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From todays USA Today.............


http://www.usatoday.com/money/industries/health/2006-07-26-travel-surgery-usat_x.htm


Sending patients packing
Updated 7/27/2006 11:46 AM ET E-mail | Save | Print | Reprints & Permissions | Subscribe to stories like this





By Julie Appleby and Julie Schmit, USA TODAY
Would you travel to India for a cut-rate heart bypass? How about Thailand for a hip replacement? Some uninsured and those with skimpy insurance have taken the risk, leading to what promoters say is a growing trade in "medical tourism."
Now, companies that help arrange such travel are eying a far bigger market: U.S. employers who want to save money on their health care costs.

The appeal is obvious: Heart surgeries and hip replacements in such countries as India, Thailand and Mexico can be had for less than one-third the cost in the USA.

At the same time, medical costs in the USA are rising rapidly, with no end in sight.

"Companies have reached that point of being pinned to the wall faster than we thought," says Rajesh Rao, CEO of IndUShealth, which helps arrange travel and medical care abroad.

Don't look for major health insurers to offer such a plan nationally yet. But several small companies that arrange medical travel have recently launched programs aimed at employers, and one Florida health plan administrator has one, too:

• Florida's United Group Programs, which offers administrative services to self-insured employers, has begun promoting surgeries in a Thailand hospital as an option for its employer clients.

• West Virginia Republican state legislator Ray Canterbury introduced a bill this year to allow state employees to fly first class to hospitals abroad, with a family member or friend, stay at a four-star hotel to recuperate and get extra sick days and cash bonuses that, in some instances, could total several thousand dollars.

• Insurers Health Net and Blue Shield of California each offer policies that allow holders to get most of their care in Mexico, but include access to some services in Southern California as well. Blue Shield's plan is sold to individuals, while Health Net sells to both individuals and employers.

Trend predicted to take off

While few employers have signed on to the idea of medical tourism yet, some benefit consultants think the trend will soon take off.

"This is going to spread much more widely," says Arnold Milstein, chief physician at consulting firm Mercer Health & Benefits, who says he's been hired by three Fortune 500 companies to assess the feasibility of outsourcing non-urgent major surgeries for their self-insured health benefit plans.

Medical tour arranger MedRetreat, which has a staff of nine split between Chicago and Baltimore offices, says it works mainly with individuals, but it will launch a division next year to promote foreign care to employers. So far, the company doesn't have competition from major health insurers, says managing director Patrick Marsek.

"They're not quite keen on sending clients overseas yet," possibly because such programs could upset the U.S. hospitals the insurers currently use, Marsek says.

Some employers may be cautious

Not everyone is convinced that employers will embrace medical care abroad for their workers. Regulatory hurdles, not to mention questions about safety and liability, may scare off employers.

"Employers will be very cautious about this," says Mike Taylor, a principal at benefits firm Towers Perrin. "Smaller employers will try it. The big employers will wait."

While about 100 hospitals abroad are currently accredited by an affiliate of the same company that checks American hospitals, not all of the hospitals used by tour companies are. And even accreditation doesn't mean that things can't go wrong. Training for doctors in other countries may be quite different from training in the USA, although some of the hospitals say they have U.S.-trained surgeons.

While prices are lower abroad, Milstein cautions that consumers should not think that quality is superior to American care.

"With the overseas sites, the pitch would be not superior quality, but equal quality and accreditation," Milstein says.

Employers focus on bottom line

For employers, the big draw is the savings.

Promoters of medical tourism contend that the option to go abroad may help cure one of the most difficult problems in America: how to provide quality medical care at an affordable price.

"This is hard-dollar savings," says Jonathan Edelheit, vice president of sales for United Group Programs, which offers a plan to self-insured employers that includes services at Bumrungrad Hospital in Bangkok, Thailand. "If we send someone there for a bypass, the employer saves $60,000 to $70,000. We would consider this a magic bullet."

Darrell Douglas, vice president of human resources at Blue Ridge Paper in Canton, N.C., says health care costs are driving his company to consider a foreign option.

The 2,100-employee paper-products manufacturer is partly union-owned and has already taken big steps to cut its health care costs, including on-site pharmacy, medical clinic and wellness programs. Even with a 3% drop in medical costs last year, the company is spending about $20 million a year on health care for workers and dependents.

After seeing a television program on medical tourism, the company's benefits director began talking with IndUShealth. After the monsoon season ends in India, Blue Ridge will send a team to check out hospitals to see if employees could have surgeries done there.

"If it's all it's cracked up to be, we'll probably advertise it as an option," says Douglas.

Countries eager to welcome travelers

The growing interest has caught the attention of countries such as India, South Africa, Thailand, Mexico and Taiwan. Many are eagerly welcoming travelers, promoting fancy hotels for recuperation and spending billions to spiff up facilities for visitors. The Confederation of Indian Industry says that medical tourism in India alone is a $300 million business and could grow to $2 billion by 2012.

"What we're doing is introducing global competition to the American medical profession," Douglas says. "If employers start sending a few patients abroad to get high-quality health care at reasonable prices, it's got to have impact."

But some economists, such as Uwe Reinhardt of Princeton University, says it may not grow large enough to make an impact.

Still, the self-insured paper company expects it would save money even if only a few workers went to India, even with the company paying the airfare for the worker and a companion. It may even share some of the savings, possibly up to $10,000, with those who choose to go.

Such incentives may be necessary, says Milstein, who surveyed consumers to see how much of a financial push they would need.

"For small incentives, Americans are not going to get on a plane and fly to a strange country and interact with a physician they don't know," he says. "The incentives will need to be in the $5,000 to $10,000 range, plus travel and hotel for the employee and spouse."

But caution is needed with incentives, as well, says Taylor at Perrin. "If you're not careful, it isn't voluntary: The incentives are so strong that you force people over there," he says.