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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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A Montreal, Quebec Canada may be well forced to shut down almost 25 per cent of its beds. In the past number of years, nearly half the doctors there — 25 of them– have resigned as a result of difficult working conditions, but only several have been hired as replacements.

“ Doctors are said to be working extra long shifts and overtime to provide medical care. “This cannot go on for long without a reduction of the standards of medical care and expertise” states the hospital administration. The hospital will need in order of 20 to 30 doctors to keep this regional center open. Doctors as if seems are in overall short supply.

The Montreal area hospital has had to reduce its level of service to the community at large. Service was reduced in order that the remaining doctors would only have to “work 12 hours or less a day, if possible,” he said.

The impact of the hospital’s decision to close the beds as of Friday is yet unclear.

“There might be longer waits in the emergency room for the patients, as well some of the ambulances may have to be rerouted to other hospitals which, for some patients, might mean being further away from home,” Keyway said.

But while some people at the hospital say it’s frustrating that the beds must close, they understand the reasoning.

“You can’t push staff beyond their reach either … if closing 30 beds allows them to give safe care, it’s too bad, but I guess that’s the way it has to be done,” one woman told CTV Montreal.

The beds might be closed at the hospital for as long as a year.

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Asking what is the best choice for medical tourism and medical travel is similar to asking ten people what is the best flavour of ice cream .  Some of course is personal presence and preference / preferences .  Other considerations are budget , location , time available to travel.  Next is what is the procedure – some countries and hospitals / medical clinics / facilitates may be better suited or have more expertise , or chosen expertise in a given area of medicine and procedures.

As with most things in life – there is no one best answer .

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