I’m in a Sicko-inspired debate over on Brian’s ISBS, which led me to the following thought.
It’s been repeatedly established that American health care just ain’t all that and a bag of chips. Meanwhile, medical tourism seems to be thriving—and importantly, provides an interesting free market window into the prospect of how people would manage their medical care if they had the freedom to do so.
As I see it, there are three things that would artificially depress American medical tourism, lower than what might be considered a rational norm:
- The widespread and erroneous belief that American medical care is the best in the world; if you think you’ve got the best in the world here (even if it’s being denied to you), why would you look for substandard care elsewhere?
- The low percentage of people who leave the US for any reason in their lifetimes. Partially a geographic effect, partially cultural; we are, after all, the physical size of Europe. Almost all of us have been to other states, but most people are taught that it’s silly or expensive to go to other countries. That’s a high psychological bar, especially for sick people.
- The internalized and externalized costs of medical care. People are used to paying thousands of dollars for insurance, and then minimizing their out-of-pocket expenses afterwards. A flight to Thailand for surgery is entirely out-of-pocket, even if the entire cost is far cheaper than similar surgery in your neighborhood.
So my question: how about an insurance company that leverages these differences to provide top-notch health care at very low cost? As follows:
- The company provides all of the advance research necessary to make you fully-informed about the care you’re getting, and that it’s as good or better as American care. When American care is the best and the most economical, that’s what you get. But you don’t have to do the 1,000 hours of research necessary to engage in medical tourism or shopping around for medications.
- Your meds are purchased by the insurer and drop-shipped to you; they get them at the best possible cost. You get what you need with no exclusions and a low deductible.
- When you need hospitalization or outpatient treatment, and it’s far too expensive in the US, the company pays complete costs for travel and lodging to ensure that you get the treatment you need, wherever it’s provided. Again, you’re provided with ample documentation to show that you’re getting US-equivalent or better care.
It seems to me that the costs for this company would be far lower than other insurance companies, which translates into lower premiums, wider coverage, and lower (or no) deductibles.
So—why doesn’t this exist?
I agree with the reasons you cite for the suppression of medical tourism. Yet, as baby boomers age into expensive, financially challenging medical procedures, forces driving international medical travel will likely override even the more unattractive, xenophobic American attributes.
Since the publication of “Patients Beyond Borders,” we’ve spoken with a number of providers, employers and carriers who seem on the verge of making changes. Blue Cross Blue Shield of South Carolina, for example, recently forged a relationship with Thailand’s JCI-accredited Bumrungrad Hospital to offer coverage for medical travelers. Health Net of California has a plan that allows its subscribers to travel to Mexico for less expensive care. If pilots like these prove successful, look for more extensive, creative rollouts in 2008.
You make some good points, but unless you can show that going overseas will be a lot less expensive, you won’t convince a lot of people. Secondly, are you sure you will be getting quality doctor care? I’m not saying that all US doctors are great, but they’ve been licensed. What are the standards that foreign doctors, hospitals, medical clinics have to comply with. These are not trivial questions.