A Cut Below: Americans Look Abroad for Health Care

Aug. 29, 2006 — -- When Sparrow Mahoney was hit by a drunk driver while vacationing in Croatia two years ago, she never imagined the accident would lead her to something that could revolutionize the American health care industry.

Lying in an intensive care unit more than 4,000 miles away from her New York City apartment, the uninsured 27-year-old entrepreneur trembled with the thought of having to pay her foreign medical bills.

Her left leg was fractured in more than a dozen places, and Mahoney was told an amputation was very likely. She was forced to weigh the merits of losing her leg against a potentially huge medical bill.

"Would you rather tell them to go ahead and cut if off if it's only going to cost me $10,000, or should I bankrupt myself and my family trying to save my leg?" she said.

Mahoney went ahead with the reconstruction. Three weeks later, she got the bill. What could have easily been a six-figure procedure came in for just under $5,000.

She marked the one-year anniversary of the accident by climbing a flight of stairs, and today Mahoney is an avid runner.

"More important, I wasn't bankrupt, and I was able to follow a dream," she said.

The experience fueled a desire to help more Americans get access to affordable health care that Mahoney found by accident -- a very painful accident.

"America did a pretty good job of marketing itself as the place for the best health care for a long time," Mahoney said. "That's largely to do with medical schools and facilities, but it has nothing to do with access."

Many Americans in Need of Coverage

More than 45 million Americans lack health insurance, and that number continues to grow. According to the Kaiser Family Foundation, between the years 2000 and 2004 the number of uninsured Americans increased by 6 million.

Mahoney believes that by looking at options outside the American health care system those who lack adequate insurance can get medical care at significantly lower prices. Often referred to as medical tourism, seeking medical care outside the United States is an idea that is taking off at new levels.

More and more Americans are looking across the border and overseas to get their medicine. Jeff Schult, author of "Beauty from Afar," a guide to medical tourism, estimates that more than 100,000 Americans a year travel beyond the boarder for cosmetic procedures alone.

In 2005, for example, Bumrungrad Hospital in Thailand served more than 50,000 American patients, a 30 percent increase from the previous year. Thailand is just one of the countries where foreign patients have flocked. India, Brazil, Costa Rica and Mexico all market themselves as medical destinations, according to Schult.

Traveling abroad for medical procedures isn't new. For years, people have voyaged to exotic locals for aesthetic procedures -- a little nip and tuck between some rest and relaxation. But now the number of Americans leaving the country for medically necessary procedures has taken off too.

"The medical tourism model has really been turned around as the health care crisis looms larger and larger," said Dr. Matt Fontana, the chief medical officer for GlobalChoice Healthcare, a medical tourism booking company in Albuquerque, N.M. "People are saying, 'I'll pick the procedure and then I'll pick the destination.'"

As patients and businesses realize they can save up to 80 percent on pricey medical procedures, the medical travel industry is booming.

Paying a Fraction of the Cost

Tom Hiland, a 57-year-old commercial real estate developer in Denver chose to travel to India for surgery to correct a heart murmur he'd had since birth. Having lost his insurance in 2003, the out-of-pocket cost for the procedure in the United States could have set him back as much as $150,000.

Hiland paid only one-tenth of that. The mitral valve replacement, which used the latest technology and was performed by an American-trained surgeon, and a 23-night hospital stay cost him only $15,000.

But is it safe? Many factors -- the lack of a uniform regulatory body, varying malpractice laws and the idea of undergoing invasive medical procedures in a developing part of the world -- cause people to question whether the savings are worth it.

"As a generalization, I would say that the medical facilities in the major international cities of the world are comparable to those across all countries, including in the U.S.," Schult said.

Schult, a medical tourist himself, added that the Internet and access to global telecommunications provide important safeguards for medical tourism. There are a number of Web forums dedicated to discussing surgery abroad. Schult said he visited one, plasticsurgeryjourneys.com, before traveling to Costa Rica for a procedure.

"If somebody is no good they aren't going to last," he said. "The word gets out very quickly on the Internet. If a doctor has a complication or two it spreads around the forums. He might as well not even practice anymore."

Some Doctors Disagree

Even with more information available, there are risks. Scott Spear, a Washington plastic surgeon, said Internet testimonials don't compare to independent regulation.

"It's a 'buyer beware' situation when you leave your home shores to go for health care as an individual," Spear said. "It's obviously much riskier than if you went to a place down the street where they have a piece of paper on the wall that says they've been certified by the state and other organizations."

The growing phenomenon has caught the eye of Congress. In June the Senate held a hearing on the globalization of health care to determine what is at the root of the growing trend.

"The ease of international travel and the growth in quality care facilities in developing countries certainly plays a part. But I believe frustration with rising health care costs in the U.S. is a key contributing factor," Sen. Gordon Smith, R-Ore., said at the hearing.

Smith isn't alone in that belief. After returning from Croatia, Sparrow Mahoney said she saw how the skyrocketing cost of health care in this country prevents access to the American medical system.

Today Mahoney runs the Web site www.medicaltourism.com out of her office outside Washington D.C. She describes it as a "Lending Tree" for health care -- a place where patients can tap into and compare health care options from around the world.

"This isn't just getting a better nose job and going to the beach afterward," Mahoney said. "This is really opening doors to Americans that have been shut for a long time."