It’s fine that people for whom money is no object are coming here in droves to seek more advanced treatments – which account for a small percentage of all illnesses – but lots of Americans are going elsewhere because our costly system would let them die. What good is it if a rich Russian comes here for a state-of-the-art facelift if at the same time your neighbor must go to India to be able to afford on the basic heart procedure his insurer won’t cover (assuming he has any insurance at all)? As the McKinsey report says, “An aortic valve replacement costs more than $100,000 in the United States, for instance, but about $38,000 at a provider in Latin America and only $12,000 at a provider in Asia.”

“only 9 percent of the travelers seek lower costs for medically necessary procedures”

I rest my case.

If I needed a high tech procedure, I would definitely shop around for the cheapest price. I understand they do a fabulous heart transplant in Zimbabwe at a very reasonable rate.

“But if U.S. patients make up 99 percent of the group traveling abroad in search of lower costs for medically necessary procedures, that’s a clear sign that our costs are out of whack.”

I’d say it’s a clear sign that some people aren’t very bright.

Consulting firm McKinsey & Co. put out a report last year on this, using a narrow definition of medical travelers as only those whose primary, explicit purpose in traveling abroad was to obtain in-patient medical treatment in a foreign country; it put the total number of travelers worldwide at 60,000 to 85,000 per year. See it here (free registration required):

The largest segment, with 40 percent of all medical travelers, seeks the world’s most advanced technologies. These men and women take their search for high-quality medical care global, giving little attention to the proximity of potential destinations or the cost of care. Most such patients—originating in Latin America (38 percent), the Middle East (35 percent), Europe (16 percent), and Canada (7 percent)—travel to the United States.

With 32 percent of all medical travelers, the second-largest segment comprises patients who seek better care than they could find in their home countries, which are often in the developing world. When selecting a destination, such patients generally trade off perceived quality against burdens such as costs, distance, and unfamiliar cultures. Some of these people disregard costs to some degree; others are looking for higher quality at the best available price. Patients in this segment seek care in several different specialties, particularly cardiology.

The third-largest segment comprises people who want quicker access to medically necessary procedures delayed by long wait times at home for orthopedics, general surgery, or cardiology. Its numbers depend on capacity in the home countries, so health investments there can reduce the need to seek care abroad. Recent and ongoing infrastructure investments in the United Kingdom, for example, have focused on cutting wait times. Those for knee and hip replacements, which used to be especially long, have fallen by about 40 percent in the past six years.

While only 9 percent of the travelers seek lower costs for medically necessary procedures, this segment has the greatest potential for growth. Since the price of treatment varies greatly around the world, patients can save significant amounts, depending on the procedure. An aortic valve replacement costs more than $100,000 in the United States, for instance, but about $38,000 at a provider in Latin America, and only $12,000 at a provider in Asia. US patients make up 99 percent of the people in this group. In 30 percent of all cases, patients are traveling for orthopedic care, and in 16 percent, for general surgery.

So, yes – people seeking the most cutting-edge treatments, for whom cost is no object, or those from developing countries tend to come to the United States for care. But if U.S. patients make up 99 percent of the group traveling abroad in search of lower costs for medically necessary procedures, that’s a clear sign that our costs are out of whack.

Oh?

Then I wonder why so many people from other countries come here to seek medical treatment?

However, “tort reform” has become a scapegoat issue for the medical field in the same way that “illegals” have become for the working class. Analysis of malpractive insurance balance sheets shows that tort costs are NOT the driver of high insurance premiums. One of the biggest impeti is losses in their investment portfolio, which they seek to offset via increased insurance income.

The other issues include: extraordinarily high loan payments for medical school, the rising cost of living, the increasingly mean-spirited and backbiting professional/management atmosphere, and a fractured social/family life which often leads to drug or alcohol abuse. All of these changes over the past 30-40 years are largely invisible but can put many doctors in a cynical, sullen mood in their working environment. Which of course works to the disadvantage of patients, who then spend much more money on needless tests or are treated callously and with a tin ear.

Some medical centers, like the Mayo Clinic, are still offering tremendous care at reasonable rates. But most clinics/hospitals/practices are not structured in a similar manner. The United States is truly one of the worst places in the world to seek medical treatment.

The stunning stupidity of that statement defies response.

In the context of what docs have to pay for insurance anyhow, is also a drop in the bucket compared to what doctors and hospitals make. And for a plaintiff to win a med mal lawsuit is really hard, and often stem from the doc failing to inform the patient of all the risks in the first place or from simply gross negligence. If the doc really has the facts on his side he’ll receive a judgment not w/standing the verdict or win on appeal.