same price,” Smith said, adding that hospitals “don’t want to publish these prices because then everybody knows how ridiculous it is.”

For example, cochlear implants that can bring hearing to a deaf baby cost about $25,000. But Smith said hospitals mark up the device to $75,000 and then charge $25,000 for the 90-minute surgery.

He charges no markup and $8,800 for the operation.

Hospitals strike deals with insurers to provide care within a physician network, charging patients more if they choose a surgeon outside the network. “It is a cartelization of care,” Smith said, which allows providers to exclude competitors like him.

Overseas providers, meanwhile, have lower costs because doctors often get free medical education there and don’t have huge debts to pay off. Wages and living standards are often much lower, and there are no U.S.-style malpractice lawsuits.

Medical Tourism Costs in Global Health Care

Article Source: Medical tourism: ‘5-star’ care at a discount.

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