Printable Version

© 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
Cuts 'will boost medical tourism'

Oklahoma City is spot for ‘medical tourism'

Venezuela’s Chavez Will Return to Cuba for Medical Exams

Protecting the Rights of Surrogate Mothers in India

Pop culture, wealthy Chinese spur medical tourism in Asia

ASSOCHAM for developing Multi-Speciality Health City at Bangalore

Top 5 Alternatives to Traditional Health Insurance

Superbug Returns to Trouble Medical Tourism in India
J. Kevin A. McKechnie, Part II
David Monteiro, Business Development Manager, Compass Benefits Group
I. Glenn Cohen: Medical Tourism, Access to Health Care, and Global Justice
Industry News
As Medical Tourism Gathers Momentum, Top Blog Channels Gain Interest
Industry News
Average Cost of US Health Coverage per Employee is Expected to Cross the $10,000 Threshold for the First Time in 2012, According to Aon Hewitt
Industry News
Drug war puts medical tourism under at the border
Industry News
Health budgets squeeze seen boosting medical tourism
Industry News
74% of American women would leave the US for IVF
Industry News
Why Silicon Valley Is Running Scared From Healthcare
Industry News
Thailand Mitigates Tourism Threat
Industry News
Satori World Medical Appoints Geoffrey Harris to Its Strategic Advisory Board
Industry News
Medical tourism from the UK set to increase due to restricted healthcare budgets
Industry News
Lessons From Abroad: The Dutch Health Care System
Upcoming Events

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

EMTC 2012 Slated for April 25-27, 2012

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Global Health Voyager

Volume 5, Issue 21

by Amanda Haar, Editor 


According to a new report from Aon Hewitt, the average cost of health coverage per US employee will surpass the $10,000 mark for the first time next year. Not surprisingly, employee contributions are also expected to rise to a new level ($2,306). 

This harsh reality will no doubt send employees and employers scrambling for more affordable options for care. On the list of options, HSAs emerge as  a contender for the top spot on the list of options. Combined with medical travel, HSAs offer both personal choice and savings, and  may provide the ease and entrée that American consumers need to make the medical travel leap. 

Adding more insight to the discussion is J. Kevin A. McKechnie, Executive Director of the American Bankers Association. We're pleased to present Part Two of our conversation with him below. 

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!

You can also follow Medical Travel Today on Twitter. For more information log ontowww.medicaltraveltoday.com

Readers Write

Editor's Note: Part One of our interview with J. Kevin A. McKechnie that ran in our last issue prompted Tim Morales, President of Costa Rican Medical Care, to pen the following response regarding the history of HSAs in medical travel. We thank Mr. Morales for taking the time to write and for sharing his insight.

Our firm, Costa Rican Medical Care, has been providing medical tourism to people who have an HSA for years, and this is just another reason why our agent network is growing --  health agents looking to provide medical tourism as an option for their clients continue to sign up with us. We have had many people take advantage of using their HSA and Costa Rican Medical Care to save money on their healthcare.

Our parent company is one of the largest HSA providers in the US Many banks and credit unions use our HSA program. We have 48 state HSA websites for people looking for information about HSAs  on many other money-saving options, such as medical tourism, discount drug cards, etc. Example: http://www.hsaconnecticut.com

Our Senior Vice President Roy Ramthun, who was the point person for the US Treasury in 2004 when HSAs were first allowed, was known as “Mr. HSA” throughout the HSA industry.

Because of this, we started Costa Rican Medical Care over three and a half years ago. We did a year's worth of work meeting with officials in Costa Rica and building our network before we ever put up our website, unlike many start-ups today. We have hosted many other HSA providers in Costa Rica. Mr. Ramthun  spoke on this subject in 2010 as the keynote speaker at the First Latin American Medical Tourism conference in Costa Rica.

We thank you for doing the story on HSAs, but this is not a new idea, as some recent press releases would have you believe.

Tim Morales
Costa Rican Medical Care Inc.


J. Kevin A. McKechnie, Part II

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.

J. Kevin A. McKechnie,
Executive Director of the American Bankers Insurance Association and Director of the Health Savings Account (HSA) Council

MTT:  We hear a lot about employers adopting domestic medical travel vs. international. Do you see a reason why they wouldn’t make the move to international?

JKM:  I don’t see any kind of regulatory impediment, and I don’t see a structural impediment.

What I do see is a liability impediment, which is a challenge to all of us.  Even if we follow the same success rates and cures rates internationally that we have domestically, we know that some people are going to come home from these trips having been treated poorly. 

We know that risk is there and so the question is, “How will our legal system and the employers respond when that one patient (statistically) comes back with a complaint?”

If we respond as adults the same way we always do — which is to cure the problem first and make the patient whole — that would ameliorate any of the differences between domestic treatments vs. international treatments.

If we go off and do something childish -- as we all want to do as Americans -- and sue, sue, sue, that will be the kind of thing that the industry will have to respond to with higher charges.  And that might be what ultimately gives it pause.

MTT:  Are you aware of the current insurance policies and the liability policies that are now out there for employers?

JKM:  Not specifically.

I can speak a little bit to what is required under an ERISA plan, but HSAs are not offered under ERISA plans.  It’s kind of a gray area. 

The way this product is positioned is correct:  If you are going to have an HSA, even if the employer is going to do the work for you and gets the qualified health plan to cooperate -- and even if they’re self-funding the qualified health plan -- it’s still on you. 

That’s something this country is going to migrate towards because we don’t have any more money to spend for entitlements.  Little by little, people are going to assume even more responsibly for themselves when that happens. 

The legal system will probably change, and you’ll be much less likely to sue your employer or your insurance company for a bad outcome -- and much more likely to sue the guy that did it – the doctor.

MTT:  What about procedures that are not approved by the FDA (i.e, certain stem cell procedures) but are available in other countries? How does an individual with an HSA use that money to take advantage of those treatments?

JKM:  The answer is they don’t if it’s the HSA money. 

Now if you are able as an HSA owner -- which is to say if you are an American that has one of these -- you can do two things:

First, if you are under the age of 65 and you need to seek a treatment that is not FDA-approved and may be experimental, what you do is tap your HSA resources, pay income taxes and a 20 percent penalty, and get the remainder of your funds to go and do what you’re going to do.

Secondly, if you are over 65, you have a different set of circumstances:  There’s no penalty for taking the funds out -- you only have to pay taxes if the purpose for which you took the money out is a non-qualified purpose. 

Let’s just assume that you are over 65 and are going to be taking your money out of your HSA, paying taxes on that money and seeking out whatever treatments you think are appropriate.  This scenario happens inside this country, although not as frequently as it is beginning to happen outside of this country.

That’s how you respond with an HSA:  Anything not on that IRS 502 publication wouldn’t be permissible to qualify as an expense.  Of course, anything that the FDA doesn’t approve wouldn’t be a procedure that you could have insured in this country.

MTT:  How about dentistry?  Dental care seems to be a very popular option for medical travel. 

JKM:  Well, that’s where an HSA really ramps up. 

There are some fine lines, so it behooves you as an HSA owner to check that out before you get on the jet. 

There are some other optional items, such as food services, that are also covered by HSAs.  Here again, it is incumbent upon the individual to double check with his or her insurance company to make certain. 

I heard this anecdotally, so I don’t know this for fact:  Some international providers are adopting the diagnosis code system that we use in this country so that they can give comfort to the American insurer that, in fact, they are getting a qualified service. 

As a result, this can be matched against the HSA deductible and cost-sharing architectures -- just as if it was happening in downtown Memphis.  That’s a very positive development. 

Also, what we just described is that HSA’s are more versatile than most other traditional insurance programs that don’t cover dental or optical – but HSAs do!

MTT:  Are you aware of a trend whereby US-based doctors are taking their patients to hospitals outside of the US, actually performing the surgery at those hospitals, and then providing the aftercare back in the US?

JKM:  I am not, and as an Executive to the American Bankers Association, it probably wouldn’t be something that we’d focus a lot of our energy on.  We’re much more interested in how the products that banks use are used here. 

We’re just aware how they are applicable elsewhere.  So no, I’m not familiar.

MTT:  As a bottom line, what is the American Bankers Association interest in medical travel?  Is it on the HSA level?  Or is it to simply weigh in and help consumers fund their own medical care and work to make the most out of their medical dollar?

JKM:  Let’s go with “yes” as the shorter answer. 

The longer answer is that it turns out that we’re seeing a shift in who owns the client.  It used to be an employee benefit broker that was autonomous of either an insurer or a financial institution that owned the client and went out to get bids.

But this has changed.  The client now actually belongs to the bank. 

The HSA is the conduit, and although it started as a complex product, it has been made significantly smoother and simplified by the application of bank and money management technology. 

You are seeing a lot of banks buying insurance brokerages, especially employee benefit brokerages for the purpose of being able to offer an integrated service to a variety of customers.  The first rank is with the customers with whom they have a lending relationship.

Now they are going to them and saying, “We can handle your employee benefits, and by the way, we can also sell you the insurance product and help you manage it.  So let’s open up the accounts and then we’ll do all of the work to get you in touch with a stable of insurance carriers such as Aetna, Cigna, Blue Cross -- those kinds of people -- and we’ll do that going forward.”

Now that they own the client, banks have this way of making you completely aware of all the various things they would like you to do -- medical tourism being one of the applications. 

And so, when  a banker is asked the question:  “I’m going to go down and get my knee replaced in Costa Rica.  Do you have any idea of what will happen?” he or she  will have an answer. 

MTT:  I read this week about Walgreens getting into this insurance marketplace and I would imagine CVS, Wal-Mart and all the others will follow.  Do you think a medical travel benefit is something that would be appealing to offer through a Walgreens?

JKM:  I would imagine it would. 

I’ve always been someone who is more in favor of competition than less.  If there’s going to be other distribution points for qualifying medical insurance for HSAs or for policies that cover you for medical tourism, I don’t see the harm of having that kind of coverage -- it would be good.

MTT:  You have been referencing Costa Rica in this discussion.  What other destinations do you think would be most appealing to Americans – India, Singapore, Korea?  New Zealand?

JKM:  I’m sure they would be. 

There are Americans every place on the planet, so it would be reasonable to expect that services may follow them or they may follow services. 

There are some natural gathering points and those gathering points would be in places where Americans are highly congregated. 

To me, that sounds like Europe or Central America.  Canada is lightening up its regulatory environment, so there are private clinics in British Columbia and Ontario where an American can go, pay some money and get service.  They’re both next door and easily accessible by air. 

Many of the farther destinations will also draw some people.  One of the problems being solved by medical tourism is quicker access to care.  But it’s not as easy to reach a hospital in India vs. Mexico.

However, if the patient’s insurance doesn’t cover any of this, many will convert to an HSA – giving them access to a financial product that makes the whole enterprise even more open for discussion.

The interest level in this is rising tremendously and it’s precisely what people want.  This is what democratizes this industry.

Previously, you had to have cash to take advantage of these options since this wasn’t something that was going to be covered by insurance. 

HSA’s are insurance and they give you something no other product gives you -- cash.

MTT:  And choice.

JKM:  Yes, and choice.  Those are huge.

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 US Courts in order to preserve the ability of Americans to pay for healthcare using an HSA.


SPOTLIGHT: David Monteiro, Business Development Manager, Compass Benefits Group

Medical Travel Today (MTT): How long has CBG been offering medical travel products?

David Monteiro (DM): Compass Benefits Group has been in business since 2004. Since that time, we've been offering insurance solutions to international travelers. A little over a year ago we expanded our offering to include medical complication insurance plans for international travelers. It really was a natural extension of what we do…it involves many of the international insurance carriers we were already dealing with, and it called on our understanding of international travel. It also tapped our expertise and understanding of the components of health claims.

Our medical travel offerings include Medical Tourism Complication Insurance, Medical Tourism Employer Liability, Employer Group Medical Tourism Insurance, and Medical Tourism Facilitator Liability Plan.

MTT: Which of your medical travel offerings is the most popular?

DM: The medical complication plan.  The medical complication insurance plan offers worldwide coverage to an international patient in the event of an accident or complication resulting from a medical procedure abroad.  

MTT: And where are most of your customers coming from and going to and for what type of care?

DM:  Most are from Australia, Norway and Canada, with the majority travelling to Thailand, Costa Rica, and Mexico.

The most popular treatment we're seeing is the MS liberation treatment, chronic cerebro-spinal venous insufficiency (CCSVI). It's particularly popular with patients from Canada and Norway where the treatment is not offered. In Canada, too, there's a very strong and active MS association promoting the treatment. Our Norway connection is actually a gentleman who works with the government.  He essentially facilitates medical travel to Germany for Norwegians who need the treatment.

Other treatments that are popular include cosmetic surgery, gastric bypass and dental.

MTT: What types of employers are most actively purchasing or considering your policies?

DM: The ones that are most seriously considering a policy are those looking to go to a self-funded plan to help reduce their costs on major medical-type procedures.   Most are US-based and tend to be smaller, with 1,000 employees or less.

MTT: Is this a tougher sell than the consumer policy?

DM: Definitely yes. On the employer side, medical travel is still very new. We're in what I consider the early development phase of the product.

On the individual side, especially abroad, medical travel has always been there. Aussies and Canadians have always gone abroad. There's not much of a learning curve in those markets, unlike in the US In fact, outside the US, many of the hospitals don't even differentiate international patients.  That's just doing business for them.

Percentage of Compass Benefits Complications Policy Customers by Country of Origin
Canada                                               44%
Australia/New Zealand                        38%
United States                                       16%
Europe                                                 7%
Other                                                   16%

MTT: What has the response to the facilitator liability product been like? 

DM: The liability policy was designed for US facilitators to protect them from the exposure of an act, error or omission in the performance of professional services. While I field several inquiries a week for the product, most facilitators are hesitant to purchase. The liability application is pretty involved. It requires a lot of documentation and legwork on the part of the facilitator. Because many US facilitators are in the start-up phase it’s difficult for them to purchase a policy that may cost up to $10,000.

MTT: Obviously there's data collected regarding outcomes, complications, etc. Do you have any plans to publish or make that information public?

DM: Not now. While the results have been favorable, there has not been enough experience with the product to make it truly credible.  We also want to protect our client’s data. However, this experience will contribute to our next phase in which, instead of offering a general complications policy, we're creating policies for specific procedures based on the unique risks, etc.  For example, using our census data we can create a policy specific for IVF or CCSVI that's both less expansive and with higher benefits.

We're very close to coming out with the offering. It will definitely launch in 2012.

MTT:  Any other new products in the works?

DM: Inbound coverage is a strong area of interest.

Up until a month ago there hadn't been a policy to address the inbound patient. Now we have that.

We're looking to build relationships and specific policies with hospitals that are actively promoting inbound medical care. This would work as an overall policy for the entire hospital to cover any type of patient coming to the facility from outside the US.

We think this could serve to accelerate the growth with which US hospitals develop their international patient program.

MTT: You've certainly come a long way from the original travel insurance product.

DM: That's true. But it makes perfect sense. Now that consumers are travelling specifically for care, they need a different kind of coverage. If you buy a regular trip insurance policy but actually go for medical care, that policy is immediately void. Our policies cover you for everything from additional treatments and rehabilitation to emergency evacuation and, in the absolute worst case scenario, repatriation of remains.

The needs of consumers, providers and employers are evolving and expanding. We're working to make sure our products keep everyone covered.

About David Monteiro

David is the Business Development Manager for Compass Benefits Group.  He is responsible for developing customized international travel insurance programs and the technology to support those programs.  David joined Compass Benefits Group in 2009 bringing 10 years sales and product management experience from the insurance and financial services industry. Feel free to contact David@dmonteiro@compassbenefits.

About Compass Benefits

The principals at Compass Benefits Group have worked to help international organizations provide high quality medical care and peace of mind to clients for
over 25 years.

Compass provides the support of a consultant and broker to ensure our clients provide a well-run and competitive plan. Our underwriting partners are among the most experienced and stable in the Medical Tourism Insurance field. Our support and unique consultative approach will dramatically improve the financial and operational results of your Medical Tourism program. 


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

Industry News

As Medical Tourism Gathers Momentum, Top Blog Channels Gain Interest

Patients Beyond Borders author now featured contributor on top sites

Chapel Hill, NCWith interest in global healthcare and healthcare reform continuing unabated, medical tourism has become a popular topic across the blogosphere. The AARP Personal Health Blog and Peter Greenberg are among the popular, influential sites currently featuring posts from Josef Woodman, author of Patients Beyond Borders.

Woodman, a leading advocate for greater consumer access to top-quality, affordable healthcare options, has also been invited to contribute to the new Huff/Post50 website, addressing the health concerns of US baby boomers. Patients Beyond Borders has also recently launched The Health Travelers Forum, now accessible through its consumer website.

At a time when much of the country is searching for answers and alternatives in healthcare, social media continue to play a greater role in bringing awareness to the millions of Americans struggling with the rising costs of medical care. "There is a huge opportunity for hospitals, clinics and agencies to engage with consumers, to communicate clearly and become more 'human,'” says Ian Youngman of the International Medical Travel Journal. "It is now time to deliver innovations, products, campaigns and experiences that truly work on social media."

Industry News

Average Cost of US Health Coverage per Employee is Expected to Cross the $10,000 Threshold for the First Time in 2012, According to Aon Hewitt

IPMI Magazine Travel Insurance, Private Medical and Health Insurance News LONDON — While health care costs are projected to increase at a lower rate in 2012 compared to 2011, the average cost per employee will surpass the $10,000 mark for the first time next year, according to Aon Hewitt, the global human resource consulting and outsourcing business of Aon Corporation (NYSE: AON).

According to Aon Hewitt's analysis, the 2012 average health care premium rate increase will be 7.0 percent, which is slightly lower than the 7.5 percent mark in 2011, and on par with the 6.9 percent increase in 2010. However, the average total health care premium per employee for large companies is projected to be $10,475 in 2012, up from $9,792 in 2011, and $9,111 in 2010.

To read more click here.

Industry News

Drug war puts medical tourism under at the border

The Monitor — 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 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 US.

“I am poor,” Rodriquez said during a morning visit this past July. “I am just an employee.”

No one referred her to Dr. Maribel Martinez Escobar. It just happened to be the closest dentist’s office to the port of entry, and she didn’t want to go any deeper into the city than she had to.

“I even came early because I think the shootings don’t take place until later in the afternoon,” Rodriguez said.

She took some comfort having a small tank and soldiers within view — in the middle of the street just south of the international bridge.

To continue reading click here.

Industry News

Health budgets squeeze seen boosting medical tourism

(Reuters) - More western Europeans are going abroad for cheaper medical treatment, with France and Germany among the top destinations, and cheaper places, such as Poland and Bulgaria, well-placed to develop medical tourism industries, a report on Friday showed.

A study by the Economist Intelligence Unit (EIU) found that France tops the ranking of global destinations for medical treatment. Germany, Sweden and Belgium are also in the top 10.

With ageing populations, the "baby-boomer" generation heading towards retirement, and healthcare budgets being squeezed around the world, the report said the flow of medical tourists — once mainly rich people from developing nations who came to prestigious hospitals in the West — would shift significantly.

As cost pressures in the healthcare systems of rich countries start to bite, this should play into the hands of developing countries keen to develop a medical tourism industry to boost revenues and develop healthcare expertise.

To continue reading click here.

Industry News

74% of American women would leave the US for IVF

LONDON, Oct. 4, 2011 /PRNewswire/ -- A recent survey conducted by Ipsos Reid to gauge American women's attitudes towards In Vitro Fertilization (IVF) has found that 74% would travel outside the US for treatment if success rates were higher and treatment costs were lower.

The trend of medical tourism is rapidly sweeping across the US and is now filtering in to medical fields where the patient is self-funded, as is the case for many IVF procedures.

The US patient has quickly learned to shop around for treatment, as the cost will determine whether or not their health insurance will cover the procedure. Most insurance companies do not cover fertility treatment even though it is a medical condition that stops the patient from conceiving naturally.

Barbados Fertility Centre, which is located in the Caribbean with direct daily flights to New York and Miami is one such facility  that has seen an increase in US patients.

Dr. Juliet Skinner, Head Clinician, said, "We have seen an increase in the number of patients that we are treating from the US and are very encouraged by the findings from the survey, especially as our success rates are higher and our treatment costs significantly lower."

Caitlin and Tyler Vale from Junction City, Oregon, tried to conceive for two years with no success, so they decided to shop around for treatment and traveled to Barbados for their IVF cycle.

Caitlin kept a track of her ovulation and, at the age of 26, couldn't understand why she and her husband were not conceiving. They consulted a specialist in Oregon and learned that Tyler was suffering from male infertility with poor sperm motility and retrograde ejaculation, a condition where ejaculation is released into the bladder. They were advised that their best option was IVF, but the cost was out of the question -- $12,000-15,000 US dollars, with ICSI costing an extra $1,000-1,500USD. Their fertility specialist in Oregon also quoted them for a package of three IVF cycles, which would have cost them $40,000USD.

Caitlin said, "It was hard to imagine paying so much for treatment, the cost was just too high for us. Because I have traveled quite a lot, I feel the care of overseas doctors can be even better than in the US, so I did my research and found Barbados Fertility Centre. We then found out we could get the procedure in Barbados with a two- week relaxing vacation as well. That was just what we wanted and thought that would work best. I spent about a year talking to them before we finally made our decision. It was the best decision we ever made. We had a wonderful experience and our baby is due in October 2011."

For Caitlin and Tyler the experience of leaving the US for treatment has had a positive outcome and only cost them $5,750USD as opposed to the $40,000USD they could have paid if they had stayed in the US.

Also, their treatment in the US may not have necessarily been successful on the first occasion because the US national average success rate for IVF is only 42% compared to the Barbados Fertility Centre’s reporting success rate of 72% using Blastocyst, which leaves the embryos to culture for five days as opposed to the usual two days adopted by most US clinics.

Industry News

Why Silicon Valley Is Running Scared From Healthcare

Theatlantic.com, by Allan May—Innovation is the jewel in the crown of the US healthcare system. We surely can't brag about having the most affordable medical insurance, or the longest-living patients. But we can brag, and do brag, about having the most cutting-edge medical- and bio-technology in the world.

So this should scare you. Medical device, biotech and diagnostic companies account for about one-third of all angel and venture capital investments. But today, this system is in collapse, jeopardizing the very foundation of what has made the US healthcare system the envy of the modern world. 

Why is this happening? I count three reasons. First, the collapse of public financing markets in the financial meltdown of 2008 cooled venture capital funding. The number of venture capital firms and the amount of venture capital have both decreased by roughly two-thirds, to levels not seen since 1994-98. 

To continue reading click here.

Industry News

Thailand Mitigates Tourism Threat

TravelDaily.co.uk—The Tourism Authority of Thailand (TAT) is preparing a response plan to mitigate the potential impact of the European debt crisis, widespread flooding in Thailand and recent bombings in the restive south. 

The agency still expects European arrivals to grow over the coming months, but is concerned about slowing arrivals from key markets. The UK, Italy and Spain are particularly vulnerable to the region’s economic woes and this will affect outbound tourism from these countries. It is expected to focus on niche markets such as golf, green and medical tourism to entice travelers. 

Key tourist locations, including Ayutthaya, have been affected by recent flooding and travel warnings have been raised in the far south of Thailand after a series of bombings. Four car bombs were set off on September 16, 2011, killing four and leaving more than 100 injured. TAT expects the effects to be short-lived and is confident tourism levels will return.

Industry News

Satori World Medical Appoints Geoffrey Harris to Its Strategic Advisory Board

PR.com—Satori World Medical, a leading medical travel company, has appointed Geoffrey Harris to serve on its Strategic Advisory Board. Satori’s Strategic Advisory Board assists the company’s Board of Directors and senior management team in the design of Satori World Medical’s forward-looking strategy and tactics.

Geoffrey Harris was previously the Managing Director in Investment Banking at Gleacher & Company. In this capacity, Mr. Harris assisted healthcare companies with capital raising, mergers and acquisitions, and restructuring.

Prior to his position at Gleacher & Company, Mr. Harris was Managing Director/Portfolio Manager at Jefferies Asset Management and at Sirios Capital Management. In addition, Mr. Harris was the Global Head of Healthcare Research at UBS Warburg and Sector Head of Healthcare Services Research at Smith Barney.

Mr. Harris has been a contributor to Health Affairs and a panelist for The Center for Studying Health Systems Change. Mr. Harris received an MS in Management from the Sloan School of Management at MIT and has a BA in Economics from Oberlin College.

Satori World Medical provides access to its global network of board-certified doctors and worldwide centers of excellence through a high-quality integrated program, which is easily added to any health plan, reducing the costs of surgical procedures by an average of 40-80 percent when compared to the same procedures performed in a US hospital. Its business model is specifically designed to deliver high-quality healthcare services, share the tremendous cost savings with plan sponsors and their employees and to coordinate all medical and travel services for individuals who need care.

Satori World Medical has done extensive due diligence on hospitals and physicians to find the best the world has to offer. Its network features hospitals that meet or exceed US standards of care, are accredited and monitored regularly by Satori on the quality of care delivered. 

Industry News

Medical tourism from the UK set to increase due to restricted healthcare budgets

Government austerity measures could lead to a rise in the number of UK patients traveling abroad for medical treatment, if NHS waiting lists start to lengthen. Many could end up going to newer EU member states such as Poland and Bulgaria, finds a new report from the Economist Intelligence Unit.

The report, entitled "Travelling for health: the potential for medical tourism", looks at the push and pull factors behind the growth of the medical tourism industry. It predicts that, thanks to ageing populations and restricted healthcare budgets, the flow of medical tourists is shifting. Whereas rich patients from developing countries used to come to prestigious hospitals in the UK and elsewhere for treatment, now UK patients are starting to travel abroad for lower cost care.

Often patients go to access care that they cannot obtain under the NHS, either because it is not funded or because waiting lists are too long. This trend could be encouraged by the EU Directive on Cross-Border Healthcare, which was passed in January 2011 and comes into force in 2013. The Directive establishes patients' rights to be reimbursed for treatment they receive in other EU countries, and could lead to more West Europeans travelling to Eastern Europe for care.

The report also looks at the US, where it predicts that the US healthcare reforms – despite meaning that more Americans will have healthcare insurance – will encourage medical tourism, as hard-pressed companies and insurers look for cheaper treatment options in an attempt to keep down premiums.

Overall, the report concludes that low costs, as well as medical expertise, are becoming the main drivers of the industry. This should play into the hands of developing countries that are keen to develop a medical tourism industry not only to bring in revenues but also to develop expertise inside their nascent healthcare systems.

To benefit, countries therefore need to offer a combination of medical expertise, low costs, and an environment that offers security both for patients and for the private healthcare companies that drive the medical tourism business. The report uses data on 60 countries to pinpoint which countries offer the best combination of these factors.

Top of the ranking comes France, while other developed countries such as the US and Germany also scored highly on the back of their medical skills and general business environment. The UK is less well-placed to benefit, partly because of comparatively high healthcare costs and partly because it has only a small private healthcare sector.

A number of developing countries also came nearer the top of the rankings, by offering a combination of medical expertise and low costs. Among them were Mexico, Poland, Bulgaria and India, which will also benefit from growing wealth levels. The report suggests that these countries are well-placed to develop medical tourism industries that will create much-needed healthcare jobs and expertise, as well as generating revenues.

But the report warns that to make the most of this opportunity, governments and private companies will need to work together to ensure that the benefits from medical tourism trickle down to the wider population. The industry will also need to develop consistent hospital accreditation and legal framework, so that patients can be sure that they will receive the standard of care they were expecting.

Travelling for health: The potential for medical tourism is available from the Economist Intelligence Unit.

Industry News

Lessons From Abroad: The Dutch Health Care System

In a new series on The Commonwealth Fund Blog, Jonathan Cohn, senior editor at the New Republic and the author of Sick: The Untold Story of America's Health Care Crisis—and the People Who Pay the Price, will explore the healthcare systems of four countries: the Netherlands, France, the United Kingdom and Germany. With Commonwealth Fund support, Cohn traveled to these nations to explore how their healthcare systems manage to achieve universal coverage at a fraction of what the United States spends, as well as high quality of care, and higher rates of public support.

To read the first installment of a two-part blog post on healthcare in the Netherlands click here.

Upcoming Events

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.


EMTC 2012 Slated for April 25-27, 2012

The key message of next year's EMTC in Berlin focuses on the huge unfulfilled potential for health tourism and medical travel in Europe. The European Medical Travel Conference, now in its fifth year, is the internationally recognized event and platform for the European medical travel market - from Munich in 2008, the event has visited Budapest, Venice and lastly Barcelona in 2011. The EMTC network has facilitated discussion on challenging topics such as:

  • The EU Directive on Cross Border Healthcare and its impact for the EU states.
  • The development of inbound and outbound European medical travel, and intra-Europe medical travel.
  • Exploiting the synergies within European healthcare systems for cost saving, competitive pricing and delivery of high-end solutions.
  • The integration and restructuring of healthcare services in a cross-border scenario.

The European Union is being driven by the current financial crisis and pressures; we are experiencing a level of collaboration, solutions and outcomes which we have never seen before. In healthcare, things are also moving quickly. Changing demographics and reduced public expenditure budgets are putting pressure on healthcare provision and opening up new opportunities for cross border cooperation. Attend EMTC 2012 and learn how these changes will affect your organization, your business or your healthcare system.

Healthcare professionals and healthcare providers within Europe can shape the future of cross border healthcare and medical travel from a truly European rather than a national perspective. The EU may come up with the first health systems merger in history.

Come to EMTC 2012 in Berlin...the 2012 medical travel event which you don't want to miss. Learn from the past, watch the present, and create the future… Attend as a delegate and learn from others, come as a speaker or panel member and tell others about your plans and ambitions, and above all work with others to shape and create the future of European healthcare.

For more information, visit the EMTC 2012 website or email chairman@emtc2012.com / info@emtc2012.com.

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
issue's winner:

Valerie Nottingham
Chief, Environmental Quality Branch, National Institutes of Health

News in Review

Cuts 'will boost medical tourism'

The Press Association— Government cuts could push up the number of patients travelling abroad for medical treatment, a new report has suggested.

If waiting times for NHS treatment rise - or therapies go unfunded - more patients will seek help abroad, according to the Economist Intelligence Unit study.

Oklahoma City is spot for ‘medical tourism'

Oklahoma City is becoming a hot destination for medical tourism, a phenomenon captured in a hilarious video recently uploaded to YouTube.

Gary Bridwell (left) and Derek Rose on their recent "radiation vacation."

Titled “Radiation Vacation,” the clip stars Derek Rose, of Las Vegas, and Gary Bridwell, of Edmond — barelegged in hospital robes, tennis shoes and visors — and smiling and waving from area golf courses, Remington Park, the zoo, BricktownBass Pro Shops, the Stockyards, the mayor's office, even Hooters.

Venezuela’s Chavez Will Return to Cuba for Medical Exams

Venezuelan President Hugo Chavez said last night that he would travel to Cuba in late October for medical exams, hours after dismissing a newspaper report that his health had deteriorated, state news agency AVN reported.

Protecting the Rights of Surrogate Mothers in India

The New York Times—NEW DELHI — The plot of the Marathi-language film “Mala Aai Vhhaychy” (“I Want to Be a Mother”) asks a deceptively simple question: Does Yashoda, a woman turning to surrogate motherhood as an escape from poverty, have any claim on the child she is under contract to bear for Mary, an American fertility tourist?

Pop culture, wealthy Chinese spur medical tourism in Asia

Reuters—… Industry experts predict medical tourism in Asia will grow at a rate of 15 to 20 percent a year, mainly due to the emergence of nouveaux riches in the region.

"Asian medical tourism ... seems to be increasing as affluence and mobility increase in Asia," said David Vequist, head of the Center for Medical Tourism Research at the University of the Incarnate Word in Texas.

ASSOCHAM for developing Multi-Speciality Health City at Bangalore

Apex industry body ASSOCHAM today called for developing Multi-Speciality Health City at Bangalore based on a public-private partnership model to enhance medical tourism potential of the state and put Bangalore on the international tourism map.

Top 5 Alternatives to Traditional Health Insurance

HealthNews.com—In today’s economy, it’s the fortunate minority that has both a job and medical benefits. In fact, the number of uninsured Americans has continued to rise, and at last count numbered 50 million. And those with the least resources, the unemployed, are experiencing a high rate of medical debt.

Superbug Returns to Trouble Medical Tourism in India

The NDM1 virus also known as Superbug has return to haunt medical tourism in India. For the first time Delhi government admitted the presence of Superbug virus in the city hospitals but downplayed the situation.

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.