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In recent years, individuals are crossing borders for more than vacations and business trips. Skyrocketing surgical costs have sent hard-pressed Americans to Asia, the Pacific Rim and South America for elective surgery and other medical procedures (most often cosmetic surgery) that can be scheduled in advance. In the UK and Canada where Socialized Medicine determines cost of treatment, people are packing their bags and taking holidays in places where the cost of care is dramatically less.
Risk factors when traveling for surgeries:
In the United States, there is a level of safety people feel and expect because of stringent regulations. This is not the case abroad, and an individual may encounter:
- Quality of care concerns – there is no international regulatory group to enforce quality standards around the world, and individuals don’t have access to the information required for in-depth credentialing
- Inconsistency in training of medical staff – physicians and nurses can have varied levels of education and experience
- Lack of post-op care – many overseas facilities do not have 24-hour monitoring
- Lack of dialog between the doctor and patient – often, discussions and consent forms dealing with procedures and potential complications are not common or elaborate
- Language barriers – not all staff may speak English, and medical forms may not be in English either
- Cultural differences – patient rooms may not have telephones, comfort and cleanliness standards are different from country to country
- No malpractice insurance – individuals generally don’t have an opportunity for legal recourse if something goes wrong, because many foreign providers do not have malpractice insurance and they have traveled outside of the U.S. legal system
“The problem is that people who don’t have insurance and can’t afford necessary procedures in their home country are now bargaining with their healthcare.” says MEDEX Global Group’s Medical Director, Walter “Ben” Koppel. “Once having made their plans and traveled to their exotic locale, patients who find the facility they booked to be ill-equipped and under-staffed, bearing little or no resemblance to the description in a brochure or on a website, shouldn’t be reluctant to return home without having their procedure done.”
Additional concerns and considerations:
- Medical systems abroad can be very different from country to country. Many provider networks are more focused on financial discounts than medical capabilities and quality of care.
- Insurance exclusions – even if you have international medical insurance, most policies (including all MEDEX policies) include an exclusion about “traveling for the purpose of obtaining medical care”
While 24-hour emergency assistance would still be provided to help if something went wrong with your procedure, expenses involved in your treatment or return home will not be covered.
- Paying cash for services – many foreign providers require travelers to pay upfront for services
- Legal matters that can affect your care – in some countries, a woman’s treatment can be contingent upon the approval of her husband
- Finding good providers & facilities – websites and brochures can be misleading and are sometimes designed to attract travelers searching for surgical bargains
“Even if a facility is qualified for orthopedic procedures, what would they do in the event of a cardiac complication during your procedure?” Koppel points out. This is a particular concern for all individuals of retirement age who are seeking care overseas. “Is there a qualified cardiac specialist in that same facility who would be able to save your life? Is there a facility nearby that you could be transferred to?”
All individuals seeking surgical procedures abroad should travel to the facility during their research stage and should plan to have a loved one with them during their procedure. “If an individual is taking all of the proper precautions, such as a pre-procedure visit to the facility and bringing a loved one for support, they may find that their bargain procedure does not actually save as much as they thought, ” Koppel explains.
MEDEX does not condone medical tourism and cautions that travelers are taking a very high risk when traveling abroad for surgeries. However, for those travelers who recognize these risks and are still determined to seek elective medical treatment abroad, the following tips can help, at minimum, to be better prepared:
- Be skeptical of claims made on websites and in brochures. Seek independent verification from other sources; perform several Internet searches for the facility and see if there are postings made by former patients.
- Ask about credentials and consult the Joint Commission International (JCI) www.jcrinc.com, which is affiliated with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
- Wherever possible, seek advice from the American or Western expatriate community living in the country to which you are going. They often share positive and negative experiences with each other.
- Remember to be prepared financially. You may not be covered by insurance and may have to pay out-of-pocket. Unexpected expenses can find your procedure delayed, or your post-op recuperative time spent drawing cash from an ATM.
- Don’t travel alone to seek treatment. Ask if the hospital has double rooms for family to stay with you. This is especially important to ensure responsive post-op monitoring and timely care.
- Ask questions before leaving. If the answers are unacceptably vague or unresponsive, move on to another facility. Relevant requests for information include statistics on minimally invasive surgeries at their facility and their compliance with International Red Cross standards for blood transfusions. NOTE: MEDEX Assistance typically advises against any blood transfusions outside of the US.
- Be prepared to turn around and come back if something doesn’t seem right about the facility or your treatment.
- If possible, schedule your own credentialing visit to check out the facility first-hand before you decide to have treatment abroad. Be sure to observe such telltale conditions as:
a. Overall cleanliness of the facility including hallways and waiting rooms;
b. Whether the staff is properly attired in uniforms with nametags;
c. Whether they use disposable equipment and dispose of it after use.
d. The number of English speaking staff members
e. The schedule of the nursing staff – is it 24/7?
f. The ratio of nurses to patients
g. The accessibility you have to your treating physician/surgeon?
- Know where to turn for help. MEDEX Assistance members can call toll-free or collect for 24-hour professional assistance in emergency situations. Click here to learn more about programs available to individuals through MEDEX Insurance Services, Inc.
NOTE: MEDEX’s international medical insurance programs do not pay for elective surgeries. Member benefits when “traveling for the purpose of obtaining medical care” (program exclusion) will be limited to the 24-hour assistance services provided through MEDEX Assistance Corporation’s Emergency Response Center.
