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Reverse Medical Tourism Points Up Pluses and Minuses of U.S. Healthcare

While soaring medical costs in this country have driven many Americans to seek healthcare abroad, many patients from other nations continue to seek high-end care in the U.S. Some hospitals that have a reputation for treating certain ailments -- especially rare ones -- are doing a good reverse medical tourism business. But if our primary care was as good as, say, our ability to cure infant heart defects, fewer of our own citizens would be going to India or Mexico for routine operations.

For example, Michigan hospitals -- including Henry Ford Hospital, Detroit Medical Center, and Beaumont Hospital -- draw patients from countries like India, Brazil and Turkey who need procedures that are not widely available at home or who have rare conditions that can't be treated there. Patients come to Michigan from all over the world to receive robotic procedures and high-beam radiation treatments for cancer, as well as spinal cord rehabilitation and treatments for epilepsy and blinding eye conditions in babies.

This doesn't happen by accident. While U.S. medicine overall has a reputation for excellent tertiary care, individual hospitals and healthcare systems are also reaching out to affluent citizens of other countries, both on the Internet and in person. For example, Edson Pontes, a urological cancer specialist at Detroit Medical Center, set up the hospital's international program in 1992. He frequently travels to other countries to lecture and work with doctors he trained in the U.S.

Hospitals in other states have also been working the international circuit hard for the past decade. For example, the University of Chicago Medical Center and Rush University Medical Center in Chicago have both recruited well-heeled foreigners to pay full freight for procedures that aren't as easy to obtain in their home countries. In some cases, these overseas patients are willing to pay as much as $120,000 for heart surgery and $40,000 for a prostate operation. That's good money for U.S. hospitals that are often forced to give insurance companies big discounts.

Many of these patients come from elsewhere in the Americas. For instance, some Canadian patients who are tired of waiting for procedures in their country's national health system come to Michigan hospitals. And in south Florida, Baptist Health, a five-hospital chain, has treated more than 10,000 international patients, mainly from the Caribbean and Latin America.

Like Detroit Medical Center, Baptist has an international center that caters to foreign patients. So does Texas Children's Hospital in Houston. Seventy-one percent of Texas Children's international patients come from Latin America, and most of the rest hail from the Middle East.

The burgeoning international business of U.S. hospitals is a tribute to the excellence of top-tier care here. But it's also a reminder that as fewer people in this country can pay for that care, hospitals are forced to seek wealthy clients abroad. At the same time, more and more Americans are going overseas to get procedures and treatments that they can't afford here.

There is something perverse about the spectacle of U.S. hospitals serving wealthy foreigners while middle-class Americans go the opposite route. If U.S. primary care were as good and as widely available as its counterpart overseas, and if more people had good insurance coverage, there would be far fewer American medical tourists. And that would be good for U.S. hospitals and doctors, too.

Image supplied courtesy of Flickr.

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