The Real Costs of Medical Tourism

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With health care costs rising, it’s not uncommon for many Americans to venture outside their own borders for inexpensive procedures. According to the Medical Tourism Association (MTA), close to 1.6 million Americans will travel abroad to get medical procedures this year, and that number is expected to increase. A growing trend, medical tourism generates around $20-$35 billion per year. Some of the most popular countries include Brazil, Costa Rica, India, and Thailand. Countries in the Middle East are quickly climbing the charts as top medical tourism hotspots, particularly Jordan, named by World Bank as the top medical tourism destination in the Middle East and North Africa. Israel and Iran are close contenders. 

Some travel abroad to get surgeries that aren’t offered or are illegal in the U.S., but according to Patients Beyond Borders, the most common procedures are cosmetic surgeries, followed by dentistry and cardiovascular procedures. Often, these countries offer the same procedures by sometimes reputable doctors at a fraction of U.S. costs, averaging between  $3K to $5K — a mere drop in the bucket compared with U.S. costs.

For example, consider heart bypass surgery. In America, this can cost upwards of $150K. In India, where many surgeons are U.S. trained anyway, the same surgery runs about $5,200. That’s an appealing number, especially for those without adequate health insurance. Increasingly popular surgeries like gastric bypass surgery — costing $20 to $30K on average — usually aren’t covered by health insurance plans. However, places like the Mexico Bariatric Center offer it for $5,295 to $7,500.

There are also those with health insurance still facing large “amounts due” even after insurance pays. As health care costs rose, so did health insurance premiums, prompting a trend of high deductible health plans. Being uninsured may be a stronger motivator for medical tourism, but it’s quite possible for an insured American to be sitting next to an uninsured American on the tourist bus taking them to doctors offering blue-light specials on surgeries.

Before you head over to Groupon to find a packaged deal for flight, hotel, and surgery, do your research. Many countries don’t adhere to the same medical and safety regulations as the U.S., and less reputable doctors may take advantage of unknowing visitors. Americans are the target audience for many hospitals and medical practices. You’re familiar with their marketing tactics — they’re in your email’s spam folder. Although some are completely reputable, others are only out for tourists’ money. There have been numerous tales of botched surgeries performed abroad, yet numerous featured horror stories in the pages of Cosmopolitan haven’t nixed this serious medical mistake.

Additionally, medical tourists would be extremely lucky if their health insurance even paid for a Band-Aid for some of the botched jobs tourists come back with. In general, if there are complications following any procedure — overseas or not — there can be difficulty getting health insurance to pay immediately. Sometimes it can take some arm twisting, but when you’ve gone out of your way — far and away — to have a “little this or that” done, your insurer won’t be sympathetic. If you’ve forgotten the terrifying, cautionary tales of medical tourism, here are a few recent nightmares about some of the most popular medical tourism procedures and the price paid for doing so.

Fertility Treatments: Romania

Most women have been told at one point or another that their “clock is ticking,” but some just want a few more minutes. At 45, women’s child bearing years are coming to a close, but an Israeli woman was determined to have just one more baby. “Just one more” is a phrase often preceding disaster, and this was no exception. She traveled to Bucharest for fertility treatments, but got a bundle of trouble instead of a bundle of joy. During the middle of treatment, authorities busted into the clinic and charged the practitioners with illegal egg trafficking. Egg trafficking, a popular practice in Eastern Europe, entails selling human eggs for in-vitro fertilization. Other egg trafficking incidents have landed doctors in prison for five or more years. Of all the things available on the global black market, that is definitely not something you want from it.

Facelift: Singapore

“Dorothy,” who wanted to remain unidentified when sharing her vacation details, definitely wasn’t in Kansas anymore when she got a facelift in Singapore. She came back with damaged facial nerves, the right side of her face collapsed, and the left side permanently swollen. It’s no secret facelifts aren’t the type of surgery health insurers deem necessary — they’re the poster surgery for cosmetic procedures, and aren’t cheap, with an average pricetag of $6,792. In the end, she spent nearly twice what she originally spent to have everything fixed — which her health insurance wouldn’t cover.

Leg Lengthening: Iran

“If only I were a little bit taller…” That was one American’s wish who traveled to Iran to lengthen his 5’6” frame. A controversial procedure banned in several countries, most recently China, it’s still legal in the U.S., but costly. It’s usually not covered by insurance either, especially for people like this 20-year-old tourist. Typically anyone over 5’ isn’t even a candidate for this dangerous surgery, much less for it to be covered by health plans. It’s still largely considered cosmetic since the end result — usually just a few inches — isn’t a life-threatening situation, even for those with Dwarfism. Tehran had some tall promises though, like many Middle Eastern countries now, so off went our eager traveler, and back he came — with some extra souvenirs. Screws protruded from his right leg, and he had broken nails in each leg. Two surgeries were needed to correct the mistakes, again, not something health insurers are willing to pay for. The biggest mystery is how he got through airport security.

Dental Implants: Costa Rica

With no dental insurance and a need for implants, Florida resident Helen Hyjek thought she’d save some money by traveling to Costa Rica. Unfortunately, the first time didn’t produce the desired results, and she traveled back to Costa Rica three more times. Under normal circumstances, that might not be so bad, but when dentures are so large gums bleed and cause pain, it’s no trip to the beach. She’s spent $15K more than what she would have spent for one well-fitted pair in the U.S., which cost an average of $9,063. Many dental insurance plans have a maximum benefit of about $1,500, often with coverage exclusions on restorative and cosmetic dentistry. However, such exclusions are preferable compared to $25K exclusions in checking accounts spent one bad set of falsies.

Fake or Altered Prescription Drugs: Multiple Countries

We’ve all heard about Americans traveling to Mexico to visit the pharmacia, but no matter where you get prescription drugs from, you should know what you’re ingesting. How do you? You don’t. We place our trust in pharmacies, and don’t think twice when we drop off prescriptions at CVS. That trust is displaced when buying medication from overseas, and people find out the hard way. According to a World Health Organization (WHO) report revealed numbers pointing to millions of lives worldwide being saved a year if it weren’t for fake or altered prescription drugs.

There are no limits as to what may be in these drugs either — best case scenario, you get aspirin instead of the hospital-grade pain medication you ordered. Worst case scenario, you drink antifreeze like more than 100 Panamanian people did in 2006 when taking a Chinese cough syrup containing an ingredient similar to antifreeze.

This has become such a growing issue that new measures are being taken by governments and the pharmaceutical industry on a global level. A new SMS-based platform called M-Pedigree’ was recently launched to check authenticity of drugs, and the Food and Drug Administration (FDA) announced last week that they funded a new handheld, counterfeit detection device to screen specific drugs, hoping it’s technology that will one day be used on a global, wide scale for checking all medications.

Prescription drug costs are rising at inscrutable levels, but it’s wiser to ask doctors for generic brands instead of crossing the border. It’s very possible the prescriptions you’ll get from overseas — particularly when ordering online — aren’t coming from the “corner of happy and healthy.”

At What Cost?

Like counterfeit drugs, the issue isn’t just about finding a good deal on sometimes life-altering procedures. For Americans, in a country with mounting health care expenses and changes ahead from health care reform, staying stateside is a wise idea for everyone. When there are complications from medical tourism, it’s another thing contributing to higher health care expenses, and consequently, insurance premiums for all of us. Think of medical tourism’s result on health care the way the pharmaceutical industry does: If eight out of 10 people stopped buying their regular medications from U.S.-based drugstore chains, the drug suppliers would then have to increase the costs of the drugs to the pharmacy to compensate for that loss, and the pharmacy would then have to increase the costs (greatly) for the two people who were still buying all of their prescriptions from their local pharmacy.

There are plenty of medical tourism tragedies, sometimes fatal. There are times procedures have been successful though, and participants saved thousands of dollars. Some people buy a $1 scratch off lottery ticket and win millions. Most never even make their $1 back. Before any serious operation, know your doctor, and know your hospital — and the language your doctor is speaking.

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