See the world, save your life

By Czerne M. Reid

czreid@thestate.com

Renowned hand surgeon Norman Cowen had patients who traveled from around the world to see him. Last year, it was his turn to go abroad for surgery.

He flew thousands of miles to Thailand for a trip that was part vacation, part surgery-and-recovery.

“The hospital was fantastic! I had a very good experience,” Cowen said of the face lift he had at Bumrungrad International Hospital in Bangkok. “I was pleased with the results.”

Cowen, who lives in South Carolina during the winter, is part of a growing trend of Americans going abroad for medical and surgical care. A local insurance company is trying to make it easier for patients like him to do so.

BlueCross BlueShield of South Carolina has contracted with Bumrungrad hospital in Thailand and World Access, a Richmond, Va.-based company, to offer a Web-based service called Companion Global Healthcare. It is essentially a one-stop shop where members can go to make overseas hospital appointments and travel arrangements.

“All we’re really doing is being a channel to help folks,” said David Boucher, assistant vice president of health care services at the insurance company. “If they’re going to do it, we’re going to make it a little easier for them.”

The insurance company is the first in South Carolina — and among the first in the country —to offer that combination of services.

More than 500,000 Americans went overseas for health care in 2005, according to the National Coalition on Health Care.

Some see the medical excursions as a way to save money on needed — or wanted — services. Others see it as another kind of outsourcing that undermines the U.S. economy.

Cowen got a very good deal on his face lift. He paid about $7,000 at the hospital/luxury hotel instead of the $25,000 he estimates it would have cost him in the Bowie, Md., area where he practiced before retiring two years ago. Procedures like heart-valve replacements cost $9,500 in India, but can cost more than $230,000 in the United States.

For far less than what it costs in the United States, patients can get services such as joint replacements and heart surgery in countries such as Thailand, India, Costa Rica and Mexico.

But it’s not just patients who save money by going overseas —insurance companies save, too.

When insurance companies help people to go overseas for care, that could give the companies more bargaining power locally, both with health care providers and with policyholders, said Tom Getzen, professor of health-care finance at Temple University and executive director of the International Health Economics Association.

“It’s the possibility of a threat,” he said.

Boucher does not know what the response to the program will be, but hopes it will help his company gain customers and keep the ones it already has.

“Thomas Friedman is right; we are living in a flatter world where competition is not just local, it is global,” said Thornton Kirby, president of the South Carolina Hospital Association.

Some industries will be able to compete globally and some won’t, he said. “I would say health care has a foot in both those worlds.”

For example, people are not likely to travel overseas to take a child to a pediatrician, or to an emergency room after an accident, or when they are in the middle of a heart attack.

On the other hand, some procedures, such as open-heart surgery, are so expensive here that even with the cost of travel, it is cheaper to go abroad.

“The question we have to ask ourselves in this country is why do these procedures cost so much more than they do in other countries?” Kirby said.

Some point to low- to non-existent malpractice claims and lower pay for doctors and other staff in those countries.

But partly, it is because paying patients in the United States have to assume a significant portion of the cost for those who cannot pay, Kirby said.

“We really ought to be working toward a system in this country where we don’t have to charge the insured ... to make up for the fact that other people don’t have insurance.”

In the meantime, Boucher hopes to form up to two new partnerships a year with hospitals around the world, to provide high-quality care to patients.

Bumrungrad, like other hospitals overseas, has physicians who are American-board certified. The hospital is accredited by Joint Commission International, the international arm of the Joint Commission, a leader in setting standards for health care.

Boucher, who has been CEO of three hospitals, visited Bumrungrad last year.

“I was thoroughly impressed with the quality of care,” he said.

But Kirby doesn’t expect to see an exodus of South Carolinians heading overseas. Up to 60 percent of patients seen in the state’s hospitals are on Medicaid or Medicare. And the poor and uninsured, who can’t afford to pay here, won’t be able to pay elsewhere either.

 Reach Reid at (803) 771-8378.

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