If You Have to Ask…Fuggedaboutit!

Trans·par·en·cy: the quality or state of being transparent. Origin:  Medieval Latin trānspārentia. Source: Dictionary.com

Transparency, a simple enough word, one that conveys the idea that something is transparent, clear, understood, can be easily recognized and seen; yet, a word that the medical tourism industry, and the health care industry at large has so far failed to grasp. This lack of transparency is clear, or rather transparent to anyone who has tried to figure out the cost differentials for treatment procedures from one part of the US to another, let alone from one country to another, for the same procedures.

This is the dilemma I have been encountering for some time as I have been writing this blog. I have tried to approach several of my contacts in the medical tourism industry to get information on certain surgical procedures such as hip, knee, spinal fusion, carpal tunnel, and other occupational-related surgeries so that those in the workers’ compensation industry in the US can compare apples to apples, oranges to oranges, as best as possible, given the number of hospitals in the Caribbean and Latin America region that cater to medical tourism. Unfortunately, I have run into difficulty getting this information for a variety of reasons.

One reason is that some of my contacts are busy with their own affairs to get such data from the hospitals, and then forward it on to me. I quite understand that, and can appreciate that if it was me, I, too would be too busy to do so. But in the case of one of my contacts, who has been more than generous with her time and assistance, we have been frustrated by bureaucracy, politics, and turf battles between hospitals in the same group, and in the same country.

It should be a simple thing to quote a price for a particular surgical procedure such as a hip replacement or a knee replacement. Even if it is an average of a range of prices, it is still better than guessing or taking it on faith that medical tourism destinations are less expensive than US hospitals, with or without the cost of airfare, accommodation and other expenses factored in. For example, in one of my earlier posts, I included the following table to compare hip and knee surgeries costs in Colombia, Costa Rica and Mexico with that of US costs.

How accurate are these figures is anyone’s guess, but at least when you look at the four countries listed, there is a discernible difference in cost, not only between that charge in the US, but between the three Latin American countries as well.

To further illustrate what I mean, and to show that transparency of prices is not limited to the Latin American region, the next table, which I cited in my white paper on medical tourism and workers’ compensation, shows price differentials between the US, India, Singapore and Thailand, and includes airfare and accommodation for two.

As the Center for Medicare and Medicaid Services (CMS) recently did here in the US with hospital charges for spinal fusions, so too should the medical tourism do the same for all procedures, at all hospitals and in all countries. Spinal fusions at the top 10 American hospitals range from $269,846 to $471,121, and overall, between $19,000 and $470,000.

It should not be so hard to find out the same kind of information from a hospital in a country that is establishing itself as a major medical tourism destination. While the American workers’ compensation industry only accounts for 2% of the health care market in the US, that market in and of itself is pretty large, and should not be ignored, especially as the American workforce is getting more and more Hispanic, and in particular, in states like Arizona, California, Colorado, Florida, Nevada, New Mexico, and Texas, as well as other states in the union with a growing Latino presence.

So, transparency, a simple word that can be defined simply as the state or quality of being transparent, clear and understood, needs to be the most important idea when any country or hospital in that country wants to pursue medical tourism business, no matter if it is from private individuals, group health care plans, or workers’ compensation insurers and employers covered under that insurance or by self-insured coverage. Transparency needs to be transparent.