Trips Take Aim at High Health Costs
By James Warren, Chicago Tribune staff writer

If you're a multitasker who inexplicably desires to combine knee-replacement surgery with a family vacation to Singapore, or perhaps twin a heart bypass with some sun and beach in Costa Rica, the May issue of Fortune Small Business will entice as it unveils the growing, cost-cutting universe of medical vacations.

"Jet-Set Surgery" explains why some (mostly smaller) American companies are flying employees overseas for supposedly high-quality but inexpensive medical procedures.

Brazil, India, South Africa and Thailand are other leading destinations for more than 500,000 U.S. citizens predicted to leave the country in 2007 for procedures that include cardiac, spinal, heart and cosmetic surgeries, as their employers (and benefit providers such as BlueCross BlueShield of Texas) seek to curb booming medical costs, notably insurance premiums.

For example, the average coronary artery bypass charge is $75,000 in the U.S., compared with $11,000 (including round-trip airfare) at the Fotis Mahali hospital in India.

A Singapore knee replacement runs nearly $18,000, or half the usual U.S. bill. This explains the growth of middleman firms, such as GlobalChoice Health Care of Albuquerque, which teams employers with foreign doctors. It finds hospitals, sends medical records and schedules the surgeries, along with being a de facto concierge, handling air travel, hotel reservations and sightseeing when desired. Self-insured companies deal directly with a firm such as GlobalChoice to arrange workers' treatments and travel, while other employers use it via their own health insurers.

All this seems to constitute an emerging footnote to our inconclusive national debate over health care, sure to grow muddier during a presidential campaign, with the claim here that "the medical tourism industry will grow to $40 billion by 2010." That does seem head-turning. But if temporarily departing the country can really determine whether small- and mid-size employers ultimately offer insurance or no medical benefits, maybe more workers should stock up on sun block and Fodor's travel guides.

Elsewhere in this issue, it wonders, "Will Green Play in Peoria?" as it inspects aggressive moves by the city of 113,000 to move to an environmentally based economy from a heavy-manufacturing one, replete with ethanol, wind and other such industries.

Quickly: The spring issue of the Antioch Review, via Ohio's Antioch University, explores the frequently confounding choices for the world's top writing award in "The Literary Politics of the Nobel Prize," with the basic thesis that a desire for bland consensus, preference for work at least translated into English, search for efforts of an "idealist tendency" (according to Alfred Nobel's testament) and an establishment leaning explain why "only 17 of the 103 winners (16.5 percent) are now recognized as great authors while 60 percent are no longer read."

This asserts a bias against women, Asians and gays amid a craving for what at a given time is politically safe, and that as Rudyard Kipling "was the only great writer to win between 1901 and 1922,"

Seamus Heaney and V.S. Naipaul are the only great ones between 1977 and 2006. For sure, it's head-turning to be reminded that Tolstoy, Chekov, Thomas Hardy and Emil Zola didn't win, nor did the likes of Joseph Conrad, E.M. Forster, James Joyce, Robert Frost, Marcel Proust and W.H. Auden, among many others. June Atlantic Monthly includes tech maven James Fallows on computer programs able to sharpen how we think and write, such as the OneNote 2007 tool from Microsoft allowing one to file and quickly index PDFs, Web clippings, audio and video files for handy retrieval.

The most ambitious gizmo he's found is Rationale, an "argument processor" created by an Australian academic philosopher that helps to weigh decision-making via a "logic map" to analyze assumptions and competing views. ... U.S. News & World Report's cover inspects "Road Warriors," namely most of us spending way too much time in traffic and concludes that, well, there aren't many appealing fixes on the horizon.