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October 19, 2012, 11:22 am
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What Obama’s Affordable Care Act Means for the World’s Hospitals

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globalpost.com – Sitting in blue scrubs in a hospital room, plastic surgeon Christian Rivera ponders a potential sea change for this Central American country’s private hospitals, triggered by healthcare reform in the US.

That’s because his profession thrives on uninsured US citizens looking for cheaper care abroad. So what happens to medical tourism when US President Barack Obama’s Affordable Care Act grants almost all US citizens health insurance by 2014? Rivera hopes he has a positive answer.

In June, the US Supreme Court declared the core of the reform constitutional. Republican presidential candidate Mitt Romney, if elected, has vowed to repeal it. At the same time, overseas medical tourism representatives are searching for ways to benefit under the new law, often called “Obamacare.”

That name started out as a favorite pejorative for critics who deride what they see as a central pillar of Obama’s agenda for big government control. But now the law’s supporters have adopted the word for legislation they believe brings Americans closer than ever to universal healthcare.

But other changes could be under way. Some experts predict a doctor shortage and longer hospital waits in the US. They also foresee insurance companies extending coverage for Americans’ international medical bills. If all this is true, medical tourism will have a healthy future.

US patients obtain healthcare treatment in foreign countries well below US rates. Treatments include dental implants, hip and knee replacements or bariatric surgeries. Americans also go abroad for more complicated procedures such as heart operations and cancer treatment, or alternative therapies such as stem cell treatment unavailable at home.

Estimates vary on the size of the medical tourism industry. In December 2010, consulting firm Frost & Sullivan put the industry’s global worth at $78.5 billion. Patients Beyond Borders, a consultancy for consumer information on the sector, put it at $15 billion, counting 5 million patients worldwide in 2011.
Estimates for how many of the patients were American vary, as well, from 550,000 to 1.6 million.

In the developing world, many doctors now work like Rivera. Physicians and surgeons train at top US medical schools, return to their homeland – whether in Mexico, Central or South America, or Asia – and provide nimble treatment to anyone who can afford their care.

The economic benefits extend far beyond the doctor’s office. In Costa Rica, patients fly in to fill hospital beds, hotel rooms and spots in tour groups all on the same trip. They tend to stay longer and spend six times as much money than the average tourist, according to Promed, a Costa Rican nonprofit association representing the private health sector. American patients often bring the family, and spend their recovery at a beach resort or in a lodge in the rainforest.

In 2010, Costa Rica attracted 36,000 medical tourists – primarily US and Canadian citizens – who spent $295 million in the country, according to Promed.

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