In his new book,
Patients Beyond Borders: Everybodys Guide to Affordable, World Class
Tourism, author Josef Woodman offers a comprehensive manual for how you
can see the world and get many of your surgical needs metall at
a cost that may be cheaper than having the procedure done at your local
hospital. But that doesnt mean you should start packing now. Preparing
for surgery overseas requires lots of homework. In this excerpt, Woodman
tells you how to get organized.
When my father was 72, he traveled to Mexico for extensive dental work.
When I first heard his plans, I felt a mixture of bewilderment and fear.
But I knew that despite my protestations, he was going anyway.
Dad and his wife, Alinda, selected a U.S. trained dentist in Puerto Vallarta
and paid around $11,000, which included two weeks of noodling around the
Pacific Coast. They returned tanned and smiling, Dad with new pearly whites
and Alinda with an impromptu skin resurfacing. In the States, Dads
procedure would have cost him $24,000double what it cost south of
My dad was a health travel pioneer. In his day, finding quality care abroad
was a far more arduous task than it is now. In a few short years, big
government investment, corporate partnerships and increased media attention
have spawned a new industrymedical tourismwhich is bringing
with it a host of encouraging new choices for patients. Individuals can
now choose from a smorgasbord of safe, reliable options for diagnosis
and treatment, ranging from dental care and cosmetic surgery to some of
the more dramatic and expensive procedures, such as hip replacement or
heart valve surgery.
An Impartial Perspective
International health travel has received a good deal of attention of late.
While one newspaper or blog giddily touts the fun n sun travel
side of treatment abroad, another issues dire, Code Blue warnings about
filthy hospitals, shady treatment practices and procedures gone bad. My
research has convinced me that with diligence, perseverance and good information,
patients considering traveling abroad for treatment have safe choices,
not to mention an opportunity to save thousands of dollars over the same
procedure here in the U.S. Hundreds of patients who have returned from
successful treatment overseas provide overwhelmingly positive feedback.
They convinced me that I should write this guide to becoming a savvy,
informed international patient. I designed it to help readers reach their
own conclusions about whether and when to seek treatment abroad.
Last year, more than 150,000 Americans, Canadians and Europeans packed
their bags and headed overseas for nearly every imaginable type of treatment:
tummy tucks in Brazil, heart valve replacement in Thailand, hip resurfacing
surgery in India, addiction recovery in Antigua, fertility diagnoses and
treatments in South Africa, thalassotherapy in Hungary or restorative
oral dentistry in Mexico.
Currently, at least 28 countries on four continents cater to the international
health traveler, with more than a million patients visiting hospitals
and clinics each year in countries other than their own. The roster of
treatments is nearly as varied as the travelers.
As baby boomers become senior boomers, theyve begun to find that
their health care and prescription costs devour nearly 30 percent of their
retirement and pre retirement incomes. But with the word out about top
quality treatments at deep discounts overseas, informed patients are finding
they have an alternative. Uninsured and underinsured patients, as well
as those seeking elective care, can realize 15-85 percent savings over
the cost of treatment in the U.S., depending upon the country and type
of treatment. Or, as one successful health traveler put it, I took
out my credit card instead of a second mortgage on my home.
A patient from Santa Ana, California, whom Ill call Margaret, was
quoted $6,600 for a tooth extraction, two implants and two crowns. One
of the 120 million Americans without dental insurance, she had heard of
less expensive dental care abroad. Through a friend, she learned about
Escazu, Costa Rica, known for its excellent dental and cosmetic surgery
clinics. Margaret got the same treatment in Costa Rica for $2,600. Her
dentist was a U.S. trained oral surgeon, who used state of the art instrumentation
and top quality materials. Add in airfare, lodging, meals, and other travel
costs, and this savvy global patient still came out way ahead.
Then theres a man Ill call Doug S., a small business owner
from Wisconsin, who journeyed with his wife, Anne, to Chennai, India,
for a double hip resurfacing procedure that would have cost more than
$55,000 in the U.S. The total bill, including travel for him and his wife,
lodging, meals and two week recuperation in a five star beach hotel was
$14,000. We were treated like royalty, said Doug, and
Im riding a bicycle for the first time in six years. We could not
have afforded this operation in the U.S.
Big Surgeries: Comparative Costs in Asia and Southeast Asia
Procedure US Cost India Thailand Singapore Malaysia
Heart Bypass: $130,000+ $10,000 $11,000 $18,500 $9,000
Replacement: $160,000 $9,000 $10,000 $12,500 $9,000
Angioplasty: $57,000 $11,000 $13,000 $13,000 $11,000
Hip Replacement: $43,000 $9,000 $12,000 $12,000 $10,000
Hysterectomy: $20,000 $3,000 $4,500 $6,000 $3,000
Knee Replacement: $40,000 $8,500 $10,00 $13,000 $8,000
Spinal Fusion: $62,000 $5,500 $7,000 $9,000 $6,000
The above costs are for surgery, including hospital stay. Airfare and
lodging costs are governed by individual preferences. To compute a ballpark
estimate of total costs, add $5,000 for you and a companion, figuring
coach airfare and hotel rooms averaging $150 per night. For example, a
hip replacement in Bangkok, Thailand, would cost about $17,000, for an
estimated savings of $26,000 over treatment in the U.S.
Dentistry: Comparative Costs in Popular Destinations
Procedure US Cost Mexico Costa Rica South Africa Thailand
Implants: $2,400 $1,500 $1,650 $2,000 $1,600
(upper and lower): $1,600 $1,000 $1,100 $1,700 $900
Crowns: $800 $375 $400 $800 $270
Porcelain Veneers: $800 $120 $160 $300 $240
Inlays and Onlays: $420 $220 $240 $320 $300
Surgical Extractions: $260 $120 $120 $250 $120
Root Canals: $750 $260 $280 $400 $110
The estimates above are for treatments alone. Airfare, hospital stay (if
any) and lodging vary considerably. Savings on dentistry becomes more
dramatic when big mouth work is required, involving several
teeth or full restorations. Savings of $15,000 or more are common.
Better Quality Care
Veteran health travelers know that facilities, instrumentation and customer
service in treatment centers abroad often equal or exceed those found
in the U.S. In fact, governments of countries like India and Thailand
have poured billions of dollars into improving their health care systems,
which are now aggressively catering to the international health traveler.
VIP waiting lounges, deluxe hospital suites, and staffed recuperation
resorts are common amenities, along with free transportation to and from
airports, low cost meal plans for companions and discounted hotels affiliated
with the hospital.
Moreover, physicians and staff in treatment centers abroad are often far
more accessible than their U.S. counterparts. My surgeon gave me
his cell phone number, and I spoke directly with him at least a dozen
times during my stay, said David P., who traveled to Bangkok for
a heart valve replacement procedure.
Even the most robust health insurance plans exclude a variety of conditions
and treatments. You, the policyholder, must pay these expenses out of
pocket. Although health insurance policies vary according to the underwriter
and individual, your plan probably excludes such treatments as cosmetic
surgeries, dental care, vision treatments, reproductive/infertility procedures,
certain non emergency cardiovascular and orthopedic surgeries, weight
loss and substance abuse rehabilitation programs as well as prosthetics.
In addition, many policies place restrictions on prescriptions, which
can be quite expensive, as well as post operative care, congenital disorders
and pre-existing conditions.
Facing increasingly expensive costs at home, nearly 40 percent of American
health travelers hit the road for elective treatments. In countries such
as Costa Rica, Singapore, Dubai, and Thailand, this trend has spawned
entire industries, offering excellent treatment and ancillary facilities
at costs far lower than U.S. prices.
Some procedures and prescriptions are simply not allowed in this country.
Either Congress or the FDA has specifically disallowed a certain procedure,
or perhaps its still in the testing and clinical trials stage or
was only recently approved. Such treatments are often offered abroad.
One example is an orthopedic procedure known as hip resurfacing. For many
patients, this represents a far superior, longer lasting and less expensive
alternative to the traditional hip replacement still practiced in the
U.S. While this procedure has been performed for more than a decade throughout
Europe and Asia, it was only recently approved in the U.S., and the procedures
availability here remains spotty and unproven. Hundreds of forward thinking
Americans, many having suffered years of chronic pain, have found relief
in India, where hip resurfacing techniques, materials and instrumentation
have been perfected into a routine procedure.
Although traveling abroad for medical care can often be challenging, many
patients welcome the chance to blaze a new trail and find the creature
comforts offered abroad a welcome relief from the sterile, impersonal
hospital environments of many U.S. treatment facilities. For others, simply
being in a new and interesting culture lends distraction to an otherwise
worrisome, tedious process. Getting away from the myriad obligations of
home and professional life can yield healthful effects at a stressful
time. Whats more traveland particularly international travelcan
be a life changing experience. You might be humbled by the limousine ride
from Indira Gandhi International Airport to a hotel in central New Delhi,
struck by the simple, elegant graciousness of professionals and ordinary
people in a foreign land or wowed by the sheer beauty of the mountain
range outside a dental office window. As one veteran medical traveler
I brought back far more from this trip than a new set of teeth.
Planning Your Journey
If you decide that a medical trip is right for you, research several physicians,
clinics or hospitals that offer the treatment you need. Dont snap
up the first option you find. Plan as far in advance as you can as well.
Three months lead time is good. Six months is great. But one month is
generally not sufficient time. .... continued in ABILITY