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State governments, which tend to offer generous health-care benefits, may find those numbers appealing. A bill in the West Virginia legislature sponsored by delegate Ray Canterbury outlines incentives for the public employee health-insurance program that are similar to Blue Ridge's. Hospital administrators attending the legislative session when the bill came up for a hearing in February nearly gagged, says Canterbury: "They were not happy. But I didn't expect them to be. The point is to make them face competition."
Is the quality of care in foreign hospitals high enough? To cater to an international clientele, many private hospitals abroad are applying for accreditation (many of them successfully) from the Joint Commission International, the global arm of the institution that accredits most U.S. hospitals. Many of the tourist hospitals teem with surgeons who have trained in the U.S. or Britain, which is a great comfort to American patients (the irony is that 25% of physicians in the U.S. got their M.D.s abroad). Escorts Heart Institute and Research Center in Delhi, for instance, was founded by an authority on robotic cardiac surgery, Dr. Naresh Trehan, formerly of New York University.
Wayne Steinard, 59, a general contractor from Winter Haven, Fla., is one of those U.S. patients "who fall through the cracks" of the health-care system, as he says. Steinard landed in New Delhi last week with his daughter Beth Keigans to get a clogged artery cleared and a stent installed. Steinard, too rich for Medicaid and too poor for insurance, certainly didn't have the $60,000 he would have had to pay back home. So he contacted PlanetHospital, a Malibu, Calif., medical-tourism agency, and learned he could get it done for about a tenth as much at Max Healthcare's Devki Devi Heart & Vascular Institute.
Things have not gone as Steinard expected. When surgeon Pradeep Chandra scanned Steinard's angiogram last week, he found the artery 90% blocked. "A stent is out of the question," he told Keigans. "Your father is going to need a double bypass, and he needs it immediately." The blood drained from Keigans' face. While she loved their plush hospital suite and the staff had been superb, this was all happening too far from home. Steinard, though, was blunt about his choices. It's either this, he said, or a fatal heart attack back home. The surgery last week was successful; the hospital's bill: $6,650.
"I'm not sure I'd ever want to come back to Delhi," says Keigans, "but I'll be telling everyone I know to come here if they need surgery. It's not just the price. They've made everything so easy for us."
Yet India is a developing country, and this can shake the confidence of even the most cavalier patient. First-class hotels are in short supply. Beyond that, the country's crumbling infrastructure and shocking income disparities--children pick through the garbage outside Steinard's hospital--make medical tourism seem a tad too adventurous for many. And for the litigious minded, good luck. The country's malpractice laws limit damage awards, one of many reasons that health care in India is cheaper.