Medical tourism describes the growing numbers of people who travel overseas primarily for healthcare. The most common reasons for seeking care in other countries include:

1. Decreased cost—for example, a bone marrow transplant is about $250,000 in the United States vs as little as $25,000 in India. Medications are also much cheaper, often less than 50% of the cost in the U.S.
2. Avoidance of lengthy delays in treatment—this is particularly true with managed care health insurance in the United States, including Medicare and Veteran’s Administration.
3. Availability of high quality care—many overseas hospitals excel in new or highly sophisticated procedures. Excellent hospitals in the United States are generally limited to major coastal cities. Local hospitals may not provide this quality of care.
4. Cosmetic or medical procedures that are unavailable in the home country—for example, stem cell therapy, which is not yet generally available in the United States.
5. The opportunity to combine a vacation with medical care. This is not available in the U.S. except for very limited procedures and highly expensive accommodations.
6. The opportunity to combine medical care for multiple family members in a single trip. This is not available in the U.S., where each family member is treated entirely separately and often in different facilities.
7. The opportunity to combine diverse types of health care: for example, cosmetic surgery, dental care, an “executive physical,” spa treatment, and alternative methods such as ayurvedic care. In the U.S., separate facilities and individual arrangements would be needed for each.

Medical tourism is already a major world industry, estimated at $40 billion per year and expanding 30% annually. McKinsey Market reports estimate that each of India, Singapore and Thailand generate $2 billion per year in medical tourism revenue.

Most medical tourists come from European and Middle Eastern countries. In 2006, over 770,000 residents of United Kingdom traveled for health care. However, relatively few come from the United States. Why?

The principal barrier to medical tourists is unfamiliarity and distrust of the services, and concerns about the availability of post-procedural care.

MediCruiser Medical Tourism Support Services will solve these limitations and facilitate overseas health care.

It has long been thought that health care was not suitable for outsourcing, unlike other services such as computer programming or clothing manufacture. However, unless a person needs emergency care, there is no reason why medical care cannot be accomplished overseas. The benefits are many:

• Medical care can be much less expensive
• It is more personal—overseas physicians give their home and cell phone number to patients to call at any time.
• There is much better nursing care
• Procedures are available that cannot be obtained in the United States
• Care can be obtained for the whole family at once
• All costs of medical care are given in a single, up-front price—unlike the U.S., where costs are determined only after the care, and there are separate charges for surgery, medications, anesthesia, radiology, etc.
• Health care can be combined with a vacation
• Recovery from surgery can be done in very nice surroundings, with daily massages and other luxurious care

However, there are also many barriers to potential medical tourists:

• Lack of knowledge. Medical tourism is poorly advertised. Knowledge is mostly shared by word-of-mouth or by persons who are Internet-savvy. However, the majority of Internet information on medical tourism is unreliable or fraudulent.
• Lack of advice, and discouragement by American doctors for major medical procedures (including dentistry and cosmetic operations). Americans usually rely on their doctor for advice. However, these doctors have little or no knowledge of medical tourism, and may feel they are losing business. Although overseas surgery may benefit patients, their personal physician will try to discourage them from using this option.
• Lack of trust. Americans believe that U.S. medical care is the best. They are skeptical of the quality of overseas medical care, and doubly skeptical of ventures that have no personal contacts.
• Lack of follow-up care. The major barrier to medical tourism is the lack of continuity in care. The Internet has many stories of people treated overseas only to return home without follow-up care and suffering complications. Many doctors refuse to provide care for post-surgical complications because they fear malpractice accusations for a surgery they did not participate in. This leaves the patient without adequate follow-up.
• Lack of medical malpractice protection. Americans know that they have legal recourse for medical malpractice in the United States. Patients may feel that they have little recourse to compensation if the surgery was done poorly or incorrectly.
• Lack of quality assurance. In the U.S., health and medical regulatory laws ensure quality. There is little way of knowing whether an overseas facility or physician has the same quality. Certainly, Internet claims are highly dubious.
• Lack of travel experience or preparatory knowledge. Even when convinced of the benefits, some people are reluctant to travel because they are insecure in foreign countries or languages.

MediCruiser will address all of these concerns and remove each of these barriers. By developing close relationships with the provider hospitals, MediCruiser ensures quality, facilitates access, and takes care of all the paperwork. MediCruiser will also offer medical insurance for the traveler, and many other services.

The renowned Max Devki Devi heart treatment center in New Delhi, India —among the best in the world.

An Illustrative Vignette

An imaginary medical tourist experience will best illustrate the MediCruiser experience.

Tom Smith is a 45 year old general contractor. He is overweight and has high blood pressure and diabetes. He knows that he must lose weight to prevent further illness and perhaps even suffer blindness or leg amputation because of his advancing diabetes. He has tried to lose weight, without success. Now, he is planning to get the new lap-band stomach-reduction surgery. However, this surgery costs an average of $23,000 in the U.S., with a total of about $30,000 after all costs are

included. Tom has health insurance, but it will not pay for his surgery since he does not meet the very strict criteria for life-threatening obesity. Tom is considering going overseas, where he can have the surgery done for as little as $5,000, with all expenses included. However, he is skeptical of Internet sites and their dubious promises.

After seeing an advertisement for MediCruiser, Tom decides to visit a MediCruiser clinic (he could also do so online if there is no clinic nearby). The MediCruiser physician discusses Tom’s situation with him and reviews his previous medical records. It becomes clear that Tom would benefit from the surgery. The physician explains that the American Medical Association strongly supports bariatric surgery (including the lap-band procedure). The treatment will probably lower his blood pressure (maybe enough so that he can stop medication) and has a 90 percent chance of curing his diabetes, in addition to many other health benefits.

Through MediCruiser, Tom watches a video of the hospital and doctors, the treatment, and a walk-through of the entire process. He can also view the hotel and sites of interest.

Tom agrees to do it. He goes to the MediCruiser clinic and has all of his pre-surgery preparation done, including physical examination, blood tests and thorough health review. He then is connected via videoconference with his surgeon overseas. MediCruiser arranges everything, including help with his passport, visa (if needed), and all medical, hotel, and travel arrangements. Tom wants to take his wife along, so MediCruiser helps arrange sight-seeing and other activities for her.

Tom and his wife fly to the country. They are met at the airport by a MediCruiser concierge who takes them in a limousine to their hotel. While their luggage is taken up for them, they are both treated to a relaxing massage. The concierge introduces them to their rooms and features. The next morning, the concierge will take Tom to the hospital to meet his doctors and have his surgery. Afterward, he will be taken back to the hotel and checked on every day for any needs or desires. The concierge gives Tom and his wife a local cell phone to make calls, and arranges any activities they choose while he is recovering. The concierge also makes sure Tom can keep in touch with his company and family back home, or even have a videoconference with them.

After Tom returns to the U.S., MediCruiser provides all follow-up care. If there are any concerns, further videoconference with the surgeon is possible. MediCruiser quickly addresses problems or any concerns.

Dr. Gahlinger’s book on Medical Tourism is the first complete guide to going overseas for healthcare. It is being published in July, 2008, but can be pre-ordered at Amazon.com.

An example:

In February, 2008, Dr. Gahlinger got an email from an anthropologist working in Papua New Guinea.  A respected community support leader had developed laryngeal cancer.  The treatment in Australia was $40,000—far more than the resources available.  Dr. Polly Weisner had heard of Dr. Gahlinger’s book and asked if he had advice for less expensive treatment.   He sent her a few pages on cancer treatment in Thailand.



This was her response:



Dear Paul,  Just a note to say that I followed your leads and other connections and now am in Bangkok launching care for my colleague from PNG with cancer of the larynx. Now he had been transferred to the Bangkok Cancer Hospital for 7 weeks of radiotherapy.  His doctor was trained at Sloan Kettering.  The total bill for everything including 7 weeks at the hospital's guest house is US$3500! 



Thanks for you help -- it worked!   cheers,   Polly