Border crossing for surgery: More than just boob jobs

With President Obama’s crusade for lower health costs in full swing, many Americans are left wondering where they’ll find quality treatment.

The answer is likely south – as in, yes, Mexico – but trends indicate the border-crossing phenomenon may also be growing at home.

There was a time when traveling across the border for prescription drugs or dental treatment –  much less a surgical procedure – meant returning with a botched boob job or worse, but many U.S. tourism companies are taking the plunge, sending their clients to Mexico, Costa Rica and beyond for medical treatments that rival those at American hospitals at half or even one-third of the cost.

A San Diego-based medical tourism company, Satori World Medical, offers a procedure list that includes everything from plastic surgery to spinal fusion at 40 to 80 percent of the cost of the same procedure done in the U.S., CEO Steven Lash said.

The same is true for BridgeHealth International, a medical tourism company that facilitates treatment for patients around the world, with one key difference:  BridgeHealth also offers its services domestically at a 30 to 50 percent discount – a huge draw for patients who’d rather get their outpatient surgery in Chicago than Singapore.

According to Dr. Juan Pablo Eng, founder of the popular DentiCenter facilities in Mexico, even dental care is booming abroad.  With six dental offices in operation to date – located as close as Tijuana and Mexicali – and, Eng estimates, 60,000 cars crossing the border daily, it’s no wonder.

But how is it so cheap?

According to MedicalTourism.com, overseas (or cross-border) health care is less expensive simply because it costs less to obtain the same end result – it is less expensive to build hospitals and pay for labor.  In addition, many foreign countries have lower taxes, administrative costs and insurance rates than those found in the U.S.

Factors such as price transparency and ability to buy across state lines have also created a boon for the industry.

“Ninety-seven percent of our work is done for U.S. patients,” Eng said.  “It’s a win-win situation.”

While Eng’s practice is across the border, he said is a member of the American Dental Association, as is much of the American dental industry.

Meanwhile, many hospitals affiliated with both Satori World Medical and BridgeHealth are accredited by Joint Commission International, an organization that works to ensure patient safety in more than 80 countries.

“We see four basic opportunities – inbound to the U.S., outbound from the U.S., intra-U.S. and intra-global – for fundamental market segments,” BridgeHealth CEO Vic Lazzaro wrote in an e-mail.  “For all combinations, we see the opportunity for tremendous growth, with BridgeHealth particularly focused on intra-U.S. travel for sponsored members of health plans and both intra-U.S. and outbound individuals from the U.S.”

According to global auditing firm Deloitte’s 2009 Medical Tourism Report, outbound medical tourism is certainly on the rise.  Though the company reports seeing a dip in the number of medical tourists from 2007 to 2008, the trend has started to make a comeback and predictions indicate that international medical tourism could reach 1.6 million or more by 2012.

The concept behind this forecast is simple:  As the cost of U.S. health care (as well as the demand for outpatient, dental and cosmetic surgery) continues to climb, more and more Americans will turn to alternative solutions, like tourism – but what kind of tourism still remains largely in the air.

“The challenge of health care reform is huge and is undoubtedly larger and more complex than the initial national conversation has outlined,” Lazzaro said.  “The basic principles of medical travel – quality, price, access, and a positive patient experience – complement, and in fact might be the basis for, a reset on the needs and problems that require the most attention in our health care system.”

American hospitals may also see a boost in another medical travel equation as well:  inbound tourism.

Lazzaro said government supervision through the FDA and Joint Commission International and a “relatively weak” currency make the U.S. an attractive market for foreigners – most commonly Europeans and Latin Americans.

Lazzaro went on to say that his company’s model of using both global and domestic networks to offset skyrocketing health care costs will ultimately help the ailing economy by filling U.S. hospitals with “inbound patients from other countries as well as intra-U.S. patients from markets those hospitals might not previously have been reaching.”

While Satori World Medical does not offer inbound medical travel, Lash said the U.S. – and San Diego in particular – is likely to attract that business, despite the fact that costs are so low elsewhere.

“I think typically people would come here for new technologies more than anything else, because one of the things that the U.S. is really a leader in is research and development and new techniques,” he said.

Because of its wealth of biotech industries and its well-known research university, San Diego is often regarded as what Lash called a “research mecca” – a standing that could boost consumer confidence in a market that can so easily play its customers.

While businesses like BridgeHealth and Satori World Medical are accredited and monitored by government agencies, many medical operations overseas are still considered a gamble.

Larry Goldstein, director of the Stem Cell Research Program at UCSD, warned that travelers should be especially cautious when seeking a relatively new cure for disease, such as stem cell treatments.

“At the present time, the only stem cell-based treatments of disease that have strong scientific evidence that they will work … are only for transplant of bone marrow stem cells,” Goldstein explained.  “There is no proven therapy to my knowledge … that uses stem cells from any other source for any other kind of disease.”

Despite that, he said, throngs of new “treatments” pop up everywhere – globally and at home.

“There are a great many companies around the world, a great many so-called ‘clinics’ that … claim that they are using stem cells to treat every disease known to mankind,” Goldstein said.  “Sometimes it’s different sources for different diseases, sometimes it’s the same kind of stem cell for all of the diseases.  I think it’s safe to say that for any company advertising something other than bone marrow transplant for diseases of the blood or the immune system, they have gone beyond what we know with a reasonable degree of certainty.”

And that, Goldstein said, is very unlikely.

Of course, it’s not just stem cells medical tourists have to worry about.  Patients need to ask themselves whether concerns such as medical malpractice, insurance and simply the danger of travel itself are going to be worth the cash when all is said and done.

For wholehearted believers like Lazzaro and Lash, the answer is simple – and the rest of America may have a reason to follow suit.

While the health care reform law has failed to address some important components of the medical tourism biz, such as cost shifting and liability excess, Lazzaro believes the legislation may still open doors for health care-hungry Americans as tourism is increasingly accepted as a health care option.

“Medical travel both inbound and outbound is becoming an increasing part of health care plans,” he said.

That means that medical travel may soon be a viable option for the more than 75 million underinsured in the U.S.

In other words, pack your bags, kiddo.

(It was previously reported that DentiCenter is linked to the American Dental Association and that both Satori World Medical and BridgeHealth International are affiliated with Joint Commission International.  While these companies are associated with these groups, the groups are not regulatory government bodies nor do they set standards of practice.)

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