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Akron Univ. School of Law

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Monday, March 16, 2009

Regulating Medical Tourism

BNA's Health Law Reports has an interesting article on the increasing popularity of Medical Tourism and the need to address the risks posed by such medicine.  Thom Wilder writes,

While medical tourism continues to become a tremendous growth industry as U.S. patients seek cheaper medical care abroad, it poses several possible risk and legal factors that must be addressed not only by patients, but also providers in both countries, experts in the field said Feb. 27.  In 2007, nearly 750,000 Americans engaged in medical tourism—defined as travel across international borders for the express purpose of receiving medical care—a number expected to swell to 6 million by 2010, representing $16 billion to $19 billion in expenditures, said J. Mark Waxman, a partner with Foley & Lardner LLP, Boston, during a BNA teleconference, titled, “Medical Tourism: From Idea to Implementation.’’

This growth has been fueled not only by the uninsured and underinsured seeking less expensive options for surgical care, but also by employers seeking to drive down costs by seeking health care in places such as India, Turkey, Dubai, and approximately 30 other countries, . . . .    These foreign medical centers—essentially promising world-class care at Third-World prices—are more cost-effective for several reasons, including lower facility construction costs and time, lower labor costs, an absence of legacy systems, very low medical malpractice and liability costs, and a corporate culture that is “better, faster, cheaper, and hungrier’’ than in the United States, according to Helfrick.  Most of that care has focused on elective procedures such as orthopedics (hip replacement, knee replacement, and spinal surgery), cardiovascular surgery (bypass surgery, valve replacements), cancer diagnosis and management, cosmetic surgery, and bariatric surgeries, Helfrick said. Dentistry also has risen in prominence in recent years, Waxman noted. . . .
In the end, it is all about money, Waxman said. For example, while heart bypass surgery in the United States can cost between $70,000 and $133,000, the same surgery would cost an average of $22,000 in Thailand and an average of $7,000 in India, Waxman said. The figures Waxman cited are from Patients Beyond Borders, a book on medical tourism authored by Josef Woodman, president of the Healthy Travel Media Co. (see chart).  But cost is not the only factor involved in deciding to seek care abroad, Dagi said. Part of this growth is a “real or perceived’’ lack of services available in the United States, or limitations imposed on care by payers or regulatory agencies, Dagi said. . . .
Dagi agreed, noting that while medical tourism is a legitimate choice, it does carry risks. Most of the medical centers abroad being sought out by Americans are “world-class facilities,’’ he said, but prospective patients must exercise some diligence in choosing where they seek treatment as not all foreign medical centers meet U.S. standards. In some instances there is variability and differences in training of medical and allied health professionals, in standards for medical institutions, and in interpretation of test results and indications for treatment, he said.
Other risks include a lack of follow-up and support networks, differences in physician/patient communication practices exacerbated by language and cultural barriers, accuracy and completeness of medical records, and possible exposure to endemic diseases, Dagi said . . . .

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