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Destination Surgery

With the rising cost of health care comes the controversial new trend of medical tourism.

Cristina Ramos sits on a plastic-cased chair, the back of her legs glued to the covering as she attempts to peel them off the sticky surface. She readjusts herself, looking to her left to see a tin table adorned with a blue sheet of paper and half a dozen metal tools resting on top. She takes a deep breath and turns to see her father, seated adjacent to the over-sized chair in which she sits. He smiles and reassures her that the process will be quick and painless. Ramos’s visit to the dentist is similar to any other routine procedure, except for one detail: She is in Mexico, hundreds of miles from her home in Santa Cruz, California.

Ramos, 22, is one of a growing number of people who have chosen to undergo medical procedures outside of his or her home country. In his article “A revolution in health care: medicine meets the marketplace,” Fred Hansen, physician and journalist, says that the market for medical tourism is predicted to jump from the $20 billion industry it is today to one worth roughly $100 billion by 2012.

The phenomenon of “medical tourism” encompasses people from a variety of backgrounds. According to a 2008 report on medical tourism by the Institute of Development Studies, a global charity for international development, medical tourists used to be affluent people able to afford to travel, typically in the United States or Europe, to receive the best medical care possible. As international travel has become more attainable, however, more and more people from a range of backgrounds are choosing this option. The primary motivator for medical tourists: costs. In some foreign countries, such as India, Thailand, and Mexico, the price of medical procedures can cost a fraction of what it does in the United States.

Medical tourists seek out a wide array of treatments and procedures, everything from routine medical and dental work to complex surgeries and procedures, such as joint replacements and cardiac surgery. Many of the procedures sought out by medical tourists are elective, such as plastic surgery and cataract surgery, simply because many health insurance companies do not cover surgeries that are not emergencies. Fueling the trend is the fact that the quality of medical care around the globe has improved. India, for example, is a forerunner for medical advancements like hip resurfacing procedures.

Although Ramos’s trip to Mexico was for a medical procedure, her father is from Mexico. Because her family was already getting prescriptions across the border, heading south seemed like a logical step to save money in an age of rising health care costs. “I’ve been in American hospitals for everything from concussions to torn ligaments,” says Ramos, noting her experience with costly medical procedures in the U.S.

Amy Costales, an adjunct instructor of Spanish at the University of Oregon, lived in Thailand and witnessed medical tourism on a regular basis.

“People from Australia, New Zealand, and Europe would come to Bangkok because they had a hospital set up just for medical tourism,” says Costales. “They had an online Web site where you could find your doctor, plan your trip, and they even helped with accommodations. People would fly to Thailand because it was cheaper,” says Costales, noting that later on, she became one of these tourists, flying from India to Thailand to have knee surgery.

Jim Krois, 62, from Williams, Oregon, traveled to Mexico in 2009 to have his hip replaced while he was uninsured. “I was diagnosed for a hip-replacement two weeks before I was laid off. To have the surgery in the U.S. it would [have] cost me anywhere from $52,000 to $80,000. India was the cheapest I could find for about $8,000 to $10,000, but I decided on Puerta Vallarta [Mexico] because of the shorter flying time,” says Krois. The surgery cost $12,000 with an added $2,500 for airfare and accommodations. In spite of the significant cost savings, Krois had reservations and worried about the safety of the procedure.

“I’ve been around the world a couple of times; I was never afraid of going to another country, but I was concerned with hygiene,” says Krois.

“We’ve all heard horror stories [about] Mexico, but I stayed in a brand-new hospital.”

Ramos could relate to these concerns. “My dentist at home is very upscale and fancy, and the place we went to in Mexico had old ads on the wall and a dirty exterior, but their quality of work and customer service was better than all the years I had gotten from my dentist in the United States,” Ramos says, explaining that, in Mexico, most of the time one or two nurses were at her side to comfort or assist her throughout the process.

Because of worldwide improvements in medical and sanitation standards, tourists have become more confident that the treatment they seek will be just as effective, if not more so, than if they stayed in their home country. Medical amenities across the globe are now comparable to medical institutions in the United States, which were once said to be the standard of quality treatment and cleanliness. These facilities offer the same standards of treatment at a much lower rate, presenting an opportunity for first-world countries such as U.S., Canada, and Europe to save thousands on health care bills.

For Krois, the thought of saving thousands of dollars outweighed his mild hesitation of the health-risks he might encounter in foreign territory.

Another worry for those seeking low-cost medical attention is the risk of scams. According to Ian Youngman of the International Travel Journal, medical tourism offices catering strictly to medical tourism are allowed to go unregulated by the government, and it is easy to become a victim of a trick. “Some national sounding names have been found to be nothing more than a guy using a laptop and an Internet café,” he says. Many medical tourists rely on what they read on the Internet—being that they are so far away—a source that may not be reliable.

According to medicaltourism.com, a Web site catering to those who are considering medical tourism, the credibility of the facility and the doctor varies from practice to practice. The key to finding a safe and suitable doctor in a foreign country is careful research.

While medical tourism might benefit those seeking treatment, it can carry some downsides for the host country. According to the Department of Tourism at Pondicherry University in India, medical tourism can create a shortage of trained health care workers for native people.

According to the department’s research, medical tourism generates an estimated $60 billion in business for India and has led to the creation of high-tech private medical facilities in India. However, questions remain about whether local residents benefit from the revenue these facilities produce. “Experience from India suggests that private hospitals attract health professionals away from the public health sector and rural areas in India,” says a report from the university’s department of tourism.

“This is a valid point,” says Costales. “Ideally, if a country has set up medical tourism, it would be nice if it benefited the country and wasn’t just a pocket of businessmen and doctors getting really rich and depleting these resources from the rest of the country.”

The idea of traveling to a foreign country for something as intimate as medical care may seem daunting to some. “There are all these fears of the unknown,” says Costales. “I think there are times when we think other countries have inferior medical care, and some do, but there are also countries with very good care.”

Despite these adverse effects, officials at the Confederation for India Industry predict that the practice of medical tourism will not slow anytime soon.

Looking back on his surgery in Mexico, Krois says, “I would do it again in a second.”