Category Archives: Thailand

Medical Travel for Americans is Alive and Well

Many of you have probably thought that going abroad for medical care after passage of ACA was a thing of the past, or that the idea that workers injured on the job would go abroad was a “stupid, ridiculous idea and a non-starter”, have forgotten that medical care in the US is the most expensive in the world.

But the simple, undeniable fact is that we spend too much on medical care and get very poor results and outcomes, while other countries spend far less and get better outcomes.

Why are we so stubborn? And why hasn’t the workers’ comp world realized that they are fighting an uphill battle to lower costs every time they come out with some new strategy or cost containment measure that never lives up to its promise industry-wide?

Sure, there are individual cases where these companies save money for a particular client, but overall, the cost of medical care for workers’ comp still rises, even if that rise is slow at times, or appears to have shrunk, only to rise once again the next year, as seen in the NCCI State of the Line reports.

An article yesterday in Salon.com said that traveling abroad for medical care simply makes more sense — even regular teeth cleaning is four times more expensive in the US than it is in Mexico.

One of the first procedures mentioned in the article involves a Minnesota couple who went out of the country for an in-vitro fertilization (IVF) procedure. On her fourth trip to the Czech Republic, it finally worked, and she got pregnant. The procedure in the US would have cost them between $12,000 and $15,000.

While IVF is not something that workers’ comp would cover, the fact remains that procedures cost far too much in the US, and in the case of IVF, only have a 29% success rate, according to a CNBC report cited in the article.

An estimated 1.7 million Americans traveled abroad for care in 2017, according the Josef Woodman, CEO of Patients Beyond Borders, and author of the same titled book. In my seven years of studying medical travel, Josef Woodman’s name has figured prominently in many articles and forums of discussion on the subject.

The article goes on to say that that is 10 times more than the 2008 estimate from Time magazine.

Some of the top destinations for medical care are: India, Israel (always go to a Jewish doctor first), Malaysia, Thailand, Taiwan, South Korea (unless that little twerp up north gets an itchy trigger finger), and Turkey.

However, there are other, more accessible destinations closer to home like Mexico, Costa Rica, Panama, etc.

Typical operations are orthopedic or spine surgery (are you listening work comp world?), reproductive operations, cardiovascular and eye surgery.

For example, a coronary artery bypass graft (CABG) in the US costs an estimated $92,000 (you could buy a couple of nice cars for that amount), whereas in India, the same operation would cost $9,800.

A total knee replacement (are you still listening ,workers’ compsters?) cost around $31,000 in the good ole US of A, but in Thailand, costs around $13,000. Tell me how you can save that much on a knee replacement using any of your so-called cost saving schemes?

These same operations in Costa Rica would cost 45 to 65% less than in the US, and would not require such long flights from most parts of the US. What are you waiting for? Save some money, I guarantee your insureds will love you for it.

Malaysia would be 60 to 80% less, but why go there when you can go to Costa Rica?

According to Woodman, medical tourism (travel) is a Band-Aid for the country’s dysfunctional health care system.

Woodman told Salon, “I don’t think you can penetrate this with philanthropy. It’s gonna be baby steps all the way. But in the meantime, medical tourism is a really important option.”

Woodman also said he did not like the term “medical tourism” because it is not a vacation. You may have noticed that I use the term “medical travel” instead. It is travel for medical purposes, and if there is tourism component to it, it is incidental to the reason for going in the first place.

Patients who cannot afford dental work, IVF or orthopedic surgery in the US, Woodman said, should consider travelling abroad. If their operation or treatment is expected to cost them $6,000 out of pocket, they will save money — even with the plane ticket.

Oh, by the way, that Minnesota couple spent, get this, only $235 for the IVF, not including flights. With such reasonable cost savings, it would be a no-brainer for workers’ comp to do the same.

But some people are stupid, ridiculous, and non-starters in my book.

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S**thole Countries and Medical Travel

The comment yesterday that the current occupant of 1600 Pennsylvania Avenue said, is not only revolting, disgusting, sick and racist. It is also a threat to the national security of the United States, and to the economic health of the nation, and of the medical travel industry.

A host on the Fox News network defended what was said Thursday by saying that this is how forgotten men and women talk. If by “forgotten men and women” he means the men and women who lost their jobs because their wealthy bosses sent their jobs overseas or they were lost due to automation, then they only have to blame themselves for voting against their economic interests, and not the immigrants they blame for losing their jobs.

As to what this means for medical travel, think carefully about who travels from the US to other countries like India, Thailand, Singapore, Costa Rica, Mexico, and others, and not to mention those countries he did mention as “s**tholes”, especially in Africa, the Caribbean, and the Middle East (a region he did not mention yesterday, but has singled out for a Muslim ban).

And consider also what this means for inbound medical travel from those continents and countries that American hospitals might want to attract. Would you, as a citizen of those countries, travel to the US if that was what the leader of the US thought about you and your country? I don’t think so.

The notion that we should take in people from Norway (not that there is anything wrong with Norwegians, in fact, I am watching a series on early Norwegian history, Vikings on the cable channel History) is proof that he is a racist and a white supremacist.

Comments on social media have even gone so far as to indicate that Norwegians would never consider moving to the US because they have a better standard of living and have free education, health care, and rank higher on all social metrics.

So, those of you in the medical travel industry should be aware that some of the resistance to medical travel from America, and from the very people who would benefit greatly from it, are the forgotten men and women the Fox host mentioned. If so, it will be a tough sell to get them over there.