By ANN RANDALL
My first experience with out-of-country medical care happened when a moped accident on a gravel road landed me in the emergency room of a rural clinic in the Bahamas. Two decades later in Costa Rica, I lost a dental filling. My hosts called their dentist and an hour later I was ushered into her clinic for a fix and cleaning that cost less than I paid for a bag of groceries back home. Until recently, I’d been a foreign patient because of travel emergencies. But when pending dental implant surgery not covered by insurance sent me looking for less expensive options, I recalled the modern dental office amenities and gentle efficiency of English-speaking Dr. Viquez in Costa Rica. I searched online for “Costa Rica dentists” and discovered an entire flourishing industry of medical tourism.
International travel in search of a health cure isn’t new. The ancient Greeks traveled distances seeking relief in the temples of Asclepius, the god of medicine. Later, well-heeled American travelers ventured abroad for medical care from exclusive European spas. However, the current U.S. trend of travel for health care is driven by the economics and bureaucracy of the medical system and insurance industry. Patients wanting low cost, high-quality medical care are seeking it in countries previously considered less developed where procedures are offered for far less than in the U.S. And those nations are discovering an untapped tourism market.
Fifty countries now actively cater to the international health traveler, according to Josef Woodman, author of the book and website, Patients Beyond Borders. Mexico, Costa Rica, and Hungary are popular destinations for dental work. Mexico, Costa Rica, and Thailand draw the most international patients for cosmetic surgery. India, Thailand, Singapore, Israel, and Malaysia specialize in invasive surgeries like cardiovascular and orthopedic treatment.
Long known by Arizona snowbirds, medical tourism is a profitable business for some Mexican border towns drawing U.S. residents south for regular dental and vision care. The community of Los Algodones, Mexico, 10 miles from Yuma, AZ, bills itself as “Molar City” with more dentists per capita than anywhere in the world. Drawn by its 350 dental clinics and 150 optical clinics, an estimated 6,000 U.S. citizens cross the border each day from November to March seeking dental and vision care that can cost two-thirds less than it does back home. In December the town even throws a party with food, drink, and live music to welcome its annual influx.
Over the past 15 years, a medical accreditation infrastructure has emerged to both attract and assure patients. Professional organizations such as the Medical Tourism Association and accreditation services like the Joint Commission International inspect, evaluate, and rate facilities and treatment to standardize quality care. The American Journal of Medicine estimates that 800 hospitals across the globe had received JCI accreditation by 2017 with 20 percent more added annually. Countries who actively promote medical tourism have their own national accreditation service such as India’s National Accreditation Board for Hospitals and Healthcare Providers. And individual hospitals sometimes promote a U.S. hospital affiliation. Baltimore’s Johns Hopkins School of Medicine has partnerships with hospitals in Saudi Arabia, China, and Panama, among other countries.
Some countries and individual facilities specialize in treatments excluded by health insurance plans such as dental implant surgery, vision treatment, cosmetic surgery, infertility treatment, bariatric surgery, and specialty treatments without FDA approval. However, even if insurance covers treatment, high deductible and co-pay requirements can make U.S. treatment cost prohibitive. A good rule of thumb, claims Woodman, is the $6,000 rule. “If your specialist quotes you a price of $6,000 or more for treatment, chances are good that one or more foreign countries can offer you the same procedure and quality for less, even including your travel and lodging expenses.”
Businesses who self-insure their employees’ health care plans are beginning to realize the value of encouraging out-of-country care. Three years ago, in Antigua, Guatemala, I met four vacationing families working for the same Colorado business whose employer annually covered their Guatemalan vacation and medical costs for dental and medical checkups because it was less expensive than offering an insurance plan.
Beyond cost, international medical facilities actively market an improved patient experience. Amenities like low nurse-to-patient ratios; deluxe hospital suites; boutique recuperation resorts; airport and in-town limo transportation and concierge services to make all arrangements during a medical stay are often included as part of the care. For less invasive treatment, the facility’s concierge or a specialized medical tourism travel agent can assist with logistics should you decide to combine treatment with vacation.
Research is important no matter what type of care you may be seeking. Is the out-of-country facility accredited by the Joint Commission International or a national accreditation? How often has the facility performed the surgery? Does the provider speak English, or do you speak the country’s language (including medical terminology)? Will your U.S. doctor share your medical records and coordinate back home aftercare? Do you need a companion to travel and stay with you? Does the facility have a concierge to coordinate logistics?
My search for a dental treatment alternative is increasingly common. The American Journal of Medicine estimates that 1.4 million Americans sought international health care in 2017. The number is expected to increase 25 percent annually, driven by a maturing population and increasing medical costs.
It turns out that an October flight to Hungary for a combination dental surgery and weeklong vacation is equivalent to the price quote provided by my dentist. It’s been decades since I’ve seen charming Budapest. It’s a tantalizing possibility.
Ann Randall is an independent traveler and writer who loves venturing to out-of-the-way locales from Azerbaijan to Zimbabwe. A former educator, she now observes international elections and does volunteer work in India. Her articles have appeared in online and print publications and she blogs at PeregrineWoman.com.
Facts and Resources
- Two-thirds of U.S. medical tourists use out of country care for dentistry and cosmetic surgery.
- International medical facilities marketing to U.S. patients are often staffed by physicians and other health professionals trained in the U.S.
- Some travel insurance companies now offer medical tourism options for treatment complications, prepaid medical costs, and trip cancellation.
- Yellow Book is the Centers for Disease Control and Prevention’s guide of health information for overseas travel, with an entire chapter is devoted to medical tourism.
- The Treatment Abroad website publishes patient reviews by treatment, country, provider, and facility. See TreatmentAbroad.com. PatientsBeyondBorders.com is another useful reference.