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© 2011 Medical Travel Today
|Medical Travel Today is a publication of CPR Strategic Marketing Communications, a public relations firm based near New York City that specializes in healthcare and life sciences, with an international clientele. CPR, its Partners, and clients are at the nexus of where medical travel is today, and where it will be tomorrow.
Publisher, Laura Carabello
Table of Contents
|From the Editor
From the Editor: This week in Medical Travel Today, Amanda Haar
|News in Review
Economics of Pulling Teeth: Drug war puts medical tourism under at Tamps border, official says
Costa Rican Medical Care Expands Providers with Hospital Metropolitano
â€¨Transgender Surgery Medical Travel Package Offered by MTY Medical Tourism in Merida, Yucatan
|J. Kevin A. McKechnie, Part I
|Gregory Ciottone, M.D., FACEP, chief medical officer, American Hospital Management Company- Washington, D.C., PART II
|I. Glenn Cohen: Medical Tourism, Access to Health Care, and Global Justice
|Global Health Voyager, Inc., Executes Memorandum of Understanding to Purchase Assets of PlanetHospital, One of the Largest U.S.-Based Medical Travel Facilitators
|Global Health Voyager, Inc. Introduces New Options to Use Health Savings Accounts for Medical Travel
Peyton Manning, Colts QB, underwent stem cell therapy in Europe for nagging neck injury
|Cleveland Clinic Releases Patients Beyond Borders® Focus On™
|Chinese Hospitals and International Patient Centers Open Their Doors to Visiting Medical Business and Insurers
|The Clinic Finder Adds Medical Tourism to Consumer Options
WTC Atlanta Hosting Medical Tourism Seminar
2012 Global Healthcare and Medical Tourism Conference: ‘Global Connected Care & 3rd MediTour Expo’ Slated for May 6-8, 2012
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THIS WEEK IN MEDICAL TRAVEL TODAY
Volume 5, Issue 20
by Amanda Haar, Editor
The eyes of the banking world will be glued to this week’s edition and the featured interview with J. Kevin A. McKechnie, Executive Director of the American Bankers Insurance Association and Director of the Health Savings Account (HSA) Council.
Kevin offers some key insights into the growing ties between HSAs and medical travel, opening up significant opportunities for both industries.
We are also touching the wide world of sports. While I've always been a mild fan of NFL football, my interest in the sport grew tenfold this week when news broke that Colts' quarterback Peyton Manning had recently traveled to Europe for stem cell therapy to stave off yet another surgery for a persistent neck problem.
The story also captured the interest of numerous media outlets worldwide. From football and sporting news websites to major television networks and general consumer publications, repeat coverage served to boost understanding of both stem cell therapy and medical travel in general.
While it's unclear when Manning will take the field again, I will be rooting for him and a sustained recovery when he returns.
Finally, thanks to everyone who ordered a copy of our new book, “Medical Travel Today: Opinions and Perspectives on an Industry in the Making.” We’re grateful for the positive feedback and support.
As always, we welcome your comments, story ideas and press releases.
Amanda Haar, Editor
|Introducing Medical Travel Today: Opinions and Perspectives on an Industry in the Making
Medical Travel Today — the authoritative newsletter for the worldwide medical travel industry — is pleased to announce publication of a new book, "Medical Travel Today: Opinions and Perspectives on an Industry in the Making." Featuring 40 of the newsletter's most compelling interviews from the first five years of publication, the volume chronicles the explosive growth of international medical tourism as witnessed and experienced by some of the key stakeholders and players. A must-read for anyone interested or involved in the industry.
|Log onto Facebook and join the Medical Travel Today Group. Look for recent news, trends, and post discussions in the board. If you would like to see something in Medical Travel Today let us know in the discussion board. If you have a question, post it there!
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J. Kevin A. McKechnie, Part I
Editor's Note: While Health Savings Accounts (HSAs) aren't exactly new, not everyone in the medical travel industry is familiar with how they work. In order to assist with reader understanding of the implications of our conversation with J. Kevin McKechnie, executive director of the American Bankers Insurance Association and director of the Health Savings Account, we developed this brief primer on HSAs. We hope you find it useful.
A Brief Overview of Health Savings Accounts (HSAs)
Health Savings Accounts (HSAs) were created in 2003 so that individuals covered by high-deductible health plans (HDHP) could receive tax-preferred treatment of money saved for medical expenses. Generally, an adult covered by a high-deductible health plan (and has no other first-dollar coverage) may establish an HSA. An HDHP is defined as having a higher annual deductible than a typical health plan, and a maximum limit on the sum of the annual deductible and out-of-pocket expenses. Out-of-pocket expenses do not include premiums, but do include co-payments and other amounts.
HSA Accounts provide a number of unique tax benefits including:
- Contributions to HSA accounts may be tax-deductible on federal income tax returns and, in most cases, on state income tax returns.
- HSA holders can pay for qualified medical expenses with tax-free withdrawals.
- Employers may offer a payroll deduction option to help make contributions on a tax-free basis. Employers may also opt to contribute to employee accounts.
- Unlike Flexible Spending Accounts, HSAs do not have a "use it or lose it" requirement.
- HSAs are "portable," meaning it stays with an individual when they change jobs or even if they leave the workforce.
Contributions to an HSA
Any eligible individual can contribute to an HSA. For an employee’s HSA, the employee, the employee’s employer, or both may contribute to the employee’s HSA in the same year. For an HSA established by a self-employed (or unCAUTION For example, employed) individual, the individual can contribute. Family members or any other person may also make contributions on behalf of an eligible individual.
Contributions to an HSA must be made in cash. Contributions of stock or property are not allowed.
Medical Travel Today (MTT): What is your interest in the medical travel market from a generic standpoint, particularly your perspectives on its tie-in to Health Savings Accounts?
J. Kevin A. McKechnie (JKM): We are big believers in freedom.
That’s a personal saying, and so to the extent that people want to travel around the world, have something fixed, and then convalesce on a beach somewhere — I’m for that.
I have the benefit of being able to work in an organization on behalf of an industry that by its nature, promotes the advantages of personal choice. Our work is designed to assist programs like the medical travel industry. After all, it’s a cash product.
MTT: Do you know of any HSAs that are currently offering a medical travel benefit?
JKM: There’s only one other gentleman that I’ve talked to about this, and he’s actually the director of a facility in Costa Rica.
He asked me about the applicability of HSAs to medical travel, and I replied that HSAs apply to anything where the service bought satisfies two requirements:
- The first applies to the HSA funds, because they’re a tax-exempt account. You have to be buying a service that is on publication 502, issued by the IRS. That’s where the IRS lists the things you can use your HSA for.
Obviously, if you pay tax on your money, you can do anything you want with it -- but that’s not an HSA, that’s a savings account. In an HSA environment, it has to be something that the IRS deems “qualified.”
- The second thing that has to occur is that it is not just about the money in the account, it’s about the insurance. So, if you would like the qualifying insurance to pay for this, it has to be a qualified medical expense.
You’re only going to get reimbursed to the extent that the insurance company would pay for that medical benefit either inside its network or, after it applied its out-of-network architecture to the charge.
Lastly, you would have to check that the insurer isn’t building its premium based upon restricting where you get the service done. All of those things have to be in place.
MTT: If you have an HSA plan with an independent HSA company, your health plan, or whatever source — and the expense qualified or actually less than you were going to be spending if you accessed care through the existing benefit program — do you see that as an attractive option for individuals?
JKM: Absolutely, especially if it falls on your deductible.
Nobody really cares about where the expense lies in terms of being higher or lower and what is reasonable and customary. You have to be able to take this money and apply it to your deductible so the insurance company knows when its obligations kick in.
There is a little hassle around that part. So let’s say you’re on the list for a knee replacement or for dialysis or something of that nature and you decide you want to go to Central America to get this done. That’s fine, and would require working up some recommendations about where you would go and the estimated costs.
Individuals need to contact their insurance company, and the insurer would probably work on this and advise you where you go.
MTT: Do you know of any people or any individuals doing this under an HSA or people that have been taking advantage of a medical travel benefit?
JKM: I don’t know anyone personally, but I know there are companies that have dealt with this issue and are addressing the queries.
As long as the treatment or procedure is a permissible expense and the expenditure isn’t above what they would normally pay, they are amenable.
Some of them may think that the expense is subject to the out-of-network architecture because obviously, their network doesn’t include a Costa Rican facility.
Either way, you’re allowed to use your HSA funds and in some cases, it’s an insurable event — which is good.
MTT: Do you think that the connection between HSAs and medical travel opportunities will be a faster-growing trend once people realize they can do this?
JKM: I do for a couple of reasons.
First of all, the Obama health reforms are going to result in massive physician shortages in about 30 months. The American Medical Association says we’re “light” about a quarter-of-a-million general practitioners and family doctors — as soon as everybody is able to go to the doctor on an insured basis, they’re going to in droves.
So, if you’re American and need to find care that is both accessible and affordable, you’re going to be looking at places like Toronto, Vancouver, and even Mexico. If you want to go even further, you are going to get on a jet and go where you can get care quickly and confidently.
The reason why that solution isn’t going to be available to the vast majority of Americans is they don’t have any cash. They have to go and talk to the insurance company exclusively to get a “yes” or a “no.” If you have cash, then think of it this way: you’re going to be allowed to spend money on a knee replacement operation which is a permissible activity according to the IRS — so off you go!
Then there will be this negotiation, which I hope is not a very large negotiation, about what percentage of the money you spent is credited toward satisfying your deductible -- and what amount of money you spent becomes insurable, either subject to the out-of-network architecture or some other contractual limitation that’s in your policy.
We are not sure how you manage this, but the issue came up in other states because it applies to medical travel. People just don’t get on a plane and go to Costa Rica. First, you get on the phone and call your insurance company, let them know what your plan is and talk it over.
Then get on the plane. You’ll then know what the financial arrangement is going to be.
MTT: So, it’s up to the individual to navigate or make arrangements that they feel are appropriate. How do you propose that the individual would know the quality or the doctors or any other standards that are being offered at the destination?
JKM: You really don’t have a very good idea — but on the other hand, you don’t have a very good idea here in this country either.
We make assumptions all the time, and so there’s something of a prejudice in that regard. But I would imagine, although I haven’t done this myself, that this endeavor is comparable to other areas of my life where I’ve investigated paths less traveled.
I imagine that people who pursue medical tourism, at least according to some of my colleagues, are vested in their own healthcare…to the extent that they are not going to leave any stone unturned and they’re not going to enter a facility that looks like something out of a bad Moscow movie. It’s not going to be that way.
These people are paying for the privilege of accessing medical services quickly. They need to be confident that rapid access to quality care is what they will be getting. That’s what matters most to people who are willing to travel.
MTT: Documenting quality is certainly a priority. Do you think JCI accreditation, and now Press Ganey scores would be important in documenting quality?
JKM: I see a lot of that, but if you go on some of the websites of institutions offering medical services out of the country, it’s really the universities that are providing the branding, per se.
A lot of these people are foreign nationals anyway. They come to the United States and study at UCLA, Harvard, or Stanford medical schools — then, they go back to Costa Rica or Columbia and say, “I’m a graduate of Harvard Medical School.”
MTT: Now a $64,000 question: What about Medicare? Do you see HSAs getting any traction in Medicare and would it open up the medical travel market more quickly?
JKM: It will, but you have to understand that the idea of putting seniors in charge of their own medical treatment is a terrifying prospect for most elderly folks.
They’re not interested in that dynamic, but they’re going to be pushed to really look at this as early as 2013. It isn’t just that the system is going bankrupt -- that’s 10 years or so away.
It’s more the fact that as people in the marketplace get older, they’re going to have 10 or 15 years experience working for John Deere or Wal-Mart or all the places that have HSAs where the experience and level of freedom and choice have been available. You simply can’t get this with any other policy.
They’re going to then come to the gates of Medicare where you can barely get an appointment. That’s another feature of the reform package: Medicare reimbursements to physicians are so low; it’s unclear to me that any physician is actually going to accept a Medicare patient.
It’s much more likely that physicians are going to opt out of all insurance completely, and patients will be forced to submit claims on their own and see what Medicare covers.
No doctor can afford to run his/her physical plant on essentially a quarter of what commercial insurance reimburses — and that’s where we are going with Medicare.
MTT: While you have not yet taken advantage of any of the medical travel opportunities, is it something you would consider personally?
JKM: Absolutely I would.
I travel pretty frequently in Europe and the Caribbean. The reason I am making the comment about our universities branding some of these facilities is because I have seen these doctors practicing there.
I don’t think we’re talking about heart transplants — we’re talking about cosmetic surgeries, sometimes reconstructive surgeries or more orthopedic right now…simply because there is a wait for all of these things.
MTT: Yes, for bariatric and others surgeries.
JKM: Exactly. For those things, I wouldn’t have any problem at all getting on a plane and going to see a doctor. And I don’t think a lot of other people would either.
It’s about convenience and price. And with HSAs, we have an insurance product that helps you do that.
MTT: With medical travel and medical tourism delivering such benefits, why do you think U.S. employers have been reticent to offer it as a benefit package?
JKM: I think it’s a couple of reasons.
To a great degree, I let employers off the hook. It was decades ago when World War II happened, and that’s when we got off on the wrong foot in making health insurance almost a captive of all of our employers in this country.
We encourage them opportunistically at every turn, and so they are going to do the kinds of things that they need to do to exert control and to cut costs. They never had a tool like HSAs in the past.
Now that they have this tool, it’s beginning to dawn on them that you can now consider a lot of the ancillary products that you didn’t previously consider. Ultimately, they are looking for a healthy employee, that’s why they offer these benefits in the first place. This might actually improve that.
Now you’ve got somebody who is not out sick for days and waiting for treatment. Maybe if they allowed medical tourism, they’d be out fewer days, they’d get the treatment they want using their HSA funds and move on.
It’s kind of a preventive care initiative, along the lines of obesity treatments and wellness programs — it’s all of the things that didn’t used to be part of an employer program that are certainly now included as companies begin to embrace happier employees.
Part II of this interview will be featured in our next issue.
About J. Kevin A. McKechnie
Executive director of the American Bankers Insurance Association and director of the Health Savings Account (HSA) Council, McKechnie ealth Savings Account (HSA)represents the ABIA and HSA Council before Congress. He served as legislative director to former Congressman William Dannemeyer, of California. He holds a B.A. in History and Political Science from York University in Toronto, Canada.
The American Bankers Insurance Association
The American Bankers Insurance Association is the separately chartered insurance subsidiary of the American Bankers Association and is the only Washington, D.C.-based full-service association for bank insurance interests. ABIA’s mission is to develop policy and provide advocacy for banks in insurance and to support bank insurance operations through research, education, compliance-assistance and peer-group networking opportunities. ABIA membership consists of banks, and their affiliated agencies, insurance companies, marketing, and administrative services suppliers, non-bank lending organizations and other firms involved in the bank affiliated insurance industry. Additional information on ABIA can be found on the Internet at www.theabia.com.
The American Bankers Association
The American Bankers Association represents banks of all sizes and charters and is the voice for the nation’s $13 trillion banking industry and its two million employees. ABA’s extensive resources enhance the success of the nation’s banks and strengthen America’s economy and communities. Learn more at aba.com.
About The HSA Council
The HSA Council is an organization of banks, insurers and technology leaders committed to increasing the adoption velocity of health savings accounts in the United States. The HSA Council represents its members before Congress, the White House and U.S. Courts in order to preserve the ability of Americans to pay for healthcare using an HSA.
SPOTLIGHT: Gregory Ciottone, M.D., FACEP, chief medical officer, American Hospital Management Company- Washington, D.C., PART II
Editor's Note: We're pleased to present the conclusion of our interview with Gregory Ciottone. To view Part I, click here.
Medical Travel Today (MTT): Why do you think that U.S. employers are still so reticent to adopt an international medical travel benefit?
Gregory Ciottone (GC): I’m not sure they have been slow to adopt. If you look at any major paradigm accepting any change in any industry, I don’t think it happens overnight.
When you look at the numbers of medical tourists -- people going to other destinations to take advantage of quality care at lower costs -- those numbers are higher than I ever thought they would be, and they are growing.
I think it’s just a reflection of a typical type of paradigm shift in how companies and people think about this new kind of provision of healthcare.
I also believe that as the industry grows, we are going to see the involvement of more companies seeking to utilize this option.
MTT: When your hospitals recruit staff, do they rely upon local doctors and nurses or do they recruit from elsewhere? Do they look to those who have been trained in Western medicine?
GC: The composition of the medical staff in each hospital does vary.
Some of them have been driven by projects, but many are funded by private investors. Frequently, whoever is driving the project will dictate the make-up of the staff. In some regions, they’re very specific that they want a local medical staff, while in other regions and areas they are more insistent that we bring as many outside medical staff as possible. It varies.
The other thing to understand is that these facilities are not simply dedicated to medical tourism. In fact, the first populations that these facilities serve are the local populations. Quite frankly, that’s what’s most appealing to me, given the knowledge and understanding that I have of these local citizens.
When we come into an area and establish one of our hospitals and, perhaps, place the first MRI or CT scanner in that city – or even in that country -- we are not only improving the healthcare that is being provided by that one facility, but also raising the standard of care around the region.
Then you start seeing other entities with higher quality care and more advanced technologies popping up around you. What’s really appealing to me is that we can go into an area and raise an overall standard of healthcare by doing the work that we are doing.
MTT: Does AHMC compete head-to-head in certain areas outside the United States with other companies or hospital management groups?
GC: Yes, certainly. There are hospital management groups out there that do exactly what we do on any given project.
Whomever is driving the project has looked at these companies and compared the services, and maybe received proposals from a number of groups, ours being one of them.
MTT: Do you ever get involved in marketing the hospital’s services?
GC: No. Our role is to manage the hospital.
The hospital groups that hire us on or whomever they designate as their key stakeholders may do so, but our job really does not include that. We specifically manage the hospital to the highest levels of quality achievable and that’s our role.
The facilities certainly conduct marketing – both locally and probably outside of the local area. But that’s not really something that falls under what we do.
MTT: What are the key quality metrics that you would look at to communicate? Do you look at outcomes? Do you look at infection rates?
GC: We measure all of these things.
The way these hospitals manage quality assurance is comparable to any western hospital. We use metrics, such as you stated -- infection rates, patient satisfaction -- and we have a number of metrics that are in place to keep our finger on the pulse of the quality.
At the same time, and as the need arises, we change policies, change practices, implement patient safety guidelines and clinical guidelines.
It’s much like any other Western hospital would do -- the main thing is quality.
MTT: Do your hospitals offer procedures that you can’t access in the USA?
GC: That’s not really our area. We don’t dictate which direction this is going for any given hospital.
If they want to go into some of these areas and as long as they work within the rules and regulations of the country that they are in, we obviously support that and we’ll help them from a managerial standpoint.
For instance, a few years ago, the hospital in Panama performed its first transplant -- and that was a neat and novel thing.
As long as it’s a sanctioned practice in the country, we’ll support it. Again, that’s not really what we do. We don’t dictate in which direction the hospital might like to go as far as what procedures to do or not do.
MTT: How do you see your role going forward – personally and within the company?
GC: My role will continue to focus upon making sure that the standards are as high as possible in our facilities.
We’ll also make sure that the medicine that we practice is evidence-based and cutting edge. We’ll ensure that all facilities are keeping current with their policies procedures and up to date with medical guidelines.
As far as the company is concerned, it is growing. We received more Request for Proposals in the last few years than we had in a long time.
It’s hard to say what the future holds, given the current economic trends and investment climate, but the demand for our services does seem to be on the rise. We are being sought after more and more and I anticipate that this will continue.
MTT: Is there an international association of chief medical officers at facilities like yours?
GC: No – not that I am aware of.
About Gregory Ciottone, M.D., FACEP
Dr. Ciottone is a practicing emergency physician with more than 20 years experience in academic, clinical and global medicine. He is internationally recognized in disaster medicine and emergency management, healthcare policy and infrastructure-building. Dr. Ciottone is a U.S. Board-Certified Emergency Physician and is an assistant professor of medicine at Harvard Medical School, where he currently is the chair of the Disaster Medicine Section and director of the Division of Disaster Resilience at Harvard Medical Faculty Physicians. He has also served as the chair of the International Emergency Medicine Section at Harvard Medical School, as well as director of the Division of International Disaster and Emergency Medicine and medical director for emergency management at Beth Israel Deaconess Medical Center, where he works clinically in the Department of Emergency Medicine. Dr. Ciottone is founder and director of the first Disaster Medicine Fellowship Program at Harvard Medical School.
In addition to these appointments, Dr. Ciottone holds a visiting professorship at Vrije Universiteit Brussels in Belgium and the Universita del Piemonte Orientale in Italy, and has served as the medical director for the Office of Security and Investigations, United States Citizenship and Immigration Service, U.S. Department of Homeland Security, Washington, D.C. He is the editor-in-chief of the textbook “Disaster Medicine,” published by Elsevier/Mosby in 2006, and has extensive field experience including 10 years as a flight physician for a LifeFlight rescue helicopter system. In 2007, he was named “EMS Physician of the Year” by Central Massachusetts Emergency Medical Services, and, in 2008, he was the “Spotlight” for the Phi Beta Kappa national publication keynote reporter. Also in 2008, the World Champion Boston Red Sox honored Dr. Ciottone by having him throw out the Ceremonial First Pitch as part of the 9/11 remembrance ceremonies at Fenway Park. In 2010, Dr. Ciottone was named by the Russian Federation Ministries of Education and Science as an approved evaluation expert for the New Eurasia Foundation, as defined within the framework of Resolution No. 220 of the Russian Federation Government. In 2011, Dr. Ciottone was selected by USAID as one of two U.S. experts for consultation to the Russian and Tajikistan Ministries of Health on the epidemic of polio in the Central Asian Region, and infectious disease epidemic threat preparedness and disaster response planning.
About American Hospital Management Company
American Hospital Management Company (AHMC), is a diversified international healthcare management and consulting firm, based in Washington, D.C., whose focus is on the administration, management and development of world-class hospitals and healthcare systems all over the world.
AHMC is the premier consultant for hospitals seeking to elevate their healthcare services to internationally recognized standards and position themselves to compete effectively in the medical tourism industry. Aside from promoting the tourism destination and available healthcare services, providers must effectively differentiate themselves from potential competitors. This is accomplished by providing prospective patients and payers with the relevant information needed for them to make an informed and educated decision regarding the healthcare service options available to them.
I. Glenn Cohen: Medical Tourism, Access to Health Care, and Global Justice
Editor's Note: This month's issue of the Virginia Journal of International Law features a paper by Glenn Cohen, Harvard assistant professor of law, on the topic of “Medical Tourism, Access to Health Care, and Global Justice.”
We're pleased to provide the following abstract and a link to the complete paper.
Medical tourism - the travel of patients from one (the “home”) country to another (the “destination”) country for medical treatment - represents a growing business. A number of authors have raised the concern that medical tourism reduces access to healthcare for the destination country’s poor and suggested that home country governments or international bodies have obligations to curb medical tourism or mitigate its negative effects when they occur.
This article is the first to comprehensively examine both the question of whether this negative effect on access to health care occurs for the destination country’s poor, and the normative question of the home country and international bodies’ obligations if it does occur. I draw on the work of leading theorists from the Statist, Cosmopolitan, and intermediate camps on global justice and apply it to medical tourism. I also show how the application of these theories to medical tourism highlights areas in which these theories are underspecified and suggests diverging paths for filling in lacunae. Finally, I discuss the kinds of home country, destination country, and multilateral forms of regulation this analysis would support and reject.
This article is the second in a trilogy of law review articles I have done on various aspects of medical tourism. The first article, “Protecting Patients with Passports: Medical Tourism and the Patient Protective-Argument, 95 Iowa L. Rev. 1467 (2010),” is available at http://ssrn.com/abstract=1523701. The third article, “Circumvention Tourism, 97 Cornell L. Rev. _ (2012),” is forthcoming and will be posted on SSRN in the near future.
To read the entire paper, click here:
Virginia Journal of International Law, Vol. 52, 2011
Global Health Voyager, Inc., Executes Memorandum of Understanding to Purchase Assets of PlanetHospital, One of the Largest U.S.-Based Medical Travel Facilitators
BEVERLY HILLS, Calif., Sep 21, 2011 (BUSINESS WIRE) -- Global Health Voyager, Inc. (GHV) GLHV +13.73% , a full-service, web-based, medical tourism facilitator today announced that it entered into a memorandum of understanding, Sept. 1, 2011, with PlanetHospital (PH), the largest medical travel facilitator in the United States, to acquire all the PlanetHospital assets from Healthcare International Network, LLC. Terms of the transaction, a pure asset purchase with no ties to any existing liabilities, were not disclosed. The deal is expected to close on or before Oct. 1, 2011.
"We are extremely pleased to welcome Rudy Rupak, founder and CEO of PlanetHospital, to the GHV management team as the president of the PlanetHospital division," said Ali Moussavi, GHV president and CEO. "Rudy is internationally recognized as an industry pioneer, enjoys high visibility in the marketplace and provides a strong voice for the medical tourism community. He will play an important leadership role in advancing our global positioning and driving GHV business objectives."
Moussavi points to the significant value of combining a public entity with the high-profile PlanetHospital brand.
"Founded in 2002, PlanetHospital captured first-mover advantage with the introduction of a medical tourism platform that offers Americans options for accessing high quality healthcare treatments outside the United States at significantly lower costs,” said Moussavi. “The company quickly captured the attention of national and international media, generating wide consumer interest in its programs. Self-insured employers, insurers, third-party administrators and other intermediaries also rely upon the PH platform for offering employees a medical travel benefit."
Rudy Rupak, founder and CEO of PlanetHospital said, "I am delighted that PlanetHospital is finally going to be a listed company. This is not an exit strategy for us, but rather an opportunity to really grow the business aggressively and take it to the next level. Expect great things."
Global Health Voyager, Inc. Introduces New Options to Use Health Savings Accounts for Medical Travel
BEVERLY HILLS, Calif.--(BUSINESS WIRE)-- Global Health Voyager, Inc. (OTCBB:GLHV.ob - News), a full-service, web-based, medical tourism facilitator, today announced that it will now offer its medical travel programs to Health Savings Accounts(HSA), a tax-advantaged medical saving account available to individuals covered by High-Deductible Health Plans (HDHP)established in 2003. This initiative gives GHV first mover advantage in the medical travel marketplace, and marks the Company’s entry into large-scale, business-to-business medical travel transactions.
"HSA account holders will now have the opportunity to take advantage of a medical travel option and access high quality healthcare services at significant savings virtually anywhere in the world,” says Ali Moussavi, president and CEO of Global Health Voyager. “Medical travel promotes the advantages of personal choice, an underpinning of HSAs, and we look forward to expanding these opportunities for all Americans.”
The funds contributed to an HSA account are not subject to federal income tax at the time of deposit, roll over and accumulate year to year if not spent, and may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty. According to a recently released report from the trade association America’s Health Insurance Plans, the number of people with HSA Plans has nearly doubled in the past three years. This year, about 11.4 million U.S. residents can use the tax advantages of an HSA.
“HSAs apply to anything where the services purchased qualify on publication 502, issued by the IRS,” adds Moussavi. “Of course, individuals will have to ascertain what percentage of the money spent on medical travel is credited towards satisfying their deductible.”
HSAs allow patients to receive needed care without a gate keeper to determine what benefits are allowed, and make consumers more responsible for their own health care choices through the required High-Deductible Health Plan.
Peyton Manning, Colts QB, underwent stem cell therapy in Europe for nagging neck injury
Colts quarterback Peyton Manning traveled to Europe for stem cell therapy that is currently not approved in the United States as he made a last-ditch effort to stave off further surgery on his neck in September, according to a report on Fox's pre-game show.
Manning, 35, missed the Colts' opener against the Houston Texans last week after undergoing his third surgery in 19 months because the stem cell treatment did not work. The Colts deemed the surgery "uneventful" and called the ensuing rehabilitation process "involved." They did not provide a timeline for his recovery, but he is expected to miss two-to-three months, and it is uncertain whether he will return this season.
Manning's rehabilitation began immediately after his most recent surgery. Prior to that he underwent a procedure on May 23 to repair a bulging disk and had hoped the four months of physical therapy would allow him to play by the Colts' opener Sept. 11, but progress leveled off, forcing him to seek further treatment.
"To say I am disappointed in not being able to play is an understatement," Manning said in a statement after his latest surgery. "I simply am not healthy enough to play, and I am doing everything I can to get my health back."
Dr. Victor Khabie, co-chief at the Orthopedics and Spine Institute at Northern Westchester Hospital, cautioned that the nerves in Manning's neck could affect his arm strength, and may limit his capabilities moving forward.
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Why Do Peyton Manning, Americans Leave United States for Stem Cell Treatment?
Lifenews.com — The United States has arguably the most advanced healthcare in the world. Which is why I was surprised at how many Americans are going abroad for stem cell treatments using their own adult stem cells.
This is called an antilogous stem cell transplant. I read nearly everyday about patients going to China, India and Germany to get treated for anything from spinal cord injuries to autism. It has even been reported that Peyton Manning went to Europe recently to get a stem cell treatment for his neck. I also have read about patients who reside in these countries getting treatments for brain injury to type II diabetes with impressive results. The Repair Stem Cell Institute, which refers patients to what they say are reputable stem cell treatment centers around the world, has a list of diseases being treated with antilogous stem cell transplants that is a mile long.
Remember, these are not cures, but therapies aimed at improving the symptoms of the disease and the quality of life for the patient. It is also important to point out that these are not the stem cell treatments that have recently been in the news where patients have received stem cells from embryos or fetuses. These are stem cell transplants using a patient’s own stem cells.
So why is this antilogous stem cell tourism happening? Many ask why are these treatments not available in the United States. It is often wrongly suggested that it has to do with Bush’s restrictions on the funding of embryonic stem cell research. It has absolutely nothing to do with that because these are antilogous adult stem cell transplants. In reality, unlike the United States, most industrialized nations have some kind of legislation that protects embryos from being created and destroyed for research.
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Cleveland Clinic Releases Patients Beyond Borders® Focus On™
First U.S. hospital to be featured in popular new digital publication for the medical traveler
Chapel Hill, NC – September 15, 2011: Patients Beyond Borders,® the best-selling consumer reference guide for medical tourism, is pleased to announce the official release of FOCUS ON: Cleveland Clinic, profiling one of the top international healthcare centers in the world.
Now available as a digital download, Patients Beyond Borders FOCUS ON: Cleveland Clinic will provide global healthcare consumers with in-depth information on the hospital’s top specialties and doctors, achievements, accreditation, international concierge services and patient case studies, as well as regional travel information.
Founded in 1921 by four renowned physicians and built on principles of “cooperation, compassion and innovation,” Cleveland Clinic has earned a standing as one of the world’s most revered hospitals. With more than 2,000 salaried physicians and researchers, 120 medical specialties, and a network of medical facilities throughout northeast Ohio, Florida, Las Vegas (Nevada), Canada, and Abu Dhabi (UAE), the clinic welcomes more than 3.7 million patients annually from the United States and 103 other countries.
“Cleveland Clinic has served the international patient long before ‘medical tourism’ became a buzzword,” said Josef Woodman, CEO of Healthy Travel Media. “With a strong reputation for outstanding customer service, cost-effective care and a commitment to excellence, Cleveland Clinic’s community of hospitals and specialty centers has much to offer the discerning global medical traveler.”
Cleveland Clinic caters to international clientele through its Global Patient Services department. The hospital’s “patients first” principle, coupled with special care from the International Center’s staff, make for a seamless medical travel experience. Services for international patients range from coordinating travel arrangements and arranging leisure activities for travel companions to providing translation services and catering to special cultural and dietary needs.
Today, Cleveland Clinic is home to some of the top-ranked specialty institutes in the world: the Sydell and Arnold Miller Family Heart and Vascular Institute, the Digestive Disease Institute, the Glickman Urological and Kidney Institute, the multidisciplinary Neurological Institute, and the Orthopedic and Rheumatologic Institute, which have helped to consistently earn Cleveland Clinic the coveted U.S. News & World Report’s America’s Best Hospitals Award¹ and, in 2009–2010, the National Research Corporation’s Consumer Choice Award.
“We are pleased to be collaborating with Patients Beyond Borders to produce FOCUS ON: Cleveland Clinic,” said Dr. William Ruschhaupt, M.D., chairman of Global Patient Services and staff physician at the Cleveland Clinic Department of Cardiovascular Medicine. “We hope the accessibility of this publication will allow us to reach an even greater number of international patients and provide them with reference data to make more informed healthcare choices.”
Woodman will lead a panel of healthcare professionals and patients, featuring Dr. Ruschhaupt, in a discussion about the benefits and risks of getting medical treatment abroad at the AARP Life@50+ National Event and Expo, 1-2 p.m., Sept. 23, in Los Angeles. Participants will learn where to go for the highest quality care, how to negotiate the best prices, what types of insurance coverage are available and what to do in the unlikely event that something goes wrong.
FOCUS ON: Cleveland Clinic will be accessible from a variety of sources including the Patients Beyond Borders website, Cleveland Clinic’s website, Kindle, GoogleBooks, Apple iBooks and other eBook readers, iPhone and other mobile devices, medical, business, and reference libraries worldwide, and all popular social networks.
Chinese Hospitals and International Patient Centers Open Their Doors to Visiting Medical Business and Insurers
China International Travel Services USA (CITSUSA) and ChinaHealthToday (CHT), a medical facilitator member of the Medical Travel Association, have organized a tour of Shanghai and Beijing hospitals and international patient centers, October 2011.
To date, 12 healthcare facilities have extended an invitation to healthcare professionals and businesses to visit. The hospitals selected include JCI-accredited facilities, hospitals accustomed to treating international patients and renowned institutions of high-tech treatment and medical education and research. The tour is open to any individual, organization or enterprise interested in a patient care, professional or business relationship. The China tour dates are Oct. 15-23, and open to only 15 registrants, who will have ample opportunity to enjoy Shanghai and Beijing attractions and experiences. For more information and a registration form, contact firstname.lastname@example.org.
The Clinic Finder Adds Medical Tourism to Consumer Options
David Nicholls, director of “The Clinic Finder”, recently announced the addition of a “medical tourism” section to the healthcare provider search engine's domestic site.
"The concept of ‘The Clinic Finder’ had always been to give people the broadest range of healthcare providers and options, be that locally or internationally," said Nicholls. "When we were formulating the strategic branding of the site, we initially felt that a separately branded site for medical tourism would be the way to go. However, our thinking changed when research and discussion revealed that, in most cases, the search for an appropriate treatment starts locally with medical tourism research ‘possibly’ coming later in the process. By putting the medical tourism option forward as an integral part of ‘The Clinic Finder’ site, the public can now consider the overseas option earlier than they would normally."
This strategy is consistent with the company's overall objective of giving the widest medical choices available, and now gives overseas specialists a chance to be considered by an audience that previously may not have considered medical tourism.
"Now the medical insurance industry is starting to take a much closer look and, in some cases, offer the medical travel option,” said Nicholls. “We truly believe that it is only a matter of time before overseas medical treatment becomes the ‘norm.’ The opportunities for exponential growth among healthcare providers in this market are still very real and we believe ‘The Clinic Finder’ can help those numbers be realized faster than ever."
To learn more about “The Clinic Finder” and partnership opportunities, either visit http://www.theclinicfinder.com or email email@example.com
Mercury Healthcare International launches the first global implant registry for health travel members
Today, as an added member benefit to its Global Access Passport™ members, Mercury Healthcare International launched a brand-agnostic, globally integrated implant registry, which tracks costs, effectiveness, clinical outcomes, patient satisfaction, and aids and assists in contact patients in the event of a manufacturer's recall. The mutual collaboration on an international registry of implants of all kinds will be essential in order to gather full and accurate data related to the full scope of implants (related to various manufacturers), used around the world, in a relatively short time.
Read more... http://www.mercuryhealthcareintl.com/about/announcements.html
David Badour Joins Satori World Medical as Director of Client Services
San Diego, CA, September 17, 2011 -- (PR.com) -- Satori World Medical, a leader in medical travel, has named David Badour director of client services.
Badour brings more than 15 years of expertise in healthcare sales and client relationship development. In his new role, he will provide leadership in all facets of client services including implementation of the Satori World Medical benefit, delivering high levels of client satisfaction and ensuring continuous quality improvement.
Prior to joining the Satori World Medical’s management team, Badour was the regional vice president of business development for Sound Physicians, a leading hospitalist organization. From 2006-2009, Badour was a regional sales director at Sodexo Health Care Services. He also held the vice president of business development position for Emergency Physicians Medical Group and was the national account sales manager of Concentra Medical Centers, where he led negotiations with insurance companies and TPAs.
Badour holds a bachelor’s degree in economics and management from Albion College. He is currently a member of American College Healthcare Executives and the San Diego Organization of Healthcare Leaders.
International Board of Medicine and Surgery Releases Summary Findings of Medical Travel/Continuing Medical Education Survey
A recent survey conducted by the International Board of Medicine and Surgery (IBMS) confirmed that the IBMS community places a high priority on Continuing Medical Education (CME) for those involved in the medical travel industry.
Results of the 14-question survey first distributed in March of this year revealed that respondents were most interested in seeing CME emphasizing or accrediting:
Discussion of potential complications and case reports
Standards for International Certification
Post-op/Pre-op Standards and Guidelines for International Provider
To read more, click here.
Doctors Targeting January for Spinal Medical Tourism in Bahamas
Thetribune242.com — Doctors Hospital is targeting January for its next medical tourism initiative, the BISX-listed healthcare institution telling Tribune Business that its $1.067 million net income performance for the first half of its 2012 financial year was "slightly ahead" of budget projections.
In a series of emailed replies to this newspaper's questions, Doctors Hospital confirmed it was establishing a spinal surgery and care centre at its Nassau facilities - a project it is undertaking with a consortium featuring U.S. specialists, a spinal parts manufacturer and Bahamian specialist, Dr Valentine Grimes.
"We have recently received medical licenses for three spine surgeons who plan to bring their patients for surgery. Dr Valentine Grimes will work with them. We hope to start them by January," the BISX-listed healthcare provider told Tribune Business, adding that its High Intensity Focused Ultrasound prostate cancer treatment centre was continuing "on a regular basis, with a trend for increasing the activity".
To read more, click here.
Medical tourism is becoming an increasingly popular alternative to the NHS
Responsesource.com — More the 2.6 million Britons have recently been or are planning to go abroad for medical treatment. The most common elective surgery procedures for outbound United Kingdom patients include hip and knee replacements, and cataract removal.
Most medical tourists go abroad to avoid paying for treatment not available on the NHS. However, if they previously had private medical coverage, they could have had these procedures done at no extra cost in the United Kingdom.
Without medical insurance, paying for a hip replacement privately in the United Kingdom can cost as much as £10,000.
To read more, click here.
WTC Atlanta Hosting Medical Tourism Seminar
The World Trade Center Atlanta and international healthcare and medical tourism firm DiscoverMedWorld are hosting a seminar on using travel to reduce employee health plan costs Oct. 24.
The event is entitled “How to Effectively Use Medical Travel to Lower Employer Healthcare Costs While Offering Excellence in Care,” and is to feature speakers from Atlanta andCosta Rica.
Marisol Wesson, president of Atlanta-based DiscoverMedWorld, is to discuss a model for employee healthcare travel.
Brad Cook, director of the international patients department of Costa Rica’s Hospital Clinica Biblica, is to speak on how U.S. employers can use medical tourism as a benefit in their health plans, as well as issues concerning patients crossing borders for healthcare procedures.
Other speakers from Costa Rica are to include J.S. Barcie, CEO of CIMA Healthcare Network & Medical Center and Massimo Manzi, director of PROMED, which promotes cooperation between healthcare providers and governments.
Participation is $20 for World Trade Center members and $25 for non-members. The 8:30am-noon event is to include breakfast.
For more information see the World Trade Center’s Web site at www.wtcatlanta.com.
2012 Global Healthcare and Medical Tourism Conference: ‘Global Connected Care & 3rd MediTour Expo’ Slated for May 6-8, 2012
MediTour Expo announced its 2012 Global Healthcare and Medical Tourism Conference: “Global Connected Care & 3rd MediTour Expo,” will be held May 6-8, 2012, at the Flamingo Hotel and Casino in Las Vegas.
This two-day conference will feature specialized topics on the globalization of healthcare. Leading technology and healthcare professionals will come together to present and discuss new global healthcare strategies, the latest trends in telemedicine and technology applications as well as insurance and quality issues. The conference will showcase presentations by some of global healthcare’s most influential leaders including Dr. Jay Sanders, M.D., FACP, FACAAI, president and CEO of the Global Telemedicine Group, adjunct professor of medicine at Johns Hopkins School of Medicine and founding board member and president emeritus of the American Telemedicine Association. Expecting to draw delegates from all around the world, this event is a must for those looking to increase contacts in the international healthcare industry.
The conference will also offer exhibit halls, discussion panels and workshops and numerous networking opportunities throughout.
According to Ian Jacobs, CEO of MediTour Expo and Arlen Meyers, M.D., MBA, president of the Society of Physician Entrepreneurs, this conference will provide education, business opportunities and a networking forum for the global healthcare and medical tourism Industry while identifying and removing barriers to adoption and diffusion.
Below are some of the event’s highlights:
- Global Physician Referral Networks and Patient Care — How to Build a Global Practice
- Self-Funded Insurance Groups -- Providing Healthcare Travel Alternatives
- M-health, Telemedicine and Electronic Healthcare Information Platforms
- Business Processes and Advanced Global Healthcare Marketing Strategies
- Integrating Global Healthcare Technologies with Medical Travel
- Legal Issues in Global Care
- Workshops in Global Practice Management, Insurance Reimbursement & Payment, Business Processes, and Legal & Regulatory issues in Global Care
- Private meeting rooms for business meetings
For information and registration, visit http://meditourexpo.net. For sponsorship and exhibitor opportunities, email: Joanne@meditourexpo.net.
AMA President Peter W. Carmel, M.D. Issues a Message to all Physicians Regarding Medicare Turning Retirees into New "Medical Tourists"
amednews.com — AMA Leader Commentary: A few words about current events in medical practice
I suspect in the minds of many patients, there is a disconnect between the turmoil in Washington and the relationships they have with their physicians.
They don't quite understand the connection between Medicare payment and Medicare physician availability for themselves. For, other people, yes, but for themselves, no.
Most people don't make the connection among cuts in Medicare physician payments, the rising cost of medical care and their own welfare. They think that Medicare will be there for them when the time comes, or as it has been since they turned 65. And for many, that will be true.
But depending on what happens during the deliberations of the Joint Select Committee on Deficit Reduction, beginning in September, it may not be the case for many others.
Year after year, increases in physician practice costs have exceeded Medicare payment updates. Even using the government's own index of practice cost inflation, average Medicare payments since 2001 have fallen about 20 percent behind.
By 2020, with the Medicare physician payment cuts forecast by the Medicare trustees, payment rates will be just half what they were in 2001. When Medicare payments no longer keep pace with the cost of care, physicians are forced to make one of two choices — either limit their Medicare patients or opt out of the program completely.
Either way, patients and physicians both suffer.
Welcoming Medicare patients has always been a good way for newly minted physicians to develop their practices, but that is becoming more difficult as the gap widens between payments and the cost of actually treating a patient.
Similarly, in many rural areas and inner-city neighborhoods, where Medicare patients are a large part of the local population, physicians cannot earn enough from treating non-Medicare patients to cover the deficits they face from treating Medicare patients.
Physician shortages already exist in many rural and inner-city neighborhoods. Another drop in Medicare payments will further hinder any effort to keep physicians in those areas — and any effort for the local residents to find doctors.
Deciding whether or not to keep seeing Medicare patients can be agonizing for physicians. The thought of turning any patient away is an anathema to most physicians.
In fact, many physicians facing that painful decision acquiesce in the end and decide they will go ahead and keep existing Medicare patients — but accept no new ones.
Lately, I have become aware of a growing phenomenon in New Jersey, where I practice. I think of it as reverse medical tourism.
Just as many parents are seeing their college-graduate students move back home, my colleagues have heard from a great number of patients who have retired and moved away — and want to come back to their original doctors for treatment.
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ANY LAB TEST NOW® Partners with Cambria Health Care, Inc.
Local Pre and Post Surgery Testing Available for Medical Tourism Patients
ANY LAB TEST NOW® announced its partnership with Cambria Health Care, Inc., to provide pre-surgery and post-procedure lab tests for patients accessing affordable, quality healthcare through international and domestic medical tourism.
Cambria Health Care is a medical tourism facilitator that works with employers and individuals that are uninsured, have insurance with high deductibles or minimal coverage, to lower their overall surgical costs without giving up quality of care.
Patients will now be able to have local lab testing performed for their procedures without leaving the United States. This arrangement makes it easier on the patient who may not know if they qualify for a specific surgery or for patients that have had surgery and testing is necessary to make sure the healing process is progressing as anticipated.
"Taking the step to follow through with a surgical process abroad, whether it is cosmetic or life-threatening, can be both exciting and emotionally stressful," said Terri McCulloch, vice president, sales & marketing, ANY LAB TEST NOW®. "We want to bridge their transition, so the patient knows when they leave, they are ready for their operative procedure." "Just think – no extra days in a hotel or hospital to wait for test results, and patients get to leave with a complete feeling of readiness when they get on that plane."
Cambria Chairman and CEO, William Widener, said, "This partnership allows Cambria to provide comprehensive services to patients, giving them peace of mind that they are in good hands. I also appreciate that the continuum of care is not interrupted, which ensures a smooth experience for the patient."
ANY LAB TEST NOW® has more than 130 locations nationwide. Clients can be assured of privacy and confidentiality and each ANY LAB TEST NOW® location is conveniently located with work-friendly hours. With no appointment necessary and no waiting, ANY LAB TEST NOW® makes specimen collection simple and easy.
About ANY LAB TEST NOW®
Founded in 1992, ANY LAB TEST NOW® is a franchise lab testing facility that provides thousands of standard lab tests to consumers and employers in a professional, convenient and cost-effective manner without the need of a doctor's order or insurance. With over 130 facilities around the U.S., ANY LAB TEST NOW® offers a variety of affordable and confidential lab tests to consumers and businesses including general health and wellness panels, pregnancy, HIV/STD, drug, paternity and many more tests. To learn more about ANY LAB TEST NOW®, visit http://www.anylabtestnow.com
About Cambria Health Care, Inc.
Cambria Healthcare is a global healthcare facilitator located in Houston, Texas, USA. We provide patients the opportunity to access physicians and hospitals, domestically and internationally, in order to decrease their costs of care, increase their access to physicians, and put the world's greatest technology in the hands of the patient. To learn more about Cambria Health Care, Inc., visit http://medicaltourism-company.com.
The Right Place, the Right Time is Right Here
The following is an unsolicited testimonial regarding one individual's success at finding employment through Medical Travel Today's Jobs/Situation Wanted listing. If you're seeking a job or a candidate, consider a listing in our next issue.
I wanted to thank you for putting the "Situations Wanted" ad on your newsletter during the spring and summer months. The ad was successful and I began a three-month contract position for Patients Beyond Borders last month, helping with data work.
I really appreciate your getting my name out there and I'm especially grateful that it helped land a position in the medical travel world.
|SEEKING OPPORTUNITY: Leyah Cole
|My goal is to obtain employment or internship in health care related industries; with a long-term goal of owning my own medical tourism company. Based on my prior work experiences, academic knowledge with a degree in International Business (Spanish Intensive) and similar career interest I believe I'd be best suited for positions, such as: business administration, research and development, consulting and/or management.
|Win a free copy of Patients Beyond Borders, Second Edition
In honor of our fifth year of publishing, Medical Travel Today will be giving away copies of Patients Beyond Borders, Second Edition, the best-selling consumer reference guide to international medical travel, with more than 100,000 copies in print, to all contributors and interviewees throughout the year. In addition, we'll be giving a copy to one lucky subscriber with each issue we publish. To earn your chance to win, email our editor with "book drawing" in the subject line.
Congrats to this
Anya Simpson, President, Benefit Plans Inc.
|News in Review
Economics of Pulling Teeth: Drug war puts medical tourism under at Tamps border, official says
Sara Rodriguez couldn’t stop wringing her hands as she sat at a dentist office, waiting to return to the United States.
Two of her family members had close calls with organized crime members in Mexico.
She didn’t want to be here, but she had no other choice. She didn’t have the $8,000 she needed to get her dental work done in the United States.
Costa Rican Medical Care Expands Providers with Hospital Metropolitano
Dr. Roberto Herrera, along with a group of Costa Rican investors, plan to open a number of these larger ambulatory clinics across Costa Rica. Before opening Hospital Metropolitano, Dr. Herrera was in charge of administration at one of the largest hospitals in Costa Rica and many of his former staff, doctors and surgeons have moved along with him. His son, Dr. Filipe Herrera, is responsible for marketing and expanding their top- of- the-line equipment and services.
Transgender Surgery Medical Travel Package Offered by MTY Medical Tourism in Merida, Yucatan
Merida, Yucatan, Mexico - Medical Traveler Yucatan (MTY) has introduced its first transgender surgery procedure. Transgender patients can now travel to Merida, Yucatan for the Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) procedure, or the Traditional Hysterectomy. This package is offered exclusively via MTY, a U.S.-Canadian medical facilitator service located in Merida, Yucatan.
Editor’s Note: The information in Medical Travel Today is believed to be accurate, but in some instances, may represent opinion or judgment. The newsletter’s providers do not guarantee the accuracy or completeness of any of the information and shall not be liable for any loss or damage caused – directly or indirectly – by or from the information. All information should be considered a supplement to – and not a substitute for – the care provided by a licensed healthcare provider or other appropriate expert. The appearance of advertising in this newsletter should in no way be interpreted as a product or service endorsement by the newsletter’s providers.