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Medical Tourism: Good Prospects

What are Latin America's prospects for medical tourism? Three experts share their insights.

BY LATIN AMERICA ADVISOR
Inter-American Dialogue 

A 2008 study by Deloitte listed Brazil, Costa Rica and Mexico as the countries in the Latin America with the greatest potential for inbound medical tourism, with medical costs ranging from 25 to 50 percent of U.S. averages. What are Latin America's prospects as a destination for medical tourists from outside the region, and what types of services and procedures have the most potential? How do intra-regional medical tourism flows—patients traveling within Latin America—factor into the equation?

Beatrice Rangel, director of AMLA Consulting in Miami Beach, Fla.: Over the past decade, U.S. patients have found that health care delivery has climbed to the top in the quality scale abroad while it crumbles at home. For many years now, U.S. citizens have traveled to Costa Rica, Argentina, Colombia, Brazil and Chile to get dental treatments that cost 20 percent of their cost in the United States. The same trend is visible in the fields of heart and joint replacement surgery as well as plastic surgery. To understand the presence and promise of medical tourism, however, one needs to examine other inductive factors. Notable among them is quality of the health services offered abroad. Quality starts with competence. Most doctors that provide top quality medical services in the developing world are trained in the United States and Europe. Culture is another important factor. Latin American doctors are very tied to their communities and are very highly regarded in their societies. They consequently have a reputation to protect and the best way to do so is by being caring and effective. Thus, most doctors in Latin America tend to go out of their way to keep patients happy. In Europe and the United States, patients are numbers and health practitioners only fear malpractice lawsuits. But given that their insurance takes care of this aspect of their profession they do not need to be caring. Costa Rica is already attracting a sizable number of baby boomer medical tourists. Mexico will also benefit from the aging of this demographic. Brazil holds an extraordinary competitive advantage thanks to the policies adopted by the Cardoso administration and left in place with enthusiasm by the Lula administration to promote the adoption of information technology in public health care outlets and to extend insurance to lower-income groups so that they can be treated in private clinics.

Jonathan Edelheit, president of the Medical Tourism Association in West Palm Beach, Fla: Latin America is poised to get a significant amount of the medical tourism from the United States because of the close proximity and the familiarity and comfort Americans have for the Latin American culture and language. Latin America has a significant amount of quality healthcare, and countries like Costa Rica and Mexico are emerging as the leaders in medical tourism, receiving a large number of medical tourists each year. Mexico and Costa Rica have country initiatives where the governments are supporting and helping to fund marketing of the countries as medical tourism destinations. Also, many large U.S. insurance companies and employers are starting to implement medical tourism and are looking to contract with hospitals in Latin America. Cuba has been a destination for Canadians, but now Canadians are also starting to go to Mexico and Costa Rica as those countries and hospitals get more aggressive in marketing their countries. It is estimated that by 2017 up to 23 million Americans could be traveling overseas spending up to $79.5 billion per year, and that over 50 percent of that business could be headed to Latin America because of the close proximity, which means shorter travel times for patients.

Elaine Scheye, president of the Scheye Group Ltd. in Chicago: In the majority of cases, medical tourism benefits payors, or cash paying patients, irrespective of which country may be providing the care. The central problems associated with medical tourism are that most patients do not know which kind of certifications and licenses to look for nor do they understand how to interpret the criteria used to evaluate doctors and hospitals. Therefore, they are at the mercy of representations made by the payors and/or travel agencies springing up now specializing in accommodating medical tourists. Neither are patients aware that if medical complications arise upon return to their native country, especially if they return to the United States, patients risk being unable to find a doctor willing to assume liability to provide a follow-up to medical care that was provided outside the country. With respect to intra-regional medical tourism, I would suspect that this already occurs with frequency and therefore not considered a new phenomenon to these countries. However, when medical facilities serve both medical tourists and patients intra-regionally, there is an inherent risk of overburdening facilities and medical teams, and potentially compromising the quality of care, especially if there is an inadequate number of specialists. The services most likely sought by medical tourists mostly include 'high ticket' kinds of care such as cardiac bypasses, hip replacements and those considered elective and therefore not covered by payors, which includes cosmetic surgery. I am not a fan of medical tourism because the best care, in most cases, is care that is provided in the country of a patient's origin, provided without the added burden of potential cultural and language barriers. Medical tourism is gaining traction because of the way medical care is financed and reimbursed, particularly in the United States. The solution is to reform the insurance, payment and reimbursement system so that patients need not travel outside their own countries to receive 'affordable care.' No patient should be forced to travel outside of their country and their comfort zone to another country to receive care potentially for the benefit of payors, in most cases.

Republished with permission from the Inter-American Dialogue's daily Latin America Advisor newsletter.

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