Health Care Abroad Saves
Cash, Worries Critics
The Associated Press
A trip to Costa Rica did wonders for Sheila Liner’s smile. The sun
and sightseeing had little to do with the improvements.
Liner spent years suffering from piecemeal dental work that led to
sinus infections and a swollen face. But she didn’t have the money —
an estimated $14,000 after insurance — for the nine crowns, three
root canals, deep cleaning and partial dentures she ultimately
needed.
At her boss’ suggestion, the 49-year-old customer service
representative from West Columbia got in touch with a subsidiary of
her insurance company and traveled to Costa Rica, where the work
cost her $3,600 out-of-pocket. Even after spending $1,700 on the
nine-day trip, including hotel, meals and sightseeing, she still
came out $9,000 ahead.
The research firm Deloitte Center for Health Solutions reported that
750,000 Americans traveled abroad in 2007 for some form of medical
care. Deloitte analysts estimated that number could increase to 6
million next year and projects the number will continue increasing.
Other experts say the trend is growing, but perhaps not as rapidly.
The draw for patients seeking dental work, surgery and joint
replacements are the discount prices for those who have
high-deductible insurance plans, make flat-rate payments, like
Liner, or have no coverage at all.
Self-insured companies, which often pay a percentage of workers’
medical bills, also can see a savings.
The Deloitte report also said more people are traveling for care
because of the perception of improved quality at overseas hospitals
accredited by the Joint Commission International, which also
inspects U.S. hospitals.
But critics raise worries that trips to hospitals in India, Mexico,
Thailand and Turkey can be problematic because of language barriers,
an inability to return for follow-up care and a lack of ability to
sue if something goes wrong.
Companion Global Healthcare Inc., the subsidiary of Blue Cross and
Blue Shield of South Carolina that helped Liner arrange her dental
care, reviews hospitals in its network to see whether “we would
ourselves feel comfortable in actually having a surgical procedure”
there, said company president David Boucher.
The subsidiary has contracts with three companies that provide their
own insurance for employees and with BasicPlus Health Insurance of
Roswell, Ga., a company offering the travel services to the 135
businesses to which it sells insurance.
Companion, which is one of several companies offering the services
around the nation, can also be used by people insured by Blue Cross
and Blue Shield.
So far, seven people have actually used Companion Global
Healthcare’s service, but it’s not hard to see why the numbers are
expected to increase.
Companion Global statistics say the average charge for a heart valve
replacement in the southeastern U.S. is $177,000. That procedure can
cost as little as $9,500 at one of the company’s network of 13
international hospitals.
The Deloitte report showed similar savings for other procedures,
including knee surgery, which can cost almost $12,000 as an
inpatient procedure in a U.S. hospital compared with $1,400 abroad —
a tally of the average of the three lowest foreign prices, including
travel costs.
Rick Wade, senior vice president of the American Hospital
Association, said his organization has not taken a position on
travel overseas for medical care. Some of the organization’s U.S.
members, including prominent teaching hospitals such as Johns
Hopkins and Duke, are partnering with international facilities and
many of the doctors in those hospitals were trained in the U.S.
Still, Wade said, patients should check with their local doctors
before seeking treatment overseas.
“Some doctors don’t want to handle follow-up care from a physician
they don’t know or a hospital they don’t know,” he said.
The biggest worry about traveling abroad for treatment is something
going wrong, either while a patient is in another country or if
complications develop later.
Arthur Caplan, professor of bioethics at the University of
Pennsylvania, said there is no dependable list of foreign hospitals
or doctors that operate at U.S. standards and people are left to
depend on the advice of insurance companies or others with an
interest in keeping costs low.
“We’ve got sort of shopping going on by middlemen who are really
watching the bottom line, so that bothers me in terms of being able
to ensure quality,” Caplan said. |
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