As a lieutenant colonel in the US Army, Steve Gallegos spent his days coordinating medical care for soldiers, officers, and retired military personnel who needed it while living overseas. By doing this job day in and day out, Gallegos began to realize the United States isn’t the only country that has top-quality health care. In some cases, the services and facilities were even better—and the out-of-pocket cost was about half.
After retiring from the service, Gallegos parlayed his in-ter-national medical expertise into a medical-tourism business, the San Antonio, Texas–based Medcentrek (www.medcentrek.com). Today, he helps private clients find good-quality health care in places like Costa Rica and Monterrey, Mexico. Gallegos estimates 70% of his clients are interested in cosmetic surgery, while 30% need dental help.
As founder of Medcentrek, Gallegos has tapped into an incredibly fast-growing market: medical tourism. According to Renee-Marie Stephano, founder of the Medical Tourism Association, a nonprofit organization that advocates for high standards and best practices in this relatively new corner of the health care market, “This is a $20 billion industry.”
Health Care Beyond the US
Countries like Thailand, Costa Rica, India, and South Africa are actively promoting medical tourism. Another company, called Fly2Doc, is now also marketing medical facilities in Spain and Portugal. Industry analysts estimate this market is growing at a rate of 25% per year.
Why the fantastic growth? Because in many European countries and Canada, national health care systems have waiting lists for nonemergency surgery, such as cosmetic and dental work. “In the UK, they have these long waiting lists, and also there are problems with deadly infections in the hospitals,” says Cristina Madeira, founder of Fly2Doc, based in Lisbon. “People need to go abroad because they don’t feel safe.”
Madeira points to an analysis by the World Health Organization (WHO) of health care in different countries (available at www.photius.com/rankings/healthranks.html). Spain and Portugal, it turns out, rank higher than the US (seventh, 12th, and 37th, respectively). France received the highest rating from WHO. “We’re among the best 15 in the world,” Madeira says. “That’s why we felt very secure about starting this business.”
Medical tourism experts claim the key to the industry’s future success is being able to connect patients with high-quality, fully accredited hospitals. Many foreign hospitals are seeking the international equivalent of Joint Commission accreditation here in the US. “They are marketing themselves as international centers of excellence,” Stephano explains. By choosing surgeons and hospitals that have been approved by Stephano’s organization (www.medicaltravelauthority.com), patients can be sure they will have a safe experience abroad.
Through his military experience and international contacts, Gallegos is able to offer clients some top-notch surgeons and hospitals. The hospital in Monterrey, Mexico, for example, is a 50-minute flight from the US. It is owned by a Houston-based health care management company, and the administrator is an American who did his training in Boston. The only thing that is different from an American hospital is the nurse coverage, which is better.
“People are amazed at the quality of care in these hospitals,” Gallegos says. “The nurse-patient ratio just blasts the hospitals in the US out of the water.”
Oh, there is one other difference: the price tag.
All-Inclusive Deals, One Low Price
In the US, the health insurance crisis is driving interest in medical tourism. An estimated 50 million Americans don’t have any insurance. Those who do have some sort of coverage find that the out-of-pocket portion of surgery costs is becoming sky-high. An additional 150 million Americans are underinsured; they may have catastrophic coverage, but if they need a knee replacement, they’re out of luck. Even fewer Americans have decent dental plans.
In many cases, medical tourists discover they can afford to pay for the surgery, plus a flight to and a hotel in an exotic locale, for the same price of doing the procedure at home. So if you have to pay out of pocket anyway, for something as unpleasant as a root canal, why not sweeten the deal with a fun trip?
The New York Times recently reported that health travelers are saving 30% to 80% on the cost of their medical and dental bills by going abroad. Stephano estimates the cost is as much as 90% less in certain places, such as India.
Gallegos explains that the cost of health care is so much lower in other countries because “they are not run amok with lawsuits.” In Mexico, for example, the government charges a $5,000 fee just to initiate a lawsuit. So that keeps down the number of frivolous lawsuits, he says. Also, nurses and practitioners in less-developed countries are not paid as much, he adds. Prescription drug costs are also much lower.
Meanwhile, many cosmetic procedures, especially those in the dental realm, are becoming more popular and accessible. Tooth whitening and veneers—once only for movie stars—are now for everyone. For that reason, HealthCare Tourism International, a nonprofit research group, estimates the number of medical travel agents will double in the near future. These specialty travel professionals bank their business on the stellar reputation of the medical providers and hospitals they suggest to clients. The travel agent can also find a luxury hotel, soothing beach, or golf course for a companion or spouse to enjoy while the patient is recuperating.
Gallegos believes many of his clients have a better recovery because they recuperate at a seaside hotel with skilled nursing staff on site (instead of relying on an untrained spouse or relative at home). “It’s a resort atmosphere,” he says. “People recover quicker because they are more relaxed.” It’s also more private for clients who may not want friends and neighbors to know they have had a facelift or breast implants.
Once word of mouth spreads, and the industry creates a successful track record with global-minded clients, Gallegos predicts US health insurance companies will start to buy into this trend, because the cost savings will become obvious.
Wish You Were There?
For clinicians here in the US, the medical tourism boom could offer new career opportunities and new chances to travel the world. Many medical travel agents, for example, may have a head for business, but they often have no medical background. They may need a physician assistant or nurse practitioner to serve as a consultant as they wade through health records and regulations in other countries.
Patients who have a relationship with a particular provider may also want to pay that clinician to travel with them, just to oversee all the details during a medical tourism trip. In some cases, PAs might be able to perform the surgery themselves, at a much lower rate, in a foreign hospital—especially if that facility is affiliated with an American hospital.
“We’re seeing a lot of medical-global cross-fertilization happening,” Gallegos says. “There’s going to be a market for clinicians to travel and perform procedures for their clients.”