The Magazine

Cash for Doctors

And other ways to escape the diktats of Obamacare.

May 24, 2010, Vol. 15, No. 34 • By TONY MECIA
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“Health care reform is only going to put a greater spotlight on MDVIP as patients look for alternatives,” he says. “The need for choice will be much more pronounced over the coming years.”

The sector is also seeing an influx of outside capital. Consumer giant Procter & Gamble bought MDVIP in December. In April, Seattle-based concierge practice Qliance Medical Management announced it had raised $6 million in venture funding from a group led by Amazon.com founder Jeff Bezos, which included actor Drew Carey and Dell founder Michael Dell as investors.

Some providers and patients are taking a different tack to get outside the system—leaving the United States altogether.

It’s not just celebrities heading abroad for cosmetic work. As other countries have become more sophisticated medically, they’re offering all sorts of elective work, typically at a fraction of what the procedures cost in the United States. Foreigners still come to the United States for treatment, but there’s an even greater number of U.S. patients heading overseas. The countries with the most accredited hospitals include India, Brazil, Thailand, and Singapore.

“Medical tourism,” as it’s known, has been growing for years. The number of U.S. patients heading abroad is expected to increase 35 percent this year—to 878,000—and then double to more than 1.6 million in 2012, according to a report last year from the Deloitte Center for Health Solutions. 

“We see [Obamacare] as a potential boon for medical tourism,” says Renee-Marie Stephano, president of the Florida-based Medical Tourism Association. Some of the more popular procedures offered abroad include bariatrics, experimental cancer treatments, and knee and hip replacements. Orthopedics in particular is expected to be a hot area in the coming years, as once-active Baby Boomers enter their 60s and 70s.

Some insurance plans, looking for ways to save money, have started experimenting with covering procedures performed abroad. There’s also great interest from patients with high-deductible plans.

Take knee replacement surgery, which in the United States might cost $50,000. A patient with insurance might have to pay an $8,000 deductible. In Costa Rica, the entire procedure costs closer to $11,500. “You can stay at home and pay an $8,000 deductible, or you can go to Costa Rica with your wife and spend three weeks recovering,” Stephano says. “This is more of a cost-conscious, consumer-driven approach.”

And the quality of care abroad can often rival or surpass that in the United States, she says. For instance, the Food and Drug Administration only approved hip resurfacing surgery—an alternative to hip replacement—in 2006, which means U.S. doctors have been performing it for at most four years. Doctors in India have been performing the procedure for more than a decade.

It’s not just cost that’s attractive, either. In Canada and the United Kingdom, health reforms have led to longer waits for procedures. If that happens here, as many expect, then Americans might take a harder look at treatment abroad.

Such market-driven approaches to health care seem poised to thrive in the years ahead. As Obamacare ramps up, doctors and health providers will continue devising creative alternatives for patients who demand choices as the government tightens its grip. “Necessity is the mother of invention,” notes Brian Forrest. “Doctors who are fed up with the way it is are going to be doing all kinds of different things.”

Tony Mecia is a freelance business writer in Charlotte, North Carolina. He is a former business writer and editor at the Charlotte Observer.


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