While US presidential candidates debate about the best possible action toward reform of the national health care crisis, a burgeoning—and possibly challenging—new trend in medical care is slowly and quietly emerging.

Mass medical tourism may be an up-and-coming catalyst for much-needed reform in the American health care system. A recent article in The Economist on this topic piqued my interest. According to the article, a recent report predicts that the number of Americans traveling abroad for treatment will soar from 750,000 last year to 6 million by 2010 and reach 10 million by 2012.¹ The report's authors think that this exodus of patients will be worth $21 billion per year in 4 years' time to developing countries.¹

Globalization is not a new concept in medicine. The outsourcing of record-keeping and the remote transcription of physicians' notes and x-ray analysis are common and is already a multibillion-dollar business. In recent years, American hospitals such as the Mayo Clinic and Johns Hopkins have set up offshoots in the Middle East and Asia.

The reasons for the current rise in medical tourism are threefold. One main motive is to save money. America faces the most expensive health care market in the world. According to a report quoted in the article, the average price for a range of common medical procedures at good facilities abroad is barely 15% of the price a patient would have to pay in the United States.¹ Throw in the option of touring after recovery, and patients have a complete "vacation" package that includes surgery and sightseeing.

Two other reasons that account for the rise in medical tourism may be that the quality at the best hospitals in Asia and Latin America is now at least as good as it is at many hospitals in rich countries. In addition, the rising number of uninsured Americans may find it cheaper to fly abroad and pay for an operation out of their own pockets than to have to pay for deductibles or copayments in the United States.

While a tremendous amount of legal issues complicate medical tourism, many employers and insurance giants have taken notice of the growing trend. Hannaford, a grocery chain based in New England, offers its 27,000 employees the option of getting a number of medical procedures done in Singapore rather than in America—at a savings to the employee of $2,500 to $3,000 in copayments and deductibles.¹ Aetna, a giant American insurer, has recently launched a pilot scheme in partnership with Singaporean hospitals. Finally, Blue Cross and Blue Shield of South Carolina started a division called Companion Global Healthcare to pursue the medical tourism opportunity. As one insurance company executive stated in the article, "[Hospitals] may be based in Columbia, South Carolina, but they have competitors and customers in Columbia, South America, as well as South Asia, and in Asia."

According the article, medical travel will represent $162 billion in lost spending on health care in America by 2012.¹ This dollar amount should be enough to shock every policy maker into prioritizing our nation's health care reform. Since medical tourism will hardly ever likely be a substitute for the current convoluted health care system in the United States, salvaging every dollar of the projected $162 billion in lost spending back into the American health care system is imperative.

Arati Murti

Reference

1. Operating Profit. The Economist. August 16, 2008:74–76.