by Johannah Cornblatt
This February, a 26-year-old Californian woman and her mother boarded a Continental flight for Costa Rica. When they arrived at the Sán Jose International Airport, a driver in a white van picked them up and took them to the five-star Intercontinental hotel. But the woman (who asked only to be identified by her first name, Jessica) hadn’t traveled to the city known as the Big Pineapple only to relax by the pool. She had flown more than 2,500 miles to undergo a weight-loss surgery—for a fraction of the price back at home.
Including airfare and accommodations (for her and her mom), Jessica saved $7,500 by choosing to go under the knife in Sán Jose instead of San Diego. “I thought it was such a good deal,” says Jessica, who needed to lose weight for medical reasons.
Jessica is what’s known as a “medical tourist,” and she’s one of an increasing number of Americans now seeking health care abroad for financial reasons. A new survey funded by Your Surgery Abroad, an online directory of medical tourism, found that more than 60 percent of Americans are willing to leave the country for cheaper medical services. “As people’s budgets in America are getting tighter, they’re much more inclined to start thinking about going abroad to save money,” says Adam Nethersole, the managing director of Your Surgery Abroad.
Wealthy patients have always crossed international borders (even the Nomads took trips to health spas), but the decreasing cost of travel has encouraged Americans of more moderate means to whip out their passports for medical procedures. And while more elective procedures like rhinoplasty and face-lifts used to attract consumers to exotic lands, a growing number of Americans are now traveling abroad for essential procedures like cardiology and cancer treatments.
Medical tourists from the U.K. and other European countries with national health-care services go abroad because of the long waiting lines for procedures. But in the U.S., Nethersole says, patients choose to go travel because surgery is cheaper in other countries. For example, the average cost of heart surgery is $50,000 in the U.S., versus $10,000 to $20,000 in other countries, according to Dr. Ron Johnson, the chief medical officer of Satori World Medical, a global health-care company specializing in medical tourism. But for less expensive procedures like colonoscopies, which run around $2,500 a pop in the U.S., it doesn’t make sense for Americans to travel, given the additional money they would need to spend on airfare and hotels, Johnson says.
The most popular surgery by far is dental, says Nethersole, an experienced medical tourist who travels 1,500 miles from London to Barcelona to see his “local” dentist. “If you’re going away for a basic crown or teeth whitening, that’s very simple and easy,” he says. “It’s not seen as something that is very stressful or risky.” The second most popular procedure is laser eye surgery, which, like dental care, is often not covered by insurance.
More than 20 percent of Americans surveyed by Your Surgery Abroad had no medical insurance. But Karen Timmons, president and CEO of Joint Commission International, a nonprofit that has accredited more than 250 hospitals in 36 countries, says that Americans who are underinsured are more likely to go abroad for surgery than those who are not insured at all. That’s because insurance companies will typically cover some portion of the cost for underinsured patients while uninsured patients, who also tend to make less money, have a harder time coming up with enough cash to cover the procedure, the flights, and a hotel room on their own, Timmons says.
Of course, there are some risks involved in country hopping for medical care. Dr. T. Forcht Dagi, co-chair of the American College of Surgeons Committee on Perioperative Care, says that Americans should not confuse cost with value. Prospective American medical tourists should know that standards of accreditation and guidelines for informed consent differ in other countries, he says. Dagi also advises patients to consider the potential language barriers and cultural gaps. For instance, many women in other parts of the world do not work, he says. “If the physician doesn’t realize how important it is for a woman who has a career to be empowered to return to it—or if there is condescension—that really changes the recovery and the attitude towards medicine and treatment,” he says.
Problems can also arise when foreign surgeons use devices that haven’t been approved in the U.S. A medical tourist might get a “perfectly good” implant abroad, Dagi says, but if there is a problem once the patient returns home, American physicians might not know how to help. In general, patients should think about follow-up care before they cross borders, Dagi adds. “Find out what your responsibility will be in the U.S. afterwards,” he says. “Who is going to take care of a complication if, God forbid, there is one?”
Then there’s the fact that many patients would like to stay in familiar surroundings with loved ones. “Most people like to go to a local hospital where their friends and family are supportive,” Timmons says. “It’s very difficult to get on a plane and travel to another country when you’re most vulnerable.”
For that reason, many medical tourists like to travel to countries to which they have a cultural affinity, according to Steve Lash, president & CEO of Satori World Medical. Among Hispanic Americans, for example, Spanish-speaking countries rank as top destinations. “They feel they will be treated better,” Lash says. Surveyors have seen similar preferences among Indian and Filipino populations, who travel to Asian countries, as well as among Jewish Americans, who travel to Israeli hospitals. On the whole, Americans tend to prefer close destinations like Canada, Mexico, and Costa Rica (in that order). Other hot spots include Thailand, India, and Singapore, Nethersole says.
Will American interest in medical tourism dwindle if national health care becomes a reality in this country? Nethersole doesn’t think so. “There are always going to be people who need surgeries, and flights are getting cheaper,” he says. “Everything is pointing to the fact that more and more people will go abroad for treatment.”
Would you fly across the ocean or cross the border to save cash on a root canal? If you're going abroad on vacation anyway, would you consider adding an extra day to get that hernia repaired? Have you gone abroad for surgery? Share your stories below.