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When U.S. Supreme Court justices question lawyers on the constitutionality of President Obama’s 2010 Patient Protection and Affordable Care Act, there is at least one industry that won’t be feeling particularly nervous about the outcome: medical tourism companies.

That’s because, whatever happens, the companies—which arrange foreign surgeries or other medical procedures at top-rated facilities (along with the travel, accommodations and the occasional tourism itinerary) with savings of up to 70 to 80% of what they would cost in the U.S.—already have a strong and ever-growing clientele, most serving several thousand people a year.

“Obamacare is not going to affect us, because it doesn’t say what insurance companies can charge you,” says Geoff Moss of Planet Hospital, a 2002-founded company that sends people abroad for everything from tummy tucks and breast augmentations to hip replacements and kidney transplants.

“Let’s say you work flipping hamburgers and have a preexisting heart condition. Blue Cross can say, sure, that’ll be $1,000 a month.”

At the similarly structured Med Retreat, managing director Patrick Marsek (who also authored The Complete Idiot’s Guide to Medical Tourism) adds that, if Obamacare sticks, the remaining problem won’t even be just a cost issue, but one of access.

“You’re going to have 50 million people minimum coming into the healthcare system,” he says, “and when it comes to getting treatment, you’re going to have to wait in line.”

Enter medical tourism—where the world is your oyster, apparently, when it comes to getting all sorts of affordable, high-quality medical care.

“Cosmetic procedures seem to be what started the whole [medical tourism] industry,” Marsek says. “But, through the years, the number of uninsured and underinsured Americans started to grow, and now it’s orthopedic, cardiac and everything else.”

So where are the top destinations among Americans seeking affordable medical care? We worked with Moss and Marsek—two of the leaders in the field, who help guide thousands of Americans overseas each year for medical treatments—to come up with our list (which is not ranked, but in alphabetical order).

Singapore and Thailand are favorites. “Bumrungrad is the crown jewel of medical tourism,” Marsek says, referring to Bumrungrad International Hospital, just west of Bangkok, known for procedures including coronary artery bypass grafts, hip replacements and spinal fusions. In general, he adds, the best pricing will be found in Southeast Asia, including Singapore.

“They don’t have problems with malpractice, and the prices reflect that.” Costa Rica is a popular choice for being closer to home, as is Mexico—particularly for dental work and surgeries including knee and hip replacements.

Japan and Korea rank high for offering extremely advanced cancer treatments, plus top-notch orthopedic work. And India is always a low-cost, high-quality option—for oncology, cardio, neuro and orthopedic surgeries, as well as for fertility treatments and surrogacy.

The issue there, both Moss and Marsek agree, is that dealing with India is a huge culture shock for most Americans.

But the bottom line, according to Moss, is this: “There are over 52 million Americans without health insurance. So if you are one of those people and need a life-changing procedure, it could cost you $125,000, and you may have to sell everything you own to have surgery.

But if I told you there was a U.S. Board–certified, JCI-accredited hospital in India that could do it for $15,000, you’d probably be on the next flight out.”

http://www.forbes.com/sites/bethgreenfield/2012/03/25/top-spots-for-medical-tourism-no-matter-what-supreme-court-rules-on-obamacare/

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Until recently US hospitals all acted independently on inbound medical tourism so there was no co-ordination or co-operation.

There are several new initiatives as part of the US government’s aim to make the country the top global destination for travel, to improve the economy, and discourage outsourcing to other countries.

The US Cooperative for International Patient Programs (USCIPP) was recently launched as a means to increase the global competitiveness of US healthcare providers and to improve access to healthcare in the US for patients from around the world.

USCIPP is a partnership of the International Trade Administration of the US Department of Commerce, UHC, and Rush University.

The aim is for domestic providers catering to international patients to share best practices and potentially grow their business collectively.

In November 2010, the U.S. Department of Commerce awarded the Rush University of Chicago, in partnership with the University HealthSystem Consortium, a three-year $500,000 Market Development Cooperative Grant to help increase medical travel to the country.

The idea is to stimulate growth through better data that tracks international patients and services, networking across institutions and the implementation of the best strategic business development practices.

The grant is intended to support President Obama’s National Export Initiative, which aims to double exports (any form of U.S. medical care purchased by people outside the country) by 2015. The aim is to create millions of U.S. jobs with the influx of thousands of patients with a vast array of needs.

Plans include establishing a forum for international patient programme, creating a standardized set of data elements to be reported on international patients, determining the value of medical care exports, hosting a series of meetings focused on strategies to increase the global competitiveness of US health care providers, and developing strategic relationships with ministries of health and private payers abroad

The federal government has been making determined noises about encouraging international travel to the USA. The new Brand USA is a public private partnership with the mission of promoting increased international travel to the United States.

The Department of Commerce is forecasting an increase in international arrivals of 6% a year in 2012-16. President Obama’s ambition is to make the USA the world’s top travel and tourism destination. In 2010, 59.7 million international visitors went to the America, generating some US$134 billion for the economy.

The USA remains the world’s second most visited, after France. The US administration and UNWTO estimate that 62.5 to 63.0 million international travellers visited the USA in 2011. Tourism is already the USA’s most important export service industry.

It is also seen as a way to boost job creation – an urgent priority in the current economic climate. Tourism represents nearly 3% of the country’s GDP and is responsible for some 7.5 million jobs, according to the US Department of Commerce.

Among the steps to be taken by the US administration to boost tourist arrivals is a streamlining of visa formalities. Efforts will be made to expand the Global Entry Program place this year, making it easier for frequent visitors to the USA (who have therefore already undergone a background check) to travel across US borders.

More countries will be invited to join the list of those whose citizens are allowed to visit America without a tourist visa under the visa waiver programme. Steps will also be taken to accelerate travel formalities for booming markets such as Brazil, China and India.

Medical travel has representation in the new travel and tourism strategy, with the appointment of Steven Thompson of Johns Hopkins Medicine International, to the U.S. Travel and Tourism Advisory Board.

Thompson is one of 32 member of the board, which advises the Commerce Department on policies and issues affecting travel and tourism.

Steven Thompson commented,” There is a growing demand for US health services coming from the international community. The adoption of travel policies that encourage and support growth in international travel are vital.”

http://floridamedicalretreat.com/350-usa-gets-organized-on-inbound-medical-tourism

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As Congress wrangles to craft meaningful health care reform to deliver to President Obama by mid-summer, consensus has emerged on three fronts: reform is no longer an option, the economy is inextricably linked to reducing the cost of health care, and whatever form the overhaul takes will require years, perhaps decades, to implement and fund.

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