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banyon
08-24-2009, 07:22 PM
So much for "doctor choice"


Let's make sure to let the industry write the bill.

Insurers aim to save from overseas medical tourism
Updated 1d 14h ago | Comments 265 | Recommend 32 E-mail | Save | Print |
http://i.usatoday.net/news/_photos/2009/08/22/medicaltourismx.jpg
Costa Rican Dr. Luis Obando prepares to perform a root canal on Bill Jones, of Dallas, Texas, at Meza Dental Care in San Jose, Costa Rica. Jones said he elected to have the surgery in Costa Rica because he was able to save substantially compared to what he would have had to pay in the USA

By Tom Murphy, The Associated Press

Elizabeth Kunz left her dentist's office this spring with a mouth full of problems and no way to pay for them.
The South Carolina resident went out of her way, literally, to find a solution, which turned out to be in Central America. Her trip to the tropics is part of a health insurance experiment for trimming medical costs: overseas care.

As Washington searches for ways to tame the country's escalating health care costs, more insurers are offering networks of surgeons and dentists in places like India and Costa Rica, where costs can be as much as 80% less than in America.

Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control.

The four largest commercial U.S. health insurers with enrollments totaling nearly 100 million people have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country.


Growth has been slow in part because some patients and employers have concerns about care quality and legal responsibility if something goes wrong. Plus, patients who have traditional plans with low deductibles may have little incentive to take a trip.

But a growing number of consumers with high-deductible plans, which make patients pay more out of pocket, could make these trips more inviting.

In the meantime, the insurance industry's embrace of overseas care has had a pleasant side effect at home: some U.S. care providers are offering price breaks to counter the foreign competition.

This domestic competition and the slumping economy have led to slower growth for medical tourism over the past year, as patients put off elective procedures that involve big out of pocket costs, said Paul Keckley, executive director of the Deloitte Center for Health Solutions.

Last year, the center estimated that 6 million Americans would make medical tourism trips in 2010. But Keckley has since shaved that projection to about 1.6 million people. Still, that more than doubles the roughly 750,000 Americans who traveled abroad in 2007, the last year for which Deloitte had actual numbers.

Keckley expects the medical tourism industry to recover, as more health insurers offer the option and as more people wind up with high-deductible plans.

Health care costs for employers who offer insurance to their workers were projected to rise 9.2% this year and another 9% in 2010, according to the consulting firm PricewaterhouseCoopers. That could mean double-digit percentage increases for employees through higher premiums, deductibles or copays.

Overseas care can lead to price breaks of more than $40,000, not counting travel costs, for procedures like knee replacement surgery or heart bypasses. Insurers, or employers who provide their own insurance, can save between 50% and 90% on major medical claims, said Jonathan Edelheit, president of the Florida-based Medical Tourism Association. A lower cost of living and lower prices for medical supplies and drugs help drive down care costs overseas compared to American providers.

While employers or insurers reap much of the savings, these lower costs can be the difference between a manageable expense and a bank-breaker for patients with high-deductible plans. These increasingly popular plans can lead to out-of-pocket expenses surpassing $5,000 for individual coverage and $10,000 for family plans.

High out of pocket costs also are common with dental coverage, which is one reason dental care trips have proven popular.

Kunz, 47, initially doubted the potential savings she might see from visiting a Costa Rican dentist though a program offered by her insurer, BlueCross BlueShield of South Carolina. But a little comparison shopping with help from the insurer persuaded her to get on a plane.

She had eight crowns replaced, a tooth filled and root canal. The work would have cost her $10,000 out of pocket back home, but she paid just $2,800 after insurance.

Ben Schreiner of Camden, S.C., would have paid the entire $10,000 deductible on his insurance policy if he had his hernia surgery done last year near home. For that reason, Schreiner, 63, had planned to wait until he turned 65 and qualified for Medicare before fixing it.

After reading about medical tourism in his insurer's annual report, the retired bank executive flew to Costa Rica and paid about $4,400, including travel expenses. Frequent flier miles covered his flight.

Schreiner said he was initially skeptical about the quality of care he might receive but reading about the doctors who could perform the surgery put him at ease.

"When you read the bios and the backgrounds of the doctors, you kind of lose your skepticism," he said.

However, apprehension about medical travel remains a high hurdle.

"People still do not understand that there could be a hospital in Thailand that can be as good as any hospital anywhere in the world or in the United States," said John Ferguson, chief marketing officer for Georgia-based BasicPlus Insurance Services.

BasicPlus, which underwrites and provides group health insurance plans to employers, started offering medical tourism as part of a benefits package last year. About 200 employers it contracts with around the country now offer that option, but no patients have used it.

Quality can be a legitimate worry, said Harvard Medical School professor Sharon Kleefield, who has worked overseas with several health care systems to establish quality measurements.

The average patient has no way of comparing hospitals worldwide on quality, which can vary widely. But, Kleefield said, insurers are helping to raise standards through careful inspections of hospitals before including them in an overseas network.

Concerns about liability also may be keeping some employers from adding overseas care options to their plans.

U.S. employers who encourage an overseas medical trip could become litigation targets. It can be difficult to sue an overseas provider in U.S. courts, said Nathan Cortez, a Southern Methodist University law school professor who studies medical tourism. And the average malpractice recovery in Thailand is about $3,000, roughly 1% of the U.S. average.

To ease this fear, medical tourism companies have started offering insurance that protects employers who send employees overseas from liability.

Some employers also have learned they don't have to send people overseas to save money.

Shortly after Hartford, Conn.-based Aetna Inc. and the Maine-based grocery chain Hannaford Bros. Co. launched a program to send patients to Singapore for hip and knee replacements, some New England hospitals countered with their own deals.

So far, three patients have benefited from the competitive pricing; Hannaford has sent no one overseas, even though the program pays travel and lodging costs.

"People travel all the time a couple hours on the interstate," said Dr. Brian Kelly, Aetna's national medical director. "That's no big deal."

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


http://www.usatoday.com/news/health/2009-08-22-medical-tourism_N.htm

petegz28
08-24-2009, 07:27 PM
You think our Fed Gov and their policies and regulations have anything to do with the ever increasing outsourcing of labor?

Saul Good
08-24-2009, 07:38 PM
I think we should let the sanitation industry advise Washington on the health care bill.

chiefzilla1501
08-24-2009, 07:45 PM
So much for "doctor choice"


Let's make sure to let the industry write the bill.

Insurers aim to save from overseas medical tourism
Updated 1d 14h ago | Comments 265 | Recommend 32 E-mail | Save | Print |
http://i.usatoday.net/news/_photos/2009/08/22/medicaltourismx.jpg
Costa Rican Dr. Luis Obando prepares to perform a root canal on Bill Jones, of Dallas, Texas, at Meza Dental Care in San Jose, Costa Rica. Jones said he elected to have the surgery in Costa Rica because he was able to save substantially compared to what he would have had to pay in the USA

By Tom Murphy, The Associated Press

Elizabeth Kunz left her dentist's office this spring with a mouth full of problems and no way to pay for them.
The South Carolina resident went out of her way, literally, to find a solution, which turned out to be in Central America. Her trip to the tropics is part of a health insurance experiment for trimming medical costs: overseas care.

As Washington searches for ways to tame the country's escalating health care costs, more insurers are offering networks of surgeons and dentists in places like India and Costa Rica, where costs can be as much as 80% less than in America.

Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control.

The four largest commercial U.S. health insurers with enrollments totaling nearly 100 million people have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country.


Growth has been slow in part because some patients and employers have concerns about care quality and legal responsibility if something goes wrong. Plus, patients who have traditional plans with low deductibles may have little incentive to take a trip.

But a growing number of consumers with high-deductible plans, which make patients pay more out of pocket, could make these trips more inviting.

In the meantime, the insurance industry's embrace of overseas care has had a pleasant side effect at home: some U.S. care providers are offering price breaks to counter the foreign competition.

This domestic competition and the slumping economy have led to slower growth for medical tourism over the past year, as patients put off elective procedures that involve big out of pocket costs, said Paul Keckley, executive director of the Deloitte Center for Health Solutions.

Last year, the center estimated that 6 million Americans would make medical tourism trips in 2010. But Keckley has since shaved that projection to about 1.6 million people. Still, that more than doubles the roughly 750,000 Americans who traveled abroad in 2007, the last year for which Deloitte had actual numbers.

Keckley expects the medical tourism industry to recover, as more health insurers offer the option and as more people wind up with high-deductible plans.

Health care costs for employers who offer insurance to their workers were projected to rise 9.2% this year and another 9% in 2010, according to the consulting firm PricewaterhouseCoopers. That could mean double-digit percentage increases for employees through higher premiums, deductibles or copays.

Overseas care can lead to price breaks of more than $40,000, not counting travel costs, for procedures like knee replacement surgery or heart bypasses. Insurers, or employers who provide their own insurance, can save between 50% and 90% on major medical claims, said Jonathan Edelheit, president of the Florida-based Medical Tourism Association. A lower cost of living and lower prices for medical supplies and drugs help drive down care costs overseas compared to American providers.

While employers or insurers reap much of the savings, these lower costs can be the difference between a manageable expense and a bank-breaker for patients with high-deductible plans. These increasingly popular plans can lead to out-of-pocket expenses surpassing $5,000 for individual coverage and $10,000 for family plans.

High out of pocket costs also are common with dental coverage, which is one reason dental care trips have proven popular.

Kunz, 47, initially doubted the potential savings she might see from visiting a Costa Rican dentist though a program offered by her insurer, BlueCross BlueShield of South Carolina. But a little comparison shopping with help from the insurer persuaded her to get on a plane.

She had eight crowns replaced, a tooth filled and root canal. The work would have cost her $10,000 out of pocket back home, but she paid just $2,800 after insurance.

Ben Schreiner of Camden, S.C., would have paid the entire $10,000 deductible on his insurance policy if he had his hernia surgery done last year near home. For that reason, Schreiner, 63, had planned to wait until he turned 65 and qualified for Medicare before fixing it.

After reading about medical tourism in his insurer's annual report, the retired bank executive flew to Costa Rica and paid about $4,400, including travel expenses. Frequent flier miles covered his flight.

Schreiner said he was initially skeptical about the quality of care he might receive but reading about the doctors who could perform the surgery put him at ease.

"When you read the bios and the backgrounds of the doctors, you kind of lose your skepticism," he said.

However, apprehension about medical travel remains a high hurdle.

"People still do not understand that there could be a hospital in Thailand that can be as good as any hospital anywhere in the world or in the United States," said John Ferguson, chief marketing officer for Georgia-based BasicPlus Insurance Services.

BasicPlus, which underwrites and provides group health insurance plans to employers, started offering medical tourism as part of a benefits package last year. About 200 employers it contracts with around the country now offer that option, but no patients have used it.

Quality can be a legitimate worry, said Harvard Medical School professor Sharon Kleefield, who has worked overseas with several health care systems to establish quality measurements.

The average patient has no way of comparing hospitals worldwide on quality, which can vary widely. But, Kleefield said, insurers are helping to raise standards through careful inspections of hospitals before including them in an overseas network.

Concerns about liability also may be keeping some employers from adding overseas care options to their plans.

U.S. employers who encourage an overseas medical trip could become litigation targets. It can be difficult to sue an overseas provider in U.S. courts, said Nathan Cortez, a Southern Methodist University law school professor who studies medical tourism. And the average malpractice recovery in Thailand is about $3,000, roughly 1% of the U.S. average.

To ease this fear, medical tourism companies have started offering insurance that protects employers who send employees overseas from liability.

Some employers also have learned they don't have to send people overseas to save money.

Shortly after Hartford, Conn.-based Aetna Inc. and the Maine-based grocery chain Hannaford Bros. Co. launched a program to send patients to Singapore for hip and knee replacements, some New England hospitals countered with their own deals.

So far, three patients have benefited from the competitive pricing; Hannaford has sent no one overseas, even though the program pays travel and lodging costs.

"People travel all the time a couple hours on the interstate," said Dr. Brian Kelly, Aetna's national medical director. "That's no big deal."

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


http://www.usatoday.com/news/health/2009-08-22-medical-tourism_N.htm

You pay for what you get.

Has anyone here ever had a great experience dealing with technical support from outsourced labor? I've had two recent experiences where inept outsourced customer service rep left me on the phone for several hours on end trying to figure out how to fix my problems.

And that's clear in this article. The cost of their health care is dirt cheap, but at what cost? You get care from uneducated, unskilled doctors and nobody is protecting your rights as a patient. Did you see the part about how the average malpractice suit is only $3,000 vs. the US' $300,000. I don't know how anybody can buy into the bullshit that we're not paying for that in some way in the end.

That's the problem with becoming obsessed with cost-cutting. We need to sustain the quality of care, while finding a way for costs to go down. But the liberals continue to insist up and down that the problem is purely costs and coverage. It's not the full answer.

banyon
08-24-2009, 07:55 PM
You think our Fed Gov and their policies and regulations have anything to do with the ever increasing outsourcing of labor?

Most certainly I do.

Did you miss the decade of sovereignty draining free trade agreements we've made ourselves party to?

Saul Good
08-24-2009, 07:57 PM
Most certainly I do.

Did you miss the decade of sovereignty draining free trade agreements we've made ourselves party to?

I think you're both on the same side of the teeter totter.

petegz28
08-24-2009, 07:58 PM
Most certainly I do.

Did you miss the decade of sovereignty draining free trade agreements we've made ourselves party to?

Nope. And I was against the majority of it.

Saul Good
08-24-2009, 07:59 PM
Which decade was that, anyway?

petegz28
08-24-2009, 08:00 PM
Which decade was that, anyway?

Actually it spanned 2....90's and the current decade

KILLER_CLOWN
08-24-2009, 08:04 PM
Most certainly I do.

Did you miss the decade of sovereignty draining free trade agreements we've made ourselves party to?

That was certainly the beginning of the end, but i see we've elected charlatans on both sides that stand for that globalist garbage of our current service economy.

Saul Good
08-24-2009, 08:04 PM
Actually it spanned 2....90's and the current decade

Enlightening. Why would Banyon have referred to it as a singular decade then? I was about to praise Clinton for keeping us out of these free trade agreements, particularly of the North American variety.

banyon
08-24-2009, 08:15 PM
Nope. And I was against the majority of it.

Ok, then I guess we agree in this limited area.

Take what happened to the manufacturing sector and now apply what you've learned (and no doubt what health insurance executives have learned) to the health care industry.

Taco John
08-24-2009, 08:26 PM
Most certainly I do.

Did you miss the decade of sovereignty draining free trade agreements we've made ourselves party to?



How can someone in one thread complain about the state of "Indonesian" workers, and then in another thread, complain about free trade agreements that are putting "Indonesian" workers in business? It's like "I don't want to see 'Indonesians' working, but if they are, they should be paid like wall street execs!"

petegz28
08-24-2009, 08:26 PM
Enlightening. Why would Banyon have referred to it as a singular decade then? I was about to praise Clinton for keeping us out of these free trade agreements, particularly of the North American variety.

Well, this is true. Going by how banyon said it, we must blame Clinton solely

petegz28
08-24-2009, 08:30 PM
Ok, then I guess we agree in this limited area.

Take what happened to the manufacturing sector and now apply what you've learned (and no doubt what health insurance executives have learned) to the health care industry.

I take that and blame it on Repubs and Dems alike. The unions cause the majority of the reasons that manufacturing jobs were outed. The Repubs encouraged it from a profit standpoint. The Dems want to continue to raise taxes and implement unfriendly business policies which encourage it (outsourcing) even further. It is fixed rather easily though, it just takes some political will.

**** the unions
Produce tax incentives that incentivize hiring American workers
close down the illegal immiration highway
penalize businesses that use illegals to the point that they have to close up shop.
And of course the American people are going to have to deal with slightly highter costs on goods. But then again, they will have a job so that is easier to deal with.

So now take that and apply it to your health care argument.

banyon
08-24-2009, 08:36 PM
I take that and blame it on Repubs and Dems alike. The unions cause the majority of the reasons that manufacturing jobs were outed. The Repubs encouraged it from a profit standpoint. The Dems want to continue to raise taxes and implement unfriendly business policies which encourage it (outsourcing) even further. It is fixed rather easily though, it just takes some political will.

**** the unions
Produce tax incentives that incentivize hiring American workers
close down the illegal immiration highway
penalize businesses that use illegals to the point that they have to close up shop.
And of course the American people are going to have to deal with slightly highter costs on goods. But then again, they will have a job so that is easier to deal with.

So now take that and apply it to your health care argument.

So you blame the AMA and illegal aliens practicing medicine for our health care woes?

Saul Good
08-24-2009, 08:36 PM
Ok, then I guess we agree in this limited area.

Take what happened to the manufacturing sector and now apply what you've learned (and no doubt what health insurance executives have learned) to the health care industry.

Look at how the quality of automobiles, televisions, and other electronic devices declined once we started purchasing them from overseas.

petegz28
08-24-2009, 08:38 PM
So you blame the AMA and illegal aliens practicing medicine for our health care woes?

I blame those who paved the path of outsourcing in the first place.

chiefzilla1501
08-24-2009, 09:20 PM
Look at how the quality of automobiles, televisions, and other electronic devices declined once we started purchasing them from overseas.

It depends on your perspective. A lot of high quality items are still made overseas, as long as you monitor your own production. I don't have a problem with a globalized economy. Protecting domestic production only leads to higher prices. Look at sugar. We pay 2-3 times as much for sugar than foreign countries do because for some reason, America protects their sugar farmers. Sounds like small grapes, unless you're Coca Cola and are forced to pay outrageous prices for sugar. That's why sodas use high fructose corn syrup.

I think where I get fed up with outsourcing is the service area. Dumb businesses assume that service is something you are required to do, rather than something you should be very good at. And they're losing customers left and right. I can't even imagine how many customers Dell has lost in the PC market.

Outsourcing is fine. It's just the abuses where it goes to shit. That means paying less for shoddy health care or getting a toy cheaper even though it has tainted paint.

Saul Good
08-24-2009, 09:25 PM
I think where I get fed up with outsourcing is the service area. Dumb businesses assume that service is something you are required to do, rather than something you should be very good at. And they're losing customers left and right. I can't even imagine how many customers Dell has lost in the PC market.

Most of those outsourced employees are much better educated than the employees here.

At my company, a large number of our customer service employees were outsourced from our home office in Philadelphia to a small city in Maine. They were able to get vastly better employees for the same price in Maine than in Philadelphia and saved money doing it.

I don't know why a national border rather than a state border would change the concept.

banyon
08-24-2009, 10:23 PM
Look at how the quality of automobiles, televisions, and other electronic devices declined once we started purchasing them from overseas.

Sure. Get your kids some Chinese toys or your pets some Chinese dog food too while you are at it. How about some Mexican tomatoes? Salmonelly-good! Mmm-mm!

KILLER_CLOWN
08-24-2009, 10:28 PM
Sure. Get your kids some Chinese toys or your pets some Chinese dog food too while you are at it. How about some Mexican tomatoes? Salmonelly-good! Mmm-mm!

What do you expect when you spray the crops with human feces?

googlegoogle
08-24-2009, 11:40 PM
http://en.wikipedia.org/wiki/Medical_tourism

chiefzilla1501
08-25-2009, 12:14 AM
Most of those outsourced employees are much better educated than the employees here.

At my company, a large number of our customer service employees were outsourced from our home office in Philadelphia to a small city in Maine. They were able to get vastly better employees for the same price in Maine than in Philadelphia and saved money doing it.

I don't know why a national border rather than a state border would change the concept.

I imagine because of the difference in standard of living.

I don't think it has as much to do with the quality of the talent. I think it has everything to do with the idea that if you make the decision to outsource customer service, it's almost always a pure cost decision. Otherwise, you wouldn't go through all that trouble when you can just pay US people a little bit more money to ramp up the quality.

I'm sure if you outsourced to Maine, quality was a big factor. That's a decision where you cut costs without sacrificing quality. If you really, really want to cut costs, you'll go through the trouble of outsourcing overseas.

BucEyedPea
08-25-2009, 04:50 AM
Originally Posted by banyon View Post
Sure. Get your kids some Chinese toys or your pets some Chinese dog food too while you are at it. How about some Mexican tomatoes? Salmonelly-good! Mmm-mm!
Don't buy 'em! You're a freeman aren't you?

Simplex3
08-25-2009, 07:32 AM
I take that and blame it on Repubs and Dems alike. The unions cause the majority of the reasons that manufacturing jobs were outed. The Repubs encouraged it from a profit standpoint. The Dems want to continue to raise taxes and implement unfriendly business policies which encourage it (outsourcing) even further. It is fixed rather easily though, it just takes some political will.

**** the unions
Produce tax incentives that incentivize hiring American workers
close down the illegal immiration highway
penalize businesses that use illegals to the point that they have to close up shop.
And of course the American people are going to have to deal with slightly highter costs on goods. But then again, they will have a job so that is easier to deal with.

So now take that and apply it to your health care argument.

You can skip all that and just stop taxing businesses. There was a poll done a while back of major foreign companies asking "if the US eliminated all corporate taxes would you open your next facility there?" and nearly every one of them said 'yes'. The ones who didn't just say 'yes' said they would also move their corporate headquarters there.

Before everyone wets their pants about not taxing companies, realize that it is hidden taxation. It's technically coming out of your pockets, but it's coming out so early in the process that the average consumer is completely blind to it.

Politicians are so afraid of a consumption only tax because then people will be able to clearly see how much of their money the government is pissing away.

InChiefsHell
08-25-2009, 07:56 AM
The article starts out with a guy who goes to Costa Rica for a root canal. From what I've read, a root canal in the US is 2k maximium, that's with the cap. So, it seems hard to believe that a trip to Costa Rica, having a procedure, and a trip back is THAT much cheaper than doing it here in the US. BTW, 2K is the most they are, there are some dentist who will do it cheaper.

I guess I wonder how much the Costa Rican dentist charges. I wish the story would have said exactly how much the guy saved...

banyon
08-25-2009, 08:02 AM
Don't buy 'em! You're a freeman aren't you?

Have you been to Wal-Mart these days? Looked for American or just non-Chinese products?

My town, like many small town doesn't have many choices like where i have lived previously. Most people here it's Wal-Mart or bust.

modocsot
08-25-2009, 08:17 AM
some U.S. care providers are offering price breaks to counter the foreign competition.


This part I like.

Now if we can add tort reform to the mix....

patteeu
08-25-2009, 08:22 AM
We could instead go with the democrats' plans for nationalized health care and bring the low wage foreign doctors here to do our medical work.

RINGLEADER
08-25-2009, 09:57 AM
The more the government tries to dictate what kinds of health care can be performed the more doctors are going to flee the regulations.

Regardless of what the insurance industry wants you'll see more doctors leaving the system. Especially the good ones.

Obamacare will hasten it. And it will also bankrupt the system. And lead to less care, higher taxes, and/or bigger deficits. No supporter of the plan can refute it.

But keep up Nancy's war against evil insurance companies...it's very persuasive... :rolleyes:

tooge
08-25-2009, 10:25 AM
One of my partners patients recently went to mexico to save money on a 4 tooth bridge. The bridge came out a few weeks ago and this yoyo had the balls to come to our office and ask for it to be recemeted. Yeah, we did it. Charged him $180 to do so, and it is such a piece of crap it is gonna need it over and over. I wonder if these types of plans mentioned in the article would pay for another trip for this guy back to mexico to have it remade. What a joke. You get what you pay for.