I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new.
Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website you can see that their wealthy patients speak Arabic or come from Latin America. These healthcare services have a long tradition of client-oriented work because they work for private clients that pay for their treatment (sometimes the client is not the patient himself but his family). The important thing was never the price, but the patient.
The passage of time and the economic and political trends have caused changes that were previously unthinkable. Rising costs in American healthcare system (as seen in the infographics), expensive insurance premiums and restrictive public health policy all lead to a pool of uninsured people. When faced with an unavoidable healthcare expense, they choose foreign countries that offer a good value for their money. Quality is guaranteed by MDs educated in the US or in Commonwealth nations and facilities with well established quality credentials, even some that many services in the USA don’t have, like the Joint Comission International. Affordable prices come from a lower cost of staff, which allows them to offer five-star treatment for the price of a two or three-star one.
Wikipedia refers to a McKinsey 2008 survey that estimated that more than 750,000 Americans traveled to another country that year looking for good healthcare at Bargain Basement prices. This trend gave birth to a new industry in the USA commited to attract this kind of client from all over the world. A sign of this has been the recent celebration of European Medical Tourism Conference in Barcelona. But at the end of the day, there were “a lot of sellers and very few buyers”, in the words of some of the attendants. Nevertheless, some of those buyers made a fortune thanks to an exclusive product.
As stated in one of the most controversial presentations, only a few ‘medical facilitators’ (the middlemen of this industry) manage more than 50 cases per year. Hence, traveling patients are not that common. It became clear to all of us in the audience that American patients will probably move to cheaper and relatively close destinations such as Latin America or South-East Asia, very competitively-priced. But there is now a widespread dream of opulence, a medical gold rush.
Every region is looking for its own wealthy patients, confident that their quality and resources will be appealing for them. Some countries do attract those clients: nations bordering Germany provided dental treatments for Germans; Maghreb provided plastic surgery to French patients. Other nations are seeking those opportunities, with varying degrees of success.
The most desired medical tourism in Europe is the one that comes from Russia or Arab countries, with a great purchasing power and very specific language and cultural needs. But these patients are scarce and scattered and tend to end up in Germany.
Another unresolved matter is the attempt of finding the right regulation for patient traffic among public healthcare systems in Europe.
The actors that could turn the expectation in real business and become their bigger clients are American insurance companies, which are very cost-conscious firms. But with some exception they do not make use of these services. They either don’t trust them, didn’t find the right way to implement it or fear the backlash by US healthcare providers.
* This post was originally published in Spanish at Una de médicos *
*This blog post was originally published at Diario Medico*