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Medical Tourism: the next reform in health care?

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Check out the feature on Medical Tourism that Bumrungrad helped develop with an Asian Community newspaper in Seattle. Bumrungrad is a current member of the MTA.

Shoreline retirees Yoshi and Naomi Minegishi, ages 70 and 61, returned this spring from a vacation in Asia and brought back a new interest in health care options. It was just happenstance, said Naomi Minegishi. They toured Thailand's Bumrungrad International Hospital in Bangkok at the suggestion of a friend. After a two-and-a-half hour tour, they were impressed. I am happy with my care here [in Seattle], but I thought that [Bumrungrad] was not bad at all, said Naomi.

Bumrungrad supersedes American hospitals in terms of care. [The hospital] makes sure your every need is taken care of in reasonable time, Minegishi said.

[The tour] opened my eyes to medical treatment overseas. I had never thought about it.

Medical tourism is the practice of traveling to another country in order to receive health care. The type of medical services varies from elective procedures such as cosmetic surgery, to complex medical procedures, to alternative healing practices.

A hotel hospital

Bumrungrad is an example of a hospital that caters to international patients. It offers a concierge service, picking up patients from the airport and transporting them to the hospital via car service. The hospital also offers a concierge desk in the lobby to assist the families of patients with their personal needs. The hospital rooms are spacious and the food court provides patrons with a variety of ethnic foods to match the diverse individuals who pass through the hospital.

Now in its 30th year, Bumrungrad is considered the top private hospital in Thailand, according to Kenneth Mays, senior director of hospital marketing and business development. In 2009, Bumrungrad had 1 million total outpatient visits and inpatient admits. Mays stated that 5 percent of the patients were Americans, including American expatriates. Eighty-two percent of the patients were from Asia.

A different perspective

These days, medical tourism is more of an option. People talk about it a lot more, said physician Dr. Frederick Chen, a faculty member in the Department of Family Medicine at the University of Washington.

Chen stated that hospitals in other countries are attractive to Americans because of the potential for saving costs and the additional amenities that hospitals like Bumrungrad provide. High-end medical hospitals provide a hotel feel to attract potential patients who have determined that the financial savings in medical treatment outweigh the travel expense.

Many hospitals in other countries employ physicians with solid training and education. The quality of care [in other countries] is not as big of an issue as you might think, Chen said. Nationwide, there are about 25 percent foreign medical graduates. Certain specialties, like primary care, do have up to 50 percent foreign graduates in training programs nationwide. Many medical students who go to U.S. medical schools come to this country with the specific purpose of practicing in another country. Also, some U.S. medical school graduates who are U.S. citizens decide to travel abroad to practice medicine.

High-end care [overseas] is much less expensive. Chen said. But he also warns that you are totally rolling the dice when it comes to health care outside the United States. The problem is, what if something goes wrong? You can't go in for a follow-up visit. Chen points out a logistical issue in providing an overseas physician with a complete set of your medical records. Conversely, if a patient follows up with a physician in the United States about treatment received overseas, it may be difficult to obtain the records and/or decipher the meaning of the notes made by the overseas physician.

Chen's general advice on medical tourism is not to do it. But Chen admits that although it is frowned upon, you can't argue the fact that it costs less. If a patient has made the decision to seek medical treatment overseas, Chen suggests to ask around [about the hospital and physician], find the physician's credentials, be clear with the physician [what will happen] if anything goes wrong, [and] determine the cost and think ahead if insurance will cover the medical treatment.

Who pays?

In general, your U.S. health insurance will not cover health care overseas, said Chen. The only exception would be if a patient is involved in an accident while traveling and has travel insurance. Furthermore, insurance companies may not cover subsequent treatment performed in the United States because of prior treatment performed overseas.

At Bumrungrad, Mays stated, About 70 percent of our patients pay out of pocket, 15 percent use insurance, and 15 percent are direct corporate contracts where the employer pays us. Bumrungrad has contracts with most of the major international health insurance companies including CIGNA and Aetna.

However, as Mays points out, this type of coverage relates to expatriates. The coverage would not cover intentional medical travel.

For her part, Minegishi was impressed by the potential savings. Even if insurance does not cover a procedure, it will still come up much less than if you received it in the U.S., he said.

While there is risk associated with seeking medical treatment abroad, the allure of a resort-like medical facility and the financial benefit may be the deciding factor in choosing health care.

This is the future. If you don't mind flying, it certainly is an option, said Minegishi. ?

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