Lower costs lure Americans abroad for health procedures

(Significant portions taken from the Kansas City Star, which I never do, but this was a fantastic story. )

Dawn and Brad Palmer had never ventured outside the United States until a trip last year to Brazil.

But rather than a trek through the Amazon River basin, their itinerary took them to Santa Cruz Hospital in the southern Brazilian metropolis of Curitiba.

That’s where they underwent obesity surgeries that were not covered by their health insurance policies. Their total tab, including medical costs, drugs, airfare and hotel bills: $24,000.

If they would have had the surgeries in this country, the combined medical costs alone would have totaled at least $140,000, Dawn Palmer said.

Besides saving more than $100,000, the Palmers have lost more than 290 pounds and feel better than they have in years.

“I’d tell people not to give up hope if there’s a procedure they want or need and their insurance won’t cover it, or they can’t get the care they’re looking for here in the United States,” Dawn Palmer said. “Just be open to the idea that you can find wonderful medical care from people in other countries.”

Growing legions of American patients — by one estimate, 150,000 last year — are following in the Palmers’ footsteps and traveling to countries such as India, Thailand, Brazil and Mexico for medical care. And while earlier waves of medical tourists sought mostly cosmetic procedures, more and more Americans are going abroad to get their hearts fixed, joints replaced and stomachs stapled.

“From a health-care competition and policy perspective, it’s significant,” said Gregg Laiben, president of the Metropolitan Medical Society of Greater Kansas City. “We are no longer operating on just a local or regional level. Once these other countries come into play, they become another marketplace that competes with U.S. health care.”

Most consumers who take the medical tourism plunge do it to save money. The cost difference between medical procedures in the United States and foreign countries can be huge. According to information presented at a hearing last year before the U.S. Senate Special Committee on Aging, the typical cost of a coronary bypass in the United States ranged from $55,000 to $86,000, compared with $7,000 to $7,500 in India and $15,612 to $16,913 in Thailand.

“It’s primarily a signal of the growing unaffordability, relative to American income, of health care,” said Arnold Milstein, chief physician for Mercer Health & Benefits in San Francisco. “For tens of millions of Americans, this is probably the only avenue to elective, non-emergency procedures.”

Experts attribute those whopping price differentials to lower earnings by most health-care personnel in developing countries. In addition, malpractice insurance premiums are non-existent in most foreign countries, and global health-care product suppliers sell to developing countries at cheaper prices.

American patients also are drawn to medical tourism by the high-quality reputations of many overseas health providers.

“Ninety percent of the doctors I recommend are U.S.-trained or board-certified, and they’re working in hospitals that are palatial and state of the art,” said Rudy Rupak, president of PlanetHospital, a California company that sets up overseas medical care.

Foreign hospitals that treat large numbers of English-speaking patients recruit U.S. surgeons. American doctors who make the trek typically are paid the same fees they earn in the United States, but enjoy the lower cost of living and lack of malpractice insurance premiums in the countries they move to, Rupak said.

Presidential candidates take note: We’ll just go overseas if you don’t fix the health-care industry.


More than $40 million in U.S. cannot afford health care

According to a federal report released this week, more than $40 million Americans say they cannot afford health care.

“There has been important progress made in many areas of health such as increased life expectancy and decreases in deaths from leading killers such as heart disease and cancer,” Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, said in a statement.

“But this report shows that access to health care is still an issue where we need improvement.”

The report, summarized by a Reuters article, contained an analysis of data from 2005, whereas now, nearly three years later, Americans’ health circumstances may have changed. And we know from polls that health care is the No. 1 most important domestic issue to voters and presidential candidates have responded, with nearly all of them presenting detailed health plans as a part of their campaigns.

Other details from the article and report:

  • The report found about one third of all children living below the poverty level had not visited a dentist in 2005, compared with fewer than one-fifth of children from wealthier families.
  • The United States spends more on health per capita than any other country, and health spending continues to increase,” the report said.
  • “In 2005, national health care expenditures in the United States totaled $2 trillion, a 7 percent increase from 2004. Hospital spending, which accounts for 31 percent of national health expenditures, increased by 8 percent in 2005.”
  • Private insurance plans paid for 36 percent of total personal health care expenditures in 2005, while the federal government paid 34 percent, state and local governments paid 11 percent, and patients paid for 15 percent out of pocket.
  • Prescription drugs accounted for 10 percent of national health expenditure in 2005.
  • Some good news: life expectancy was up to 77.8 years for a baby born in 2004 — three years more than in 1990. “Mortality from heart disease, stroke, and cancer has continued to decline in recent years,” the report said.

Study: Illegal Hispanics not a health-care burden

Despite the fact that many anti-immigration activists say illegal immigrants are a burden to U.S. health-care programs, a new study by researchers at the University of California’s School of Public Health found that illegal Latinos are no more burden to our health-care system than legal or American-born Latinos.

The study, based on a 2003 telephone survey of thousands of California residents, specifically found that although such immigrants tend not to have a regular doctor or other health-care provider, they do not visit emergency rooms – often a last resort in such cases – with any more frequency than Latinos born in the United States, according to a report by Reuters.

The makeup of the studied group:

  • 1,317 undocumented Mexicans
  • 2,851 citizens with Mexican immigrant parents
  • 271 undocumented Latinos from countries other than Mexico
  • 852 non-Mexican Latinos born in the United States

What researchers said:

One recurrent theme in the debate over immigration has been the use of public services, including health care,” wrote lead researcher Richard Ortega and his team in the report, which was published in the Archives of Internal Medicine (pdf).

“Proponents of restrictive policies have argued that immigrants overuse services, placing an unreasonable burden on the public. Despite a scarcity of well-designed research … use of resources continues to be a part of the public debate,” they said.

  • Illegal Mexican immigrants had 1.6 fewer visits to doctors than people born to Mexican immigrants
  •  Other undocumented Latinos had 2.1 fewer physician visits than their U.S.-born counterparts


Perhaps critics shouldn’t worry so much about illegal immigrants draining resources meant for Americans.

“Low rates of use of health-care services by Mexican immigrants and similar trends among other Latinos do not support public concern about immigrants’ overuse of the health care system,” the researchers wrote.

Undocumented individuals demonstrate less use of health care than U.S.-born citizens and have more negative experiences with the health care that they have received.”

Then again, illegal Latinos may have had fewer doctors’ visits than others, but they still had some, and in my opinion, any unauthorized use of social services meant for Americans is illegal and should be stopped.

Symantec announces new program to save health-care industry

Symantec Corp., the makers of Norton AntiVirus and other computer security programs, announced earlier this week a new program, the Symantec Healthcare Provider Solution, which includes a variety of services to help health providers become more efficient.

The new program will help health providers protect and manage their critical infrastructure and ensure that vital patient information is both protected and accessible, according to an article on CNN Money.
The concept of computerizing patient data is not new; many of the presidential candidates have included in their health-care reform packages a plan to organize patient information electronically in order to save time and money.

And, apparently, it works.

“Symantec gives Baptist Health the confidence that our critical patient information is protected, and simplifies the management of our infrastructure to help us ensure compliance, better serve our patients and enhance employee productivity,” said Allen Montgomery, of Baptist Health South Florida, which serves approximately 100,000 patients annually.

With Symantec, we have saved close to $2 million in IT administration costs, leaving more funding to focus on initiatives that directly benefit our patients.”

Among the functions of the new program:

  • Protect interconnections and mitigate security risk –  Symantec helps healthcare providers protect critical endpoints (workstations, servers, databases, mobile devices), enforce security policy, prevent data loss and monitor and report access to systems for compliance with internal policies and regulations
  • Manage data in an increasingly complex environment – Advances in medical digital imaging and electronic medical records (EMRs) have enabled healthcare providers to streamline diagnosis and treatment, reduce medical errors, increase efficiency and improve patient care
  • Automate compliance amid changing industry regulations – Healthcare providers must thrive in a landscape of constantly changing regulations and standards imposed by federal, state, and local governments, accrediting bodies and regional health organizations

U.S. spends more cash, gets less care than other countries

A survey published Wednesday in “Health Affairs: The Policy Journal of the Health Sphere” concluded that, compared with individuals residing in six other countries, United States citizens tend to pay significantly more for health care, report more medical errors and “waste” more time on superfluous paperwork.

On the upside, however, U.S. residents reported more accessibility to quality health care and less wait time for elective surgeries.

Survey Particulars

The 2007 Commonwealth Fund International Health Policy Survey interviewed 12,000 adults in seven countries regarding their experiences with their respective health-care systems. It is important to note that all of the countries surveyed but the U.S. have a single-payer, universal health-care system in place, similar to what most Democratic presidential hopefuls are promoting in their campaigns. The countries surveyed were:

  1. The United States
  2. The Netherlands
  3. The United Kingdom
  4. Germany
  5. Canada
  6. Australia
  7. New Zealand

The survey, which was conducted by The Commonwealth Fund and Harris Interactive in March, and published on Wednesday, covered everything from access to health care, quality, cost, waiting times, insurance coverage, after-hours care and preventive medicine.

The Good:

  • Eighty percent of U.S. respondents said they have a primary-care physician or primary-care system in place, which the study concluded allows them better overall access: to preventive care, knowledge of medical history, after-hours care and coordination of care in case a specialist is required. At 80 percent, however, the U.S. individuals’ access to a regular doctor was significantly lower than in all the other countries; in the Netherlands, it was 100 percent.
  • Because of privatized medicine and insurance, U.S. respondents had the least wait time for elective surgeries. But U.S. residents were also the most likely to forego the necessary procedures due to affordability issues.
  • The U.S. respondents also claimed to have the best access to quality care, probably because of private insurance, but much of the care was deemed to be cost-prohibitive.

The Bad:

  • The U.S. spends twice per capita than the other six countries on health care, and receive less of it — most being bogged down in insurance and overhead costs.
  • One-fifth of the U.S. respondents said they had difficulty paying medical bills over the last year — more than double the rate of the other countries.
  • Thirty percent of insured and 34 percent of insured Americans spent more than $1,000 in out-of-pocket medical costs during the last year.
  • Thirty-two percent of Americans switched their insurance carrier at least once in the past year, which means the possibility of losing the all-important primary-care physician or system.
  • The chances of Americans having a “medical home”; that is, a regular doctor or clinic who is familiar with their medical history and current medical status were significantly affected by income level: 58 percent of high-income residents had a “medical home” as opposed to only 26 percent of low-income residents. This could be the result of low-income people having to resort to clinics and/or emergency rooms because they cannot afford insurance.
  • U.S. adults were the least likely of any country to report same-day access to a doctor and the most likely to experience a long wait (six days or more) when sick.
  • Patients in the U.S. were also the least likely to say that their doctor always spent enough time with them during visits or answered all their questions.

The Prognosis:

The good news about all the bad news is that at least now we know what to fix. As most of the presidential candidates have said, Americans do need access to more and better-quality health care. Additionally, as again the candidates have noted, the seemingly endless paperwork connected with doctors’ visits needs to be reduced; most presidential hopefuls have mentioned a switch to electronic medical records to alleviate this problem. Another significant problem to be addressed is the high rate of uninsured and underinsured Americans, which makes medical care cost-prohibitive and places a great amount of financial stress upon patients.

Perhaps this study, if widely publicized, will allow lawmakers to compare their proposed health-care reforms to the systems already in place – and already working – in foreign countries.

AMA goes after Medicare cash

In an editoral in its journal, “American Medical News,” the American Medical Association argued that Medicare Advantage (Medicare HMO plans) needs to be cut in order to fund some upcoming decreases in Medicare physician fees.

“Meanwhile, many more seniors could well be affected by physician pay that faces a staggering cut, currently estimated at about 10% for 2008, and 15% through 2009,” it read. “It’s no surprise that an AMA online survey of nearly 9,000 physicians, released in June, reports that about 60% of doctors say the cut will force them into the position, at the least, of having to limit the number of new Medicare patients they take.”

This means that seniors will certainly be at a disadvantage in finding quality medical care, which is exactly what presidential contenders are trying to combat. See what the Health Care Policy and Marketplace Review had to say.

Health-care conference to feature 160 leading companies

Executives from more than 160 health-care companies will attend a conference next week at the Waldorf Astoria Hotel in New York City, according to a news release on CNN Money.

 The conference comes at a time when the nation is in the midst of earnings season, the 2008 presidential campaign and much talk of Medicaid and Medicare reform. Speakers from pharmaceutical, biotechnology and health-care provider companies are expected to address some of these issues.

It is the largest investor conference in the health-care industry, according to the release.