Thursday, May 28, 2009

Another Healthcare Myth Debunked

Apparently Canadians don’t, in fact, come to America for healthcare by the busload.

I’ve heard that talking point before and always suspected it was bullshit, since I only know people who do it the other way: go to Canada for their Lasik surgery, for example, because it’s far less expensive. But regardless, conservatives love to repeat the myth that Canadians are lined up to get into America for their healthcare. The message being: sure American healthcare sucks, but it sucks even worse in the land of super-scary Socialized Medicine.

I have a friend who broke her foot while visiting India a few years ago, and was able to get it x-rayed, set, and all of the follow-up care (rehab, etc.) for $15. She promply cancelled her American health insurance policy, deciding that it would be cheaper to fly to India if something went seriously wrong. “The doctors are all trained in America or England, anyway,” she reasoned.

That struck me as absolutely crazy (still does), but I remembered all of those stories about "medical tourism” that we used to hear in the media. Everyone seems to have forgotten about those stories, now that the country is debating healthcare, which I find rather curious. But regardless, it seems increasing numbers of Americans are traveling to places like India, Thailand, and Mexico for major medical procedures that would cost ten times as much here at home.

There has always been a grand assumption that folks going abroad for their healthcare are undertaking elective procedures like nose jobs and facelifts and the like. However, that’s not true, as this story from 2006 attests:
As word has spread about the high-quality care and cut-rate surgery available in such countries as India, Thailand, Singapore and Malaysia, a growing stream of uninsured and underinsured Americans are boarding planes not for the typical face-lift or tummy tuck but for discount hip replacements and sophisticated heart surgeries. Bumrungrad alone, according to CEO Curtis Schroeder, saw its stream of American patients climb to 55,000 last year, a 30% rise. Three-quarters of them flew in from the U.S.; 83% came for noncosmetic treatments. Meanwhile, India's trade in international patients is increasing at the same rate.

Medical tourism is a booming industry. According to this CNN story from March 2009, the number is expected to grow to six million next year.

Fueling this flood of medical refugees are American employers, who can no longer afford our bloated healthcare costs:

That's why three major corporations that collectively cover 240,000 lives asked Dr. Arnold Milstein, national healthcare "thought leader" at the consultancy Mercer Health & Benefits, to assess the best places to outsource elective surgeries. Procedures in Thailand and Malaysia, he found, cost only 20% to 25% as much as comparable ones in the U.S.; top-notch Indian hospitals sell such services at an even steeper discount.

The bottom line: If more private payers sent patients abroad for uncomplicated elective surgeries, the savings could be enormous. "This has the potential of doing to the U.S. health-care system what the Japanese auto industry did to American carmakers," says Princeton University healthcare economist Uwe Reinhardt.

That’s a scary thought. American car manufacturers haven’t exactly been the most forward thinking bunch.

You know, I’m looking at a future where healthcare is yet another thing Americans look to other countries to provide for us, along with our manufactured goods, our food, heck, our tech support. Other than consuming, what exactly do we plan to contribute to the global community, aside from war, mountains of debt and Hollywood blockbusters?

This is not a philosophy that will serve our country well.

Is there a reason we don’t choose to fix our healthcare system in America, instead of ceding this industry to other countries? If insurance companies, HMOs, hospitals, labs, pharmaceutical companies, etc. are going to piss and moan and whine that they can’t possibly cut costs, driving those patients who can afford it overseas and those who can’t out of the system completely, how can that be good for the industry as a whole?

This is indeed starting to look like a redux of the American car industry, which lobbied against national healthcare initiatives, higher CAFE standards, and kept manufacturing cars nobody wanted into their graves.

We simply must do better.