Photo by Kelly Sikkema on Unsplash
In early 2020, I visited my auto mechanic, Joe, for new tires. Every time I see him, we end up talking for at least 45 minutes. During that particular visit, he told me about how he had undergone ‘part one’ of his hair transplant surgery in Turkey during the fall of 2019. When he took off his cap, sure enough, where there was previously a mainly bald top-of-the-head, now there was a noticeable amount of new growth. Not too much, but enough to realize that the procedure had worked. He excitedly told me about how, outside of the medical procedure, he and his wife were able to do some sightseeing and lots and lots of shopping in Istanbul. I was genuinely happy for him, and secretly entertained the idea of taking a medical vacation to Turkey with my husband in the near future for his growing locus of baldness.
Medical tourism has grown into a burgeoning, robust worldwide industry which is projected to reach almost $275 billion by 2027. The OECD estimates that the world’s medical tourists are numbering in the 50 million range, with an annual increase of 25 percent expected in the next decade. Thailand, Mexico, and the US are the top three destinations, which collectively receive somewhere in the area of three million patients per year. Singapore, India, Brazil, Turkey, and Taiwan are other popular destinations. Even several leading US medical centers, including Harvard, Johns Hopkins, and the Cleveland Clinic, have set up clinics and hospitals outside of the US in order to capitalize on this market.
In Rachel Cooper’s article from 2013, she mentions that employers had begun to explore the idea of outsourcing the medical care of the employees they insure in order to cut costs. Given the ever-rising healthcare costs in the US, many companies are now providing incentives for their employees and dependents to have procedures done outside of the country. An outfit in Denver, Colorado, called NASH (North American Specialty Hospital) does the work of bringing together self-insured American employers, well-trained American surgeons, and foreign hospitals with their foreign medical expert providers to create a safe and quality healthcare experience for American patients at much lower costs. There are more companies like NASH, and they are mitigating some of the ‘Buyer, beware!’ concerns that Ms. Cooper had highlighted. The American doctors are incentivized to fly down for a quick trip to perform the surgeries because they can earn three times the fee they would have otherwise been paid by Medicare in the US, and companies like NASH are purchasing additional malpractice insurance for the doctors, should dissatisfied patients decide to sue when back in the US.
Employees who are willing to travel for these procedures, such as knee replacements, are not only saving money, but in some cases are making money for agreeing to take this leap. A knee replacement surgery, which can cost anywhere between $30K to $90K in the US, only costs $12K in Mexico. It is no wonder that some employers are paying their employees thousands of dollars to have their surgeries abroad, in addition to covering their total travel expenses. Even with all the incentive payments, companies are saving a considerable portion of their healthcare costs.
The concern for the citizens of the host country still remains. Many excellent physicians are lured away from public hospitals to the glamour and salaries of upscale, private hospitals, even if they are still physically located in their host nation. This is to the detriment of the local population. However, there still exists a good argument to continue with providing medical care to traveling patients. In Turkey, for example, there is an annual growth rate of roughly 23 percent. In 2017, over one million people traveled to Turkey for medical purposes, bringing in approximately $10 billion of foreign currency into the economy. In 2013, the Turkish Ministry of Health had enacted many initiatives to grow the industry, including improving the quality of Turkish hospitals, creating many publicly funded city hospitals, and increasing the number of private medical schools and thereby the number of medical graduates. This has all lead to positive reform in Turkey’s healthcare system and has provided the Turkish people with a quality healthcare system which rivals those in the west. While this rapid growth has led to concerns of patient safety, and where flourishing private hospitals are still creating a ‘brain drain’ of good doctors from public hospitals, the overall boon to the Turkish healthcare system and greater access to this better quality of care justifies the further investment into medical tourism. Also, given the tragedy of the recent earthquake, this industry can help the rebuild the country’s economy.
In the end, I agree with Ms. Cooper that it is a shame that citizens of the wealthier countries have to look outside their nations’ borders for elective or life-saving healthcare, whether it is for cost-savings or quicker accessibility or availability purposes. We can only hope that this outflow of US patients can somehow contribute to some future reform within the US healthcare industry, where Americans will not feel the need to go elsewhere to find affordable and accessible medical treatments. In the meantime, I am happy for my mechanic Joe. My latest visit to his shop revealed a full head of hair, as he went back to Turkey for part two of his treatment sometime last year and had a great experience, both medically and leisurely.