Tag Archives: Cross-Border Health Care

Ashley Furniture and Medical Travel, part 2

As promised last month, here is the Spotlight article from Medical Travel Today.com about Ashley Furniture’s foray into Medical Travel for their employees.

In case you missed it, here is the link to part 1 of the article.

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Foreign Patients Get Liver Transplants in US Hospitals First

ProPublica, those lovely folks who published several articles some time back on workers’ comp, are at it again.

This time, they are focusing their ire on how foreign patients are getting liver transplants at some US hospitals ahead of Americans waiting for such transplants.

The story, published yesterday, was co-published with a local Fox station in New Orleans.

From 2013 to 2016, New York-Presbyterian Hospital gave 20 livers to foreign nationals who came to the US solely for a transplant, essentially exporting the organs and removing them from the pool of available livers to New Yorkers.

Dr. Herbert Pardes (I was familiar with his name from living in NY), wrote that, “Patients in equal need of a liver transplant should not have to wait and suffer differently because of the U.S. state where they reside.”

Dr, Pardes was the former chief executive, and is now the executive vice president of the board at New York-Presbyterian.

Yet, according to the story, Dr. Pardes left out NY-P’s contribution to the shortage, as stated above from 2013 to 2016.

These 20 livers represent 5.2 percent of the hospital’s liver transplants during that time, which was one of the highest ratios in the country.

ProPublica reported that unknown to the public, or to sick patients and their families, organs donated domestically are sometimes given to patients flying in from other countries, who often pay a premium. Some hospitals even seek them out.

A company from Saudi Arabia said it signed an agreement with Ochsner Medical Center in New Orleans in 2015.

The practice is legal, according to the story, and foreign nationals must wait their turn in the same way as domestic patients. The transplant centers justify this on medical and humanitarian grounds, but at a time when we have an Administration touting “America First”, this may run counter to the national mood.

The  director of the transplant institute at the Mount Sinai Hospital in New York, Dr. Sander Florman, said he struggles with “in essence, selling the organs we do have to foreign nationals with bushels of money.”

Between 2013 and 2016, 252 foreigners came to the US purely to receive livers at American hospitals. In 2016, the most recent year for which there is data, the majority of foreign recipients were from countries in the Middle East, including Saudi Arabia, Kuwait, Israel and the UAE. Another 100 foreigners staying in the US as non-residents also received livers.

At the same time, more than 14,000 people, nearly all Americans, are waiting for livers, a figure that has remained very high for decades, they report. By comparison, fewer than 8,000 liver transplants were performed last year in the US, an all-time high. National median wait time is more than 14 months, and in NY, the time is longer.

In 2016. more than 2.600 patients were removed from waiting lists nationally, either because they died or were too sick to receive a liver transplant.

All this is happening at a time when the party in power is seeking to take health care away from those who recently received care for the first time in a long time from the ACA, and at a time when the medical travel industry is focused not on transplant surgeries, but on boutique treatments and surgeries for wealthy or upper middle class Americans to go abroad for bariatric, plastic or reconstructive surgery, knee surgery, dental care, etc.

And yet, when the very idea of medical travel is broached in the medical community, it is disparaged and discouraged by physicians and others as unsafe, impractical, and not worth the effort, Obviously, it is well worth the effort on the part of foreign patients to come here and take organs meant for Americans, so why not allow Americans to take their organs?

Is it because the hospitals that supply these organs to foreign patients are making huge sums of money, and the poor schnook American with liver disease (or kidney disease, as in the case of yours truly) must die so that an American hospital can improve its bottom line?

It is high time to cut the crap and promote medical travel the right way and for the right reasons, not only for those who can afford it, but those who need transplants and can’t get them here.

That is the true nature of the globalization of healthcare…a two-way street.

 

Time For Medical Tourism Industry to Clean Up Its Act

An article in Arizona Central (see link below) highlights the problem with weight-loss surgery in Mexico.

https://www.azcentral.com/story/money/business/health/2017/11/16/mexico-gastric-sleeve-weight-loss-surgery-deaths-arizona-medical-tourism-risks/576309001/

This isn’t the first article on this subject, and won’t be the last, but the industry must clean up its act, stop patting yourselves on the back at all these fancy conferences around the world, come together to lay down guidelines and industry-driven protocols and standards of care and legal protections, and lastly, get rid of the crooks (you know who they and you are), charlatans, con men, and carnival barkers who promote medical travel, and give it a black eye.

Naturally, there are risks to any surgery, no matter where it occurs, but if medical travel is to be marketed as less costly, with better outcomes, the quacks and thieves must be removed from the industry.

Stop dissing each other, start cooperating with each other, and cut back on the conferences. Nobody of any real importance to the growth of the industry attends; only those who talk a great deal or are promoting their own businesses.

Here is a video that goes along with the article.

https://uw-media.azcentral.com/video/embed/106607688?placement=embed

 

 

Ashley Furniture and Medical Travel, part 1

From the One Hand Washes the Other department comes the following Spotlight article from Medical Travel Today.com.

Ashley Furniture, based in Wisconsin, is one of the largest manufacturers of home furnishings in the world.

I met Rajesh Rao in 2014 when I attended the Costa Rican Medical Travel Summit in Miami Beach. Rajesh’s company was also instrumental in convincing another furniture manufacturer, HSM in North Carolina, to first send patients to India, then to Costa Rica for medical care. I have written about this in previous posts.

This article is part one, and part two will run next month.

The Fork in the Road in Medical Travel

Returning to the main theme of this blog, I came across the following insightful article by Ruben Toral last week that posed the question, “Is Medical Tourism Dying a Slow Death?”

As someone who has been interested in opportunities in Medical Travel for some time, and  disappointed in not being able to elicit interest in my idea for Medical Travel, I was interested in seeing what Ruben had to say, and to see if it measured up to my views of the industry, as I know it.

According to Ruben, the industry exhibits the traits of a typical product/business cycle, whereby the first and fast movers establish leadership by developing and commercializing the concept, then late adopters pile in to get in on the action.

He goes on to decry the same speakers at every medical tourism event around the world talking about the same things, which is enough to hit the snooze button and go back to sleep.

He also laments the lack of innovation, and says that key players are just trying to manage the slow growth rather than investing in the next wave.

VC investors, Ruben says, talk of getting burned on medical tourism investments that simply cannot scale like other businesses, because, as they quickly learn, healthcare is a different animal than retail and you burn through a lot of cash fast trying to buy eyeballs and audience.

And investment analysts ask the same question after pouring through hospital financial reports and see how hospitals are managing and protecting profit margins: “Where’s the growth?” And even large meeting and events companies are not “flogging medical tourism” because attendance and interest is way down.

So, is this the beginning of the end or the inflection point for medical tourism?, Ruben asks. For his part, he does not know, but if it is not the beginning of the end, or an inflection point, it is most certainly a fork in the road.

Where it goes from here is as good a guess as mine and Ruben’s, but it is up to those who are serious and dedicated to growing the industry to regroup and start again to build interest and enthusiasm for medical travel, and to address some of the glaring issues facing the industry.

But that won’t happen until there are changes within and without the industry…in technology and in strategy.

Now It’s Personal

Last week, some of my LinkedIn connections, as well as several other connections, learned of my recent hospitalization. The reason for this was not mentioned at the time, but I will tell you now.

Not having health insurance through an employer, and being denied renewal of a local county health care program, led to my going from Stage 4 to End Stage Kidney Disease.

The hospitalization last week was to place a catheter in me for peritoneal dialysis, and to repair an umbilical hernia.

My hospitalization was brought to light quite unexpectedly by my friend, Maria Todd. Maria’s sending best wishes for my speedy recovery and quick discharge from the hospital was much appreciated, and the warm words by others in response, and the thirty plus “likes” made me feel that people cared. For that. I am grateful.

But the events of the past month have brought home to me one very important point, given the current activity surrounding the so-called “repeal and replace” of the ACA, and the two Congressional bills that many consider doing more harm than good.

This nation needs Medicare for All.

There, I said it.

I know in the past, I have advocated single payer for others, but my illness has shown that anyone who loses health care for any amount of time, once they have reached adulthood, cannot go without health insurance.

This is what happens when men and women are removed prematurely from the workforce, for whatever reason, employer decides you are no longer wanted, economic downturn or just to eliminate positions that affect the bottom-line of the company, and are generally targeted to individuals in their 40’s, 50’s and early 60’s so that the company can save on health care costs for those employees, and so that younger workers can be hired to replace them.

This is not something new, and not related to automation and artificial intelligence disrupting whole industries, which is inevitable.

My initial view on single-payer was that if employers were no longer responsible for the health insurance of their employees, and they were guaranteed full coverage by the government, some of the job losses of the past decades would not have happened, and many talented men and women out of the workforce would be employed until their retirement.

If you don’t believe me, go to LinkedIn and read the many posts from such individuals who are still unemployed. One fellow in Texas even got turned down from jobs at fast food restaurants.

So, now it is personal for me.

I also know that many of you make your living from the health care system we currently have, and that some of you have expounded on why you think a single payer system is unrealistic.

I get it that your financial outlook depends on working in a broken, free-market system because it pays your salary, but healthcare was not supposed to be a business, nor was it supposed to marketed like any other commodity.

If you don’t believe me, read what Pope Francis said: “health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”

But try telling that to Messrs. McConnell, Ryan, Paul, et al in Congress, and the current POTUS, all of whom want to eliminate medical coverage for millions of Americans they received under the ACA, cut back Medicare and Medicaid, and destroy Social Security.

Now that I will be receiving dialysis, and quite likely will qualify for disability, the prospect of not having those resources is very personal to me, and could literally mean my life.

Look in the mirror, then look at your spouse, your children, your parents, your neighbors, friends, etc. What do you think would happen to them if these programs were eliminated? Would you have enough money to care for them? Would you have money to pay for private insurance?

I lost my mother last month to dementia. She died on her 85th birthday in a nursing home some miles from my home (the home she and my father bought), but if the Republicans in Congress had gotten their way, and she had lived longer, I feared she would have been forced out of that nursing home, with no place to go, and would have been an even bigger burden to me.

So, I really don’t care if you are a Democrat, Republican, Independent, Libertarian, Socialist, Liberal, or Conservative, we all need health care at some point in our lives.

One of the friends I met here in Florida back in the 90’s died last July of a stroke. He was 73. He worked out, never smoked, had a good life, three kids, and like many of you, worked in Risk Management, as well as Human Resources, the legal profession, and served in Vietnam. But despite all that, he died prematurely, and went into involuntary retirement because he was in his 60’s. Luckily, his wife worked. But you get the picture.

We must all do our part to see that every American can get health care. Not just access to care, which is a Republican euphemism for being able to afford it, and if you can’t, too bad. But actual health insurance. Medicare for All.

Cross-Border Dental Care in Mexico

On Sunday, NBC Nightly News ran a video report on dental care in Los Algodones, Mexico, south of the border from Arizona, and west of Yuma.

According to the report, during the winter months, up to 7,000 Americans travel to Los Algodones for dental care.

Los Algodones, also known as “Molar City”, is the self-proclaimed dental capital of the world. While that sounds like hype, I can tell you from personal experience that it is not the only town on the border where one can find dozens of dental offices.

When I presented at the 5th Mexico Medical Tourism and Wellness Business Summit in 2014, I visited a town east of Reynosa called Nuevo Progresso where I saw some of the dental offices, along with some of the other attendees.

Here is the video from NBC.

http://www.nbcnews.com/widget/video-embed/1018704963518

And here are some pictures from Nuevo Progresso.

I took these pictures in a small medical center on the main street of Nuevo Progresso, just over the border from Texas. To the left of the picture on the left, is the bridge crossing the Rio Grande (Rio Bravo) into the US.

And the people I saw on the street were not Mexicans, they were Americans.

Still think medical travel is a stupid and ridiculous idea? Try telling it to the thousands who go across the border.