Category Archives: Cross-border Health Care

The Further Adventures of Ashley Furniture in Medical Travel

Readers of this blog will remember two previous articles I linked to back in October 2017 and November 2017 about the Ashley Furniture Company’s foray into Medical Travel.

Now comes a new article, courtesy of Kaiser Health News, that shows just how American patients are saving money by having surgery in Cancun, Mexico for procedures such as knee surgery (are you listening, Workers’ Compsters?)

Not only are the patients traveling to Cancun, but so are the physicians from the US.  As pictured below, Donna Ferguson, the wife of one of Ashley’s employees, is shown in the hospital in Cancun, along with her doctors, one of whom will be performing knee replacement surgery. As stated in the article, all she had to do was walk out of her hotel, and into the Galenia Hospital through a short hallway.

Donna Ferguson, center, of Ecru, Miss., had no contact with Milwaukee surgeon Dr. Thomas Parisi, left, before meeting him in Cancun the day before he performed her knee replacement surgery. (Rocco Saint-Mleux for KHN)

Donna’s surgeon, Dr. Thomas Parisi, from Milwaukee, had flown to Cancun the day before. To get this surgery, which she was getting for free, she would also receive a check when she got home. (I’ve said this before, but you never listened)

According to the article, the employees of Ashley receive a $5,000 payment from the company, and all their travel costs are covered. They use this option because they have no out-of-pocket copayments or deductibles, so it made financial sense for both a highly trained orthopedist and a patient from Mississippi to leave the US and meet at an upscale Mexican hospital. (Let’s see Trump try to built a wall to stop that!)

Dr. Parisi spent less than 24 hours in Cancun, so no one could accuse him of slacking off to play golf, and was paid $2,700, which as the article stated, was three times what he would have gotten from Medicare. The cost of the surgery for Ashley was less than half of what it would have been in the US.

To understand better, just why Ashley is doing this for their employees and their families, let’s look at what the average knee replacement would cost in the US: about $30,000 — sometimes double or triple that; whereas in Mexico, at Galenia, it was only $12,000. according to Dr. Gabriela Flores Teón, the hospital’s medical director.

The standard charge for the night at Galenia is $300, compared to an average of $2,000 at US hospitals, said Dr. Flores.

But besides the big savings on the surgery, there was also savings on the cost of the medical device, made by a subsidiary of the Band-Aid people, J&J, in New Jersey. The implant cost $3,500 in Mexico, but nearly $8,000 in the US, Flores continued.

In case you WC hotshots were wondering, Galenia Hospital is not some fleabag hospital on the cheap. It is accredited by the international affiliation of the Joint Commission (JCI). They set the standards for hospitals in the US.

However, so that doctors and patients could feel comfortable with surgery, NASH (North American Speciality Hospital) based in Denver, and who has organized treatment for dozens of American patients at Galenia since 2017, along with Galenia, worked to go beyond those standards.

In the two SPOTLIGHT articles referenced above, the manager of global benefits and health at Ashley, Marcus Gagnon said, “We’ve had an overwhelming positive reaction from employees who have gone,”

The company has also sent about 140 employees or dependents for treatments at a hospital in Costa Rica, and together, the foreign medical facilities have saved Ashley $3.2 million in health care costs, said Gagnon. (Wake up, you WC guys! Why are you being so stubborn?)

Gagnon continued, “Even after the incentive payments and travel expenses, we still save about half the cost of paying for care in the United States,” “It’s been a nice option — not a magic bullet — but a nice option.”

So, if Ashley can do it, and if HSM could do it too, the so could you. Not all the hospitals outside of the US are fleabags. Galenia in Cancun is one example. Bumrungrad in Thailand is another, and there are plenty more around the world that cater to medical travel.

The whole point of my advocacy for medical travel and workers’ comp was so that American workers and their dependents like Donna could travel abroad and see what the world is really like, so that political, hate-filled rallies and incidents we are seeing everyday since the election of a white supremacist to the presidency, would not take place.

How else will the American worker learn about the real world beyond his borders if not this way? Certainly not from Fox News.

“Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.”

― Mark Twain, The Innocents Abroad / Roughing It

 

Cross-Border Health Care – Insurance Industry Finally Takes Notice

Readers of this blog have no doubt read my first post on cross-border health care, Cross-Border Health Care a Reality in California, among others. Many of them dealt with getting medical care under workers’ compensation, and the others were confined to the health care space.

Thanks to fellow blogger, Joe Paduda, who sent me a copy of the following Quick Take from the GB Journal, a publication of Gallagher Bassett, the issue of cross-border health care, especially in workers’ comp (my idea originally) is finally getting traction in the industry.

Not that I am blowing my horn, mind you, but it would have been nice to get some recognition a few years back when I started writing.

Well, anyway, here is the item from GB Journal:

Quick Take 2:
Cross Border Health Care

Employers in Arizona and California’s huge agriculture business figured this out a long time ago. For many employees who are either Mexican nationals or who have extensive family connections in northern Mexico, getting needed medical treatment in Mexico can be both more convenient and much more cost effective than treatment north of the border. Your humble correspondent set up group health PPO networks in Mexicali and Tijuana for seasonal farm workers back in the 80s. They worked remarkably well and provided this generally underserved group with excellent care at affordable rates. A recent article in Risk & Insurance’s online service describes how the same concept is now being used for treatment under workers’ compensation. 

Yes, this is legal under California law. (The R&I article does not mention Arizona comp law.) The author makes specific reference to the Mexican HMO Sistemas Medicos Nacionales, S.A. de C.V. (SIMNSA), which is – an important point – licensed by the State of California. In addition to lower costs and convenience, treating in Mexico can have additional advantages for injured workers who are not fluent in English and who feel more comfortable in a familiar cultural setting. Getting medical treatment in Mexico is not suitable for all claims or all employees, obviously, but if you have a significant comp exposure close to our southern border, you might want to check this out with your comp carrier or TPA, if you have not already.

If you want any additional information, or would like to explore this option for your workers’ comp needs, contact me and I will work with you to put together a plan for you.

Dental tourism has some travelling abroad to save money

Another tweet from Josef Woodman about dental tourism in Costa Rica.

Getting a million dollar smile can cost thousands of dollars, money that a lot of people are not willing to spend. That’s why more and more Southwest Floridians are traveling abroad for a dental vacation.

Source: Dental tourism has some travelling abroad to save money

Lower Prescription Drug Prices Lure Americans To Mexico To Buy Meds : Shots – Health News : NPR

Good morning all.

Thanks go out to Josef Woodman who tweeted the following today from NPR about prescription drugs and going across the Mexican border to buy them at lower cost.

This is in addition to the article I recently posted, Run for the Border (Not a Taco Bell Commercial).

So wall, or no wall, Americans are going to look for cheaper prescription drugs, either in Mexico or Canada, or elsewhere, until we allow the government to negotiate prices for medications under an improved and expanded Medicare for All.

But thanks to a former Louisiana congressman who left Congress to become the President and CEO of PhRMA, a pharmaceutical company lobbying group, Congress passed a bill that prevents Medicare from negotiating lower drug prices and bans the importation of identical, cheaper, drugs from Canada and elsewhere.

But it does not have to be this way. We can lower drug prices, but by allowing the government to negotiate them, and not giving the pharmaceutical industry huge giveaways.

Here is NPR’s article:

Faced with high U.S. prices for prescription drugs, some Americans cross the border to buy insulin pens and other meds. At least 1 insurer reimburses flights to the border to make such purchases easy.

Source: Lower Prescription Drug Prices Lure Americans To Mexico To Buy Meds : Shots – Health News : NPR

Run For the Border (Not a Taco Bell Commercial)

Yesterday, one of my contacts in the medical travel space commented on an article that was posted on LinkedIn that explained why the author was sent south of the border to purchase prescription drugs (you thought I was going to just say drugs, right?) for his company.

He found out that the same drugs, made by the same manufacturer, but packaged in Spanish were much cheaper than ones packaged in English and sold north of the border.

I decided to ask for his permission to re-post his article, and with his kind permission, I am doing so here in its entirety, as posted to LinkedIn. Here is the link in case you want to read the original.

Why Pharma Sent Me South of the Border…

Published on February 3, 2019

You may have heard of people heading to other places for medical care, but is it really the right thing to do?

We know that the cost of healthcare is ridiculous. And, of course, no one is to blame…right? (Tongue in cheek)

I can’t blame the doctors – they’re great folks just trying to charge enough to cover the bills after all the red tape is required from insurance, Medicare, federal regs, etc. I can’t blame the hospitals – most of them are running in the red from having to support a widespread indigent population with recurring visits for drug overdoses and covering that overhead with Medicare reimbursement rates of 20%. I can’t blame the insurance companies – they’re the good folks just trying to break even as “non-profits”, right? (Just ask them) I can’t blame us the patients…after all, we’re just trying to get the care we need (note sarcasm as a handful overuse and abuse the system). I can’t blame pharma because they’re just trying to make drugs that save the world (snark, snark). I can’t blame government – they’re just trying to do the most for society (OK…ran out of snarks).

With no one to blame, no one is responsible to fix this.

What does this mean for me as an employer? It’s simple…

HEALTH CARE REFORM STARTS WITH ME…

No outside party can do it – I have to find ways to partner with my employees to find the right solutions to help manage costs. Let’s talk about just one of them.

SOUTH OF THE BORDER DRUG RUNS

It sounds ominous, but it’s one of the best thing we’ve found. Here’s the opportunity – I can get the same medication from the same manufacturer at substantially lower costs because I get it from a pharmacy that just happens to be located five minutes over the Mexican border. It comes in the same packaging, but it’s just written in Spanish. We verify the sourcing, we verify the manufacturing, we verify everything… And everything is above board. By working with the hospital where the pharmacy is located, we coordinate care with the physician in the United States to ensure that the patient has the right prescription, is seen by a physician in Mexico, and receives the quality product when they arrive. Legally, they can transport up to a 90 day supply over the border per day. To make it worth our while, we have them fly down to San Diego, have a courier pick them up and take them over the border for the first 90 day supply, transport them back and have them stay overnight in San Diego. The next day, the transport picks them up, takes them down for the second 90 day supply, bring them back and they fly home. That way they can get a 180 day supply per trip.

So what’s the catch?

I can’t think of one yet. Last year, our company ran a beta test with two individuals with a specialty drug each. We pay for their travel down, pay for the courier to transport them over the border to the hospital where they are met with the physicians at the hospital, we pay for the pharmacy representative, the medication, the overnight accommodations in San Diego, and a stipend to cover food and ancillary costs. What’s in it for the employee? We also cover their co-pay so they do not have to cover any costs for the medication – the medication becomes free to them, saving them hundreds of dollars if not thousands of dollars a year. Additionally, they get to keep any money that they save from the per diem money that we provide to them for their daily costs.

What’s in it for us is the employer?

Last year, after paying for the medication, all of the transportation costs including the employee costs of travel, the concierge fees for our broker who assists us with this arrangement, and all additional fees, the savings on these two individuals for one medication a piece was well over $70,000.

Do I have your attention?

Everything is legal. Everything is above board. Everything is safe. And the customer service is beyond everything that we can imagine.

This is not unique to us. The State of Utah just adopted this as their primary option for specialty medications for their employees. As I understand it, they are using a different service than I do. However, the results are similar.

We will be rolling this out to all of our employees this year. As you can imagine, there is great anticipation about how much we can save as we consider solutions and opportunities with program such as this. When it comes to healthcare, it is a game – and the people who understand the rules will win. The ones who do not understand the rules of the game will continue to pay more and lose.

Until we get a handle on controlling costs with things such as pharmaceuticals, we must continue to look for new ways to control these costs. If you would like additional information on the solution, feel free to message me.

In the meantime, feel free to get a hold of my pharma tourism broker – I promise I don’t get anything from this. I just share good news is I get it. @rockstarcurrywillix

Here’s to your success!

Dr. Wade Larson

@DrWadeLarson

wade@wadelarson.com

http://www.wadelarson.com

Millions of Americans Flood Into Mexico for Health Care

I wrote about this town in Mexico back in July of 2017 when I posted an article titled, “Cross-border Dental Care in Mexico.”

As the Truthout.com article implies, this is a caravan that no one hears about, and would be closed down if the Orangutan, Rush Limbaugh, Ann Coulter, Fox News, and Pat Buchanan (he called for a wall on the Mexican border back in 1992 when he challenged the late President George H.W. Bush for the GOP nomination. See Kornacki’s book, The Red and the Blue, page 152) get their way.

Here is the Truthout.com’s article:

The US’s “dental refugees” flock to Mexico in the thousands every day, seeking affordable care.

Source: Millions of Americans Flood Into Mexico for Health Care

Utah insurer will pay for members’ travel to Mexico to fill pricey prescriptions

In an effort to combat rising drug prices, one Utah health insurer will pay its members to travel to Mexico to fill prescriptions for certain expensive drugs, according to The Salt Lake Tribune.

Source: Utah insurer will pay for members’ travel to Mexico to fill pricey prescriptions