izzygoer

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came across this article in business week last month. it's one thing when plastics head overseas but what happens when every day bread and butter cases start heading there.

this is becoming reality especially when insurers start recommending it. frankly i dont know how it is legal for an insurer to tell an american who has paid premiums to head overseas for elective surgery. but it is illegal to order cheaper drugs from these countries.

http://www.businessweek.com/magazine/content/08_12/b4076036777780.htm?chan=rss_topStories_ssi_5

"
Outsourcing the Patients

More U.S. health insurers are slashing costs by sending policyholders overseas for pricey procedures

by Bruce Einhorn
For years, Americans have been traveling abroad to save money on elective procedures or dental work. David Boucher, 49, doesn't fit the usual profile for such medical tourists. An assistant vice-president of health-care services at Blue Cross & Blue Shield of South Carolina, he has ample health benefits. But Boucher recently chose to have a colonoscopy at Bumrungrad International Hospital in Bangkok, mainly to make a point about the expanding options available to Blue Cross customers. And his company happily picked up the $640 tab—a bargain by U.S. standards.

Blue Cross and other insurers would like to see more policyholders traveling abroad for medical care. Since the start of the year, Boucher has signed alliances with seven overseas hospitals and hopes to add five more by yearend, including them all in coverage for his company's 1.5 million members. As health-care costs continue to rise in the U.S., "medical travel is going to be part of the solution," he says.

Yes, just like manufacturing facilities and call centers, health care is moving offshore. "All of the largest U.S. insurers are starting to educate themselves or are putting [offshore] programs in place," says Jonathan Edelheit, president of the Medical Tourism Assn., an industry group formed just last year. Companies that self-insure are also bombarding Edelheit's group with requests for information.

Getting covered employees to leave the U.S. won't be that hard, says Edelheit. An insurance company could waive all deductibles and co-pays, offer to cover travel costs for the patient and family members, even throw in a cash incentive, and still save tens of thousands of dollars. After all, a heart procedure that costs $100,000 in the U.S. runs only $10,000 to $20,000 at some of the best private hospitals in Asia. And the quality of care? Foreign hospitals in such arrangements are typically approved by Joint Commission International, part of the same nonprofit organization that accredits American hospitals.

Blue Cross took the lead in medical offshoring when its Companion Global Healthcare subsidiary formed its first partnership, with Bumrungrad Hospital, in February. Since then, Companion Global Healthcare has signed similar pacts with the Parkway Group Healthcare, owner of three hospitals in Singapore, and with hospitals in Turkey, Ireland, and Costa Rica. Three members of India's Apollo Hospitals Group are also joining the network. And another large Indian chain, Wockhardt Hospitals, is talking with U.S. insurers as well. "Americans haven't come to grips with having their heart surgery in Thailand," says Curtis Schroeder, the American CEO of Bumrungrad. "But that will change."

The shift is sure to leave some policyholders disgruntled, of course. Offering international coverage might make it easier for employers to limit benefits at home, for instance, by raising the deductibles on U.S.-based procedures. It's also extremely difficult for patients to sue for malpractice in most Asian countries. Bumrungrad has offices for marketing and promotion in 20 countries, but not the U.S.—in part because having a U.S. office would open the door to potential liability, hospital officials say. So it will take a while for the trickle of insured U.S. patients in Asia to become a torrent. But over time, for policyholders and payers alike, the price may be hard to resist."
 

jwk

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Somehow by the time you add in airfare, hotel costs, food, etc., I'll bet you're not saving a dime. And very few insurance companies pay "retail" for hospital and physician costs. With my recent outpatient GI procedure, Aetna's discounted payment to the hospital was 50%, and the GI doc doing the procedure got less than 25% of her standard charge.
 

sallyjoe

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Somehow by the time you add in airfare, hotel costs, food, etc., I'll bet you're not saving a dime. And very few insurance companies pay "retail" for hospital and physician costs. With my recent outpatient GI procedure, Aetna's discounted payment to the hospital was 50%, and the GI doc doing the procedure got less than 25% of her standard charge.
On major procedures like the article mentions health plans will save plenty of money to pay for airfare and travel expenses. If you can save 80,000, you can afford to cover airfare to almost anywhere. I had seen where health plans will pay for a week of vacation in order to encourage their clients to have major surgery done in the third world.
 

ZigmaSudo

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On major procedures like the article mentions health plans will save plenty of money to pay for airfare and travel expenses. If you can save 80,000, you can afford to cover airfare to almost anywhere. I had seen where health plans will pay for a week of vacation in order to encourage their clients to have major surgery done in the third world.
Yes, on major procedures, you can save plenty of money if you use medical tourism. How much you save will depend on the country you choose to have your procedure in. India is cheaper than Turkey or Mexico, for instance.

An uncle of mine had his cardiac bypass in India. He didn't have any insurance so he had to pay everything out of his pocket. But he told us that the company he used for making arrangements got him a 90% discount even after paying for travel, lodging and food for himself and his son. I think they used http://www.healthbase.com.
 

jwk

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On major procedures like the article mentions health plans will save plenty of money to pay for airfare and travel expenses. If you can save 80,000, you can afford to cover airfare to almost anywhere. I had seen where health plans will pay for a week of vacation in order to encourage their clients to have major surgery done in the third world.
I was speaking mainly to the example from the OP about a colonoscopy.

So tell me - whom will these patients see for post op complications once they're back in the US?
 

sallyjoe

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I was speaking mainly to the example from the OP about a colonoscopy.

So tell me - whom will these patients see for post op complications once they're back in the US?
From
http://www.annfammed.org/cgi/eletters/3/2/122

"Currently, the total cost for colonoscopy performed in our hospital GI lab runs between $2500-$3500. Consider a couple with no insurance. You are asking them to pay $5,000 - $7,000 for screening. Is this reasonable?"

If you were faced with paying $3500 in the USA or shelling out $640 if you can find a cheap ticket to Bangkok you could easily find the funds to cover the cost of a trip to Bangkok. For $2960, I could easily cover the cost of a trip to Bangkok plus have extra cash to stay a nice hotel. Even on a minor procedure like a colonoscopy there is enough saving to make an overseas junket cost effective.
 

jwk

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From
http://www.annfammed.org/cgi/eletters/3/2/122

“Currently, the total cost for colonoscopy performed in our hospital GI lab runs between $2500-$3500. Consider a couple with no insurance. You are asking them to pay $5,000 - $7,000 for screening. Is this reasonable?”

If you were faced with paying $7,000 in the USA or shelling out $640 if you can find a cheap ticket to Bangkok you could easily find the funds to cover the cost of a trip to Bangkok. For $6000 I could easily cover the cost of a trip to Bangkok plus have extra cash to stay a nice hotel. Even on a minor procedure like a colonoscopy there is enough saving to make an overseas junket cost effective.
Well, that's two patients, not one, so everything is doubled. How much is a cheap ticket to Bangkok? $2000 maybe?

And what happens if they find something?
 

TaiShan

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I can see that it might interest people without insurance. For the insured ones, I really do not think most people want to be operated in another country so that their insurance company can save money.
 

sallyjoe

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I can see that it might interest people without insurance. For the insured ones, I really do not think most people want to be operated in another country so that their insurance company can save money.
Insurance company probably will not start forcing you to go overseas any time soon but, for major operations. They many start offering choices like, free airfare and two weeks of paid recover time at a five star beach resort near the third world hospital if you have your operation there. That would be a powerful incentive to many patients, plus even with the cost of the resort and airfare they will be saving lots of money.
 

Winged Scapula

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Well, that's two patients, not one, so everything is doubled. How much is a cheap ticket to Bangkok? $2000 maybe?

And what happens if they find something?
Business class might run you that much.

But as someone who has traveled to Thailand a couple of times, you can get a coach class ticket from the west coast for much much less, usually in the $700-$900 range, if you time it right. You can sometimes find it from NYC for the same.