Medical tourism on the rise

Proponents cite lower costs, reduced wait times

By Phil Zinkewicz

Until 1858, France’s now-famous Lourdes was a quiet, modest town with a population of only some 4,000 inhabitants. Lourdes was a place people passed through on their way to the waters at Bareges, Cauterets, Luz-Saint-Sauveur and Bagneres-de-Bigorre, and for mountaineers on their way to Gavarnie, where certain events, which were to change history, took place.

According to legend, on February 11, 1858, a 14-year-old girl named Bernadette Soubirous claimed that a beautiful lady had appeared to her in the remote grotto of Massabielle. The lady is said to have identified herself as the Immaculate Conception, and the faithful in the village believed her to be the Blessed Virgin Mary. Moreover, they believed the spring waters from that grotto possessed healing powers.

The rest, as they say, is history. An estimated 200 million people have visited the shrine at Lourdes since those early years, and the Roman Catholic Church has officially recognized 67 miracle healings. There are impressive candlelight and sacramental processions, and tours from all over the world visit the Sanctuary. Bathing in the Lourdes waters to improve health is commonplace. Over the last 150 years, Lourdes has grown from a small, quiet town into a world-renowned center of healing and renewal.

In that sense, the legend of Lourdes is the precursor of today’s emerging trend toward medical tourism. An increasing number of U.S. businesses and insurance companies are outsourcing health care services to developing nations as a way to provide needed care at lower cost. Last year, roughly 500,000 U.S. residents traveled to countries such as India, Singapore and Thailand for medical treatment.

Forbes magazine reports that medical tourism is being fueled by rising health care costs in the United States and longer waiting lists for certain procedures in Canada. The magazine reports that cost savings can be as high as 90%, depending on the procedure and the country in which it is performed, and often there is virtually no wait time.

“Experts estimate there are currently 47 million uninsured U.S. residents,” says Art Seifert, president of U.S. Risk Underwriters. “Many of these underinsured will need the treatments regularly provided in foreign medical centers.

“In addition, health insurance companies are beginning to send insureds overseas for treatment,” he continues. “And many large companies carrying retentions of more than $1 million are looking to have the necessary and elective surgery that is covered in their medical insurance plan provided overseas to keep their self-funded medical costs down.”

The insurance executive says that in 2006 medical tourism generated $60 billion in revenue and noted that by 2012 that number is expected to rise to more than $100 billion.

How it works

How does medical tourism work? Says Seifert: “In the United States, medical tourism service providers will conduct a patient pre-evaluation for a small fee, say $200. They will collect medical data and have a U.S. board-certified physician review the data. A recommendation is then made for treatment abroad, and a price for the procedure is quoted. If the patient decides to move forward, a nonrefundable 10% of the cost of the medical procedure is collected. Full payment for the procedure and travel is collected before the client departs.”

Included in the package are booked roundtrip airfare, recuperative accommodations, special 24-hour concierge service in the host country, private air-conditioned transportation, passport and visa assistance, and a mobile phone for the patient’s use.

Insurance companies are striking deals with global health networks to provide the medical tourism option to their insureds. Recently BasicPlus Health Insurance of Roswell, Georgia, announced that it has entered into an agreement with Companion Global Healthcare Inc. of Columbia, South Carolina, to include a network of accredited overseas hospitals in its most popular limited benefit health insurance plans.

The agreement means that those enrolled in BasicPlus’s FlexMed (for employers) and BasicPlus (for individuals) limited benefit plans have the option of seeking surgery and other covered services at hospitals in Companion Global Healthcare’s network. All of the network’s hospitals hold the prestigious Joint Commission International (JCI) accreditation, and all offer a range of services at rates lower than those typically charged in the United States.

FlexMed and BasicPlus members treated overseas will receive Companion Global Healthcare’s concierge medical travel services, including assistance with scheduling appointments and arranging travel.

Chuck Green, CEO of BasicPlus, says, “Since our members have fixed benefit maximums, the inclusion of Companion Global Healthcare’s option in our products allows members to limit their out-of-pocket payments while availing themselves of JCI-accredited hospitals in foreign locations.”

“To our knowledge, this is the first fully insured, limited benefit product with a global health care benefit included,” says Robert Rhodes, chief operating officer of TCC of South Carolina, the third-party administrator that supports the BasicPlus product line. “This arrangement will help FlexMed and BasicPlus members dramatically stretch their limited benefit plans dollars.”

Companion Global Healthcare President David Boucher says his company’s network of overseas hospitals is a helpful addition for limited benefit plans.

“While many limited benefit plans provide coverage for basic health care, most would cover only a small portion of the bill for a lengthy inpatient hospital stay in the United States,” Boucher says. “Treatment at a JCI-accredited hospital overseas will be an attractive, more affordable option for many policyholders.”

Companion Global Healthcare Inc. provides streamlined access to JCI-accredited hospitals for those who elect to travel abroad for health care. The company provides a single launch point for appointments, travel services, case management and follow-up care in the United States.

All BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina members have access to Companion Global Healthcare’s network hospitals at discounted rates for services not covered by their plans. Companion Global Healthcare also serves uninsured individuals, and it contracts with insurance companies and employer groups that wish to include an overseas option in their benefit plans. Companion Global Healthcare is a separate company that does not offer BlueCross BlueShield of South Carolina or BlueChoice HealthPlan products.

Seifert says that the new trend toward medical tourism is not without challenges so far as the liability insurance industry is concerned.

“Because medical tourism service providers are responsible for the overall customer experience, it is likely they will be drawn into lawsuits for everything from missing luggage to medical malpractice,”says Seifert. “The insurance industry will have to develop a suite of products in order to meet the needs of this dynamic industry. Having medical services provided in a foreign country creates unique exposures. For example, what happens if a medical complication develops when the client returns to the U.S.? Who treats the complication?

“Many doctors do not want to be involved in post-op complications in cases where they did not perform the surgery,” Seifert continues. “More important, who pays for the medical treatment? The insurance industry will need to develop coverage for this type of incident to help medical tourism grow,” he concludes.

U.S. Risk Underwriters recently launched a professional liability product for the medical tourism industry called MedTour Pro. The product covers medical tourism professionals for damages caused by any actual or alleged negligent act, error or omission. The company is planning to launch additional products for this industry. *