Earlier this month, the insurance company WellPoint announced a program that will allow employees of a Wisconsin printing company to get coverage for non-emergency surgeries in India. It's a first for WellPoint, but puts the insurer in good company. Over the past few years, some U.S. insurance companies dismayed at losing income from uninsured Americans who get cheap surergies abroad or clients who choose to pay out of pocket for discount foreign surgeries rather than expensive in-network co-pays have announced plans to include foreign medical procedures among those covered by health plans.
It's no wonder. The medical tourism industry has experienced massive growth over the past decade. Experts in the field say as many as 150,000 U.S. citizens underwent medical treatment abroad in 2006 the majority in Asia and Latin America. That number grew to an estimated 750,000 in 2007 and could reach as high as 6 million by 2010. Patients are packing suitcases and boarding planes for everything from face lifts to heart bypasses to fertility treatments. (See The Year in Health, from A to Z.)
People have been traveling for centuries in the name of health, from ancient Greeks and Egyptians who flocked to hot springs and baths, to 18th and 19th century Europeans and Americans who journeyed to spas and remote retreats hoping to cure ailments like tuberculosis. But surgery abroad is a fairly modern phenomenon. As health costs rose in the 1980s and 1990s, patients looking for affordable options started considering their options offshore. So-called "tooth tourism" grew quickly, with Americans traveling to Central American countries like Costa Rica for dental bridges and caps not covered by their insurance. (A large percentage of today's medical tourism is for dental work, as much as 40% by some estimates.)
Many U.S. doctors and dentists were appalled at the idea of their patients turning to foreign hospitals for care that they considered dangerously cheap. But where many U.S. medical professionals saw great peril, countries like Cuba saw opportunities. Beginning in the late 1980s, the island country started programs to lure foreigners from India, Latin America and Europe for eye surgeries, heart procedures and cosmetic procedures. The Cuban government said it welcomed 2,000 medical tourists in 1990. (See pictures from an X-Ray studio.)
After Thailand's currency collapsed in 1997, the government directed its tourism officials to market the country as a hot destination for plastic surgery, hoping to boost revenues. Thailand quickly became the go-to country for comparatively inexpensive sex-change operations, where patients faced fees as low as $5,000, as well as looser requirements for pre-surgery psychological counseling. Thailand is now a destination spot for all types of plastic surgery as well as a host of routine medical procedures. Bumrungrad International Hospital in Bangkok is probably Thailand's best-known mecca for medical tourists, boasting patients from "over 190 countries" and an "International Patient Center" with interpreters and an airline ticket counter.
In recent years, companies all over the U.S. have sprung up to guide Americans through the insurance and logistical hurdles of surgery abroad, including many in U.S. border states affiliated with medical facilities in Mexico. The physician-managed MedToGo in Tempe, Arizona, founded in 2000, says its clients save "up to 75% on medical care" by getting it in Mexico. The Christua Muguerza hospital system located in Mexico, but run by U.S.-based Christian hospital group since 2001 includes a scrolling text box on its web site informing visitors how "very close to you" its Mexican facilities are. ("from Houston 1 hr 37 mins!" "from Chicago 3hrs 15 mins!") Meanwhile, New Zealand is trumpeting its expertise in hip and knee replacements and South Korea is enticing medical travelers with high-end non-medical amenities like golf.
For those who wrinkle their noses at the thought of going under the knife in a foreign, let alone still-developing, country, the American Medical Association introduced a set of guidelines in June for medical tourism. The AMA advocates that insurance companies, employers and others involved in the medical tourism field provide proper follow-up care, tell patients of their rights and legal recourse, use only accredited facilities, and inform patients of "the potential risks of combining surgical procedures with long flights and vacation activities," among other recommendations. Joint Commission International, a non-profit that certifies the safety and record of hospitals, has accredited some 200 foreign medical facilities, many in Spain, Brazil, Saudi Arabia, Turkey and the United Arab Emirates.