In the world of medicine, there are two trains headed toward each other with increasing speed. The first is the growing number of treatments available to prolong life. The second is the growing cost associated with such treatments. At the collision point, we face a difficult question: How much is another day with Grandma worth? Of course, the answer can change dramatically when you are Grandma (or Grandpa).
In some ways, the point is moot. In general, Grandma’s treatment options are limited to what her insurance will cover. And yet, our natural desire to stay above the sod at nearly any cost is why roughly half of all personal bankruptcy filings are due to medical problems, either from the cost of care or the loss of income due to illness. Damn the cost, I want to live!
Which seems pretty reasonable to me. I’m a long way from being tired of living, and the choice between bankruptcy and death seems pretty easy.
As with so many other things, the Internet has a role to play in this conflict. As you might expect, a heart bypass in San Francisco costs significantly more than a heart bypass in Bangalore. This fact has led to the creation of a whole new industry, called “medical tourism” (or, more euphemistically, “global health care”). A patient flies to another country, has a procedure done by an English-speaking doctor in a modern hospital setting, recuperates in a five-star hotel next door and returns home.
Potential clients include those seeking elective treatments, such as plastic surgery, cosmetic dentistry, eye surgery or weight-loss procedures, as well as those who are un- or under-insured for non-elective procedures. And, for reasons of their own, some people are simply looking to keep their medical treatment under the radar of employers and others.
Expedia and its Web-based ilk brought us self-service travel, now we’re facing self-service medical care, of which medical tourism is just one aspect. What this really comes down to is that information technology (specifically, Google and the Internet) makes it possible for motivated consumers to investigate the full range of treatment options available.
This level of information can force consumers to think carefully about what’s important. Obviously, people want a successful outcome, but what, exactly, is that? How much experience is enough for a doctor? Does accreditation mean anything? And how does price factor into the equation?
On the downside of medical tourism, there are important issues an uninformed consumer may overlook. What happens when you need follow-up care (routine or not)? Does the foreign facility have the same standards for, say, blood screening as a U.S.-based hospital? What legal rights do you have if something goes wrong? (One reason offshore medical services are less expensive is that offshore providers don’t have to contend with expensive malpractice insurance and litigious consumers.)
The danger, of course, is that consumers will shop on price alone. I hate hearing those radio commercials that tout low-priced laser eye surgery. If someone is taking a laser to my irreplaceable eyeballs, I’m not interested in saving $100. But there are those who’ll be influenced by the commercial and the price. Why don’t we, as Internet-enabled consumers, have more information about the outcomes from various providers? Sure, every case is different, but I want to pick a provider on the upper half of the bell curve. What I really want, and I think the Internet will soon deliver, is a listing of every doctor who does the procedure in which I’m interested, that I can filter by experience, outcomes and total cost (including travel and support services).
In a global health care environment, the number of options available to a consumer who needs a heart bypass or a hip replacement is overwhelming. As a result, facilitators have sprung up who will vouch for the expertise of a provider and make all the arrangements for travel, recovery and outright vacationing. Think of them as health care travel agents or medical concierges.
Given that state-of-the-art medical technology is expensive, it behooves hospitals and medical groups in other countries to increase the use of expensive resources by actively marketing themselves to facilitators, health insurance companies and U.S. based employers and health care providers. This need, in turn, provides an opportunity for someone to bring all the parties together—and charge for it.
The first World Medical Tourism and Global Health Congress took place in San Francisco for four days during September (see www.medicaltourismcongress.com). Looking at the list of platinum, gold, silver and bronze sponsors is fascinating. You see countries like Korea, the Phillipines, India, Costa Rica, Guatelmala, Italy, Spain, Mexico and even Vietnam all promoting themselves as medical tourist destinations. Even the accounting/consulting firm, Deloitte, was on hand with a 16-page glossy brochure full of graphs and text detailing the state of medical tourism.
At the same time, the weak U.S. dollar makes us a potential medical tourism destination for visitors from first world countries in Asia and Europe. Given the desirability of the North Bay as a tourist destination, can medical tourism in the Wine Country be far behind? Fly in to Charles Schulz Airport, have your surgery at Memorial Hospital, recuperate at The Vintners Inn, and then enjoy a week in Sonoma and Napa to finish your stay. The opportunity for North Bay doctors and hospitals to market themselves to a well-heeled global clientele is just waiting for someone to take the next step.
Regardless of the opportunity for health care providers to find new clients, Web-based information technology offers you, me and Grandma the tantalizing prospect of getting the very best doctor in the world—or, at the very least, the best health care we can afford, regardless of where it’s found.
