Cope Cod Times

By PHIL MATTINGLY

CONTRIBUTING WRITER

December 20, 2007

WASHINGTON - Once considered a fad for the wealthy or a calculated risk for the poor, the option of traveling overseas for medical procedures has hit the mainstream.

With more than 150,000 Americans traveling out of the country for medical procedures and an estimated $20 billion in profits in 2006, the medical tourism industry has long since passed fad status, according to Josef Woodman, author of "Patients Beyond Borders," a guidebook for those considering medical travel.

Woodman was one of the featured speakers at the International Medical Tourism Conference, sponsored by Consumer Health World (a medical conference management company), in early December in suburban Washington, D.C., that attracted people from all over the world.

Doctors, CEOs and government officials roamed the halls, and a host of men and women in power suits streamed out of a meeting room, all speaking Spanish, as representatives from several South American countries joined doctors and hospital managers from India, Singapore and Thailand at the hotel in Arlington, Va..

Many of the foreign visitors had booths in the downstairs exhibition area, set up to demonstrate the medical capabilities available in their respective countries.

"The overwhelming reason people go overseas is cost," said Woodman, who estimates savings between 25 and 75 percent on procedures done outside the United States. One of the featured speakers at the conference was Dr.

Robert Crone, who until recently served as dean for international programs at Harvard Medical School. Crone, who played an integral role in setting up viable regional hospital facilities throughout the world, doesn't just support medical tourism. In the case of some elective procedures, he recommends the idea.

"Frankly, the U.S. loses when it comes to cost," Crone said. "It's going to cost you 10 percent less to get your heart fixed in Mumbai compared to what it will cost you in the U.S. If you could have the same level of quality and a very substantial decrease in cost, why not go to India?"

The difference in cost of a knee replacement between an Indian hospital and the average American hospital is $41,000, according to estimates by Wockhardt Hospitals, based in Mumbai, India, and associated with Harvard Medical International. That difference in cost jumps to between $50,000 and $70,000 for open-heart surgery.

The business plan is not foolproof, though, and a number of roadblocks still lie in the path of a globally accepted medical tourism industry. Chief among them might be perception, said Skip Brickley, the conference organizer, referring to horror stories reported by the media of overseas surgery going terribly wrong.

"You're always going to run into some, as you have in the United States, that don't necessarily meet the standards," said Brickley, president and CEO of Transmarx, a company responsible for putting on conferences that bridge new technology and business. "But by and large, the serious players in the international economy are as well equipped for care as any hospital in the U.S."

Addressing another major roadblock could eliminate the perception issue: the lack of a strict set of standards and a regulatory body. "There have to be standardized rules and regulations put in place so that globalization can occur," said Crone, something he expects to be in place within a decade.

More than 140 overseas hospitals already are accredited by Joint Commission International, a division of the nonprofit Joint Commission, the largest accreditor of health care organizations in the United States. That number is expected to triple in the next few years.

Another major concern has been insurance coverage. Up to this point, medical travelers are largely paying out of their own pockets. It will take a decision by the major insurance companies to cover out-of-country procedures to really boost the industry, according to Crone.

"The real change will occur when the Aetnas and the Blue Crosses of the world offer international health care as one of the options of their portfolio," Crone said. "Then I think this will take off."

In March 2007, Blue Cross and Blue Shield of South Carolina launched a subsidiary, Companion Global Healthcare, to make travel arrangements and schedule appointments for medical procedures outside the country. Crone said he expects other insurance companies to follow suit within the next two years.

The industry also has spawned a group of travel agents specializing in medical tourism. With deals linking flights, hotels, hospitals and doctors, these companies are working to turn medical travel from niche business into a booming industry.

"You will see increasing choice and infrastructure," Woodman said. "It will get to the point where it will be getting easier and easier to find the hospitals and make the travel plans."

Though no one at the three-day conference went so far as to say that medical tourism would reshape the American health care system, all in attendance were clear that the industry is in the midst of a rapid ascent.

"We're living in a global economy; we've proven that in nearly every facet of business," Brickley said. "And at the end of the day, medical tourism will produce one major winner: the consumer."