The surgeon visited on both Saturday and Sunday: Medical tourism to Switzerland

Colleen McGarry's story:
During my four-day quiet stay in a Swiss private clinic, staff stopped by frequently and served homemade meals. The surgeon visited on both Saturday and Sunday. The only paperwork that I had to complete was my signature on the safe deposit box. In this expensive country, my room was $500 per day.

This experience was a bit surprising as my prior encounters with hospitals had been limited to American institutions. Lower malpractice premiums and awards may help keep costs down, but they are not the only factors. In this era of globalization, one wonders why hospital managers do not examine what works well in other countries.

While there is great respect for American medical research and expertise, there is a general fear that American-style health care delivery practices will eventually find their way here. Let us hope that it is the other way around.

Advice to those thinking of expensive elective surgery: Consider medical tourism.

Read another story about medical tourism. Thanks to Colleen for her letter to the editor, reprinted here from the June 15 issue of the New York Times.

She was visiting: Medical tourism to Israel

Caroline Ardeeser, a 78-year-old retired Florida resident, decided to forgo Medicare and hospitalization in the U.S. and pursued surgery in Israel. She was visiting Israel earlier this year, when her knees "gave out." Rather than return home, where she had stopped paying health insurance premiums, she chose to have the reconstructive surgery performed at the Sheba Hospital in Israel. The 90-minute surgery and a week's stay in the hospital cost her $16,000, which she had in savings.

She says that at her age, she cannot obtain private health insurance in the U.S. And even if she could, she estimates that with the co-pay, the surgery and the rehabilitation at home could have cost three times as much. She plans to have surgery on her other knee soon and is recuperating in a rented house in the West Bank city-settlement of Ariel. "I had a most positive experience here," she says.

Much of the medical tourism industry in Israel depends on brokers like Ira Nissel, who handled Caroline’s case. An immigrant from New York who came to Israel in the late 1970s, he is an entrepreneur who formed IMS Global four years ago to promote medical tourism to Israel.

A survey in 2008 by Deloitte Center for Health Solutions found that in 2007, 750,000 Americans traveled overseas for medical treatment. Spokespersons for the Israeli government said about 20,000 foreign tourists were served in Israel in 2007.

Advice to people lacking insurance: Consider the merits of getting care abroad – or of getting a U.S. president who favors universal health insurance.

Read a story about medical tourism.

Thanks to Netty Gross for the source article in the Oct. 13 issue of the Jerusalem Report.

What do I have to lose?: Experimental stem cell therapy

I have been tossing and turning all night wondering where I get my strength, but I dig deep and find the answer, always, somewhere in my mind's abyss. A friend told me yesterday [now a year ago] that this will be my calling when I get better to breathe life back into people and talk about my experience with this illness and my journey to get better.

Drew Schemera, 35, wrote this in his blog, The Journey, a year ago before going from his Connecticut home to Beike Biotechnology in China for experimental stem cell therapy, six months after being diagnosed with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's Disease), and being given a life expectancy of 2.5 years.

He feels he did the right thing. There were "no clinical trials in the USA of any significance and no cure on the horizon," he wrote. "I made a choice to come to China and work my butt off in therapy and change my diet, and I'm slowing it [ALS] down. I probably will die from ALS, but I'll be damned if I'm not going down swinging! What do I have to lose?"

However, experts at the International Society for Stem Cell Research and elsewhere caution that professional standards for stem cell therapy have not yet been set. Dr. George Daley, the president of the Society, decries a "misconception by some patients that the cure is already here." He adds, "We need to be clear that the path to cures is a long and arduous one."

Advice: Make your own critical decisions, after careful thought.

Thanks to Neil Munshi for the source story in the Boston Globe of June 13.

Reluctantly, he said the dentist had done a good job: Medical tourism

When Josef Woodman's father decided to fly to Mexico for a few months to have some restorative dentistry done, his son was horrified, and took the trip with him out of fear for his father's well-being, as well as to satisfy his own curiosity.

"My dad had isolated three clinics in the area of Puerto Vallarta that performed the procedure he needed, and had eliminated two of them rather quickly. At the third, a board-certified dentist performed work that, here in the States, would have cost about $24,000, for $11,000 including accommodations and traveling costs for a month."

"I've traveled for my own procedure – a $4,000 root canal that, in Cost Rica, cost about 25% less. There were many Americans in the waiting room. Upon returning home, I had my dentist check the work. Reluctantly, he said the dentist had done a good job."

The Joint Commission International (JCI) a US-based accrediting body that evaluates medical facilities overseas with a particular focus on state-of-the-art technology, has been accrediting hospitals overseas for about 10 years, and in 2002 there were less than 40 accredited hospitals. Now, there are more than 130.

Singapore alone receives 400,000 visitors a year as part of medical tourism, and most speak English. It seems to be a growing trend; about 200,000 Americans, and even more Canadians, travelled abroad for medical care last year.

Upon their return, Mr. Woodman had a new smile – and his son had a new focus for his writing. Now Josef has written a book, Patients beyond Borders [which I haven’t read yet] about medical tourism.

Advice to underinsured people needing expensive care: In considering medical tourism, do your homework about the quality of care.

Browse for related stories in the index at the very bottom of this page, or read another medical tourism story.

Thanks to Jaclyn Stevenson for the source article in the March 2008 issue of The Healthcare News of Western Massachusetts.

Everyone thought I was crazy: Medical tourism for a liver transplant

Last year, Kevin Stewart learned he had cirrhosis of the liver, and that a liver transplant was his only option.

He owns a landscape maintenance business in Naples, Florida. Because of the high premiums for self-employed businessmen, he let his health insurance lapse.

Luckily, he had a potential donor – his sister – so he called hospitals to see how much a liver transplant would cost. "It was $30,000 for them to check me out – to see how worthy I was, how badly I needed a liver. And, if they decided I needed a liver transplant, I should pay them $300,000," he said – much more than he could afford.

To look to other countries for medical treatment, he contacted WorldMed Assist, a medical tourism web site. They researched his situation and identified two hospitals that could perform the liver transplant, both in India.

Kevin chose a New Delhi hospital and a surgeon who had already performed 120 liver transplants.

Four months after the transplant, Kevin is doing fine, recuperating in the Florida Keys, and looking forward to getting out on his boa and fishing. The total cost of his treatment and travel to India was less than $90,000 – one-fourth of what he would have paid in the U.S.

"Everyone I spoke to thought I was a crazy person. 'Why would you go there, you're going to get infected, it’s a dirty place….' Now I’m certainly happy to spread the word to people that you do have choices. You don’t have to lay down and die."

Advice to Americans in need of ruinously expensive surgery: Consider other alternatives too.

Read another story of a solution to costly care for a liver problem, or read Greg Allen's source story from All Things Considered on National Public Radio.