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THIS WEEK IN MEDICAL TRAVEL TODAY Volume 3, Issue 14 by Amanda Haar, Editor Greetings, There's much and varied news to cover in this week's issue. We begin with a conversation with John C. Goodman of the National Center for Policy Analysis. Goodman was kind enough to speak with us about his views on what U.S. facilities need to do in order to stay competitive in the global healthcare arena. We've also had a number of interesting news items spanning everything from fertility treatments and right-to-die treatments to new publications and good advice for anyone entertaining a speaking gig at an upcoming conference. Plus we have news of a number of new conferences including Service Summit Guatemala 2009 scheduled for September 10-14 in Guatemala City. As always, we welcome your comments, story ideas, and press releases. Cheers, Amanda Haar, Editor
SPOTLIGHT: John C. Goodman, president & CEO, National Center for Policy
Editor's Note: Readers are no doubt familiar with John C. Goodman, president and CEO of the National Center for Policy Analysis (NCPA). Often referred to as the "Father of Health Savings Accounts," Goodman also maintains a health policy blog where pro-free enterprise, private sector solutions to health care problems are routinely examined and debated by top health policy. In light of the recently proposed health reforms, Medical Travel Today decided to catch up with Goodman and find out what he and his colleagues think of the proposed reforms and how they may or may not influence domestic and foreign medical travel. Medical Travel Today (MTT):Thank you for your time today and your willingness to discuss the future of medical travel. John Goodman (JG): It's my pleasure. If I may, I'd like to suggest we start this interview by asking the question, "Why would anyone go outside the United States for healthcare?" JG: In the United States, healthcare costs are growing at twice the rate of our income. It's been this way for the past 40 years and there are no signs of abatement. When any major expenditure grows at twice the rate of the consumer's income, the consumer gets squeezed. In the United States we have no price competition for healthcare. And that's because you tend to have competition on price only when there's no third-party payer. Interestingly, if hospitals and physicians do not compete on price, they don’t compete on quality either. So in order for U.S. citizens to get the full benefit of competition, they have to leave the country. MTT:As you point out, the U.S. system is built around a third-party payer. Given that, is there anything a U.S. provider can do to compete? JG: I believe there is, but it involves more than a new model. It involves a new mind set in the way we approach care. I believe that in order to keep patients here, we have to have facilities that are willing to post their prices and are willing to compete on price. The successful facilities internationally are the ones that are willing to quote package prices and make those prices truly transparent to customers. As deductibles rise and co-pays rise, what we're seeing is that patients and insurance companies, who were once adversaries, now find themselves on the same team ― a team that's looking to find the best price and quality options for care. What we're going to see is insurers and employers encouraging patients to travel (both within the country and out of the country) for lower-priced, higher-quality care. The resulting savings are going to be shared by the insurers and employers with the patients. That type of model is going to force U.S. facilities to compete in a different way if they are going to stay in business. MTT:Which facilities in the United States are best prepared to deal with this kind of competition? JG: The ones that are already involved in treating foreign patients. Right now there are about 50 major U.S. hospitals actively marketing in Latin America to recruit patients. They're already competing in an international marketplace and many are doing it with a package price structure. They are doing the things they need to do to compete effectively on quality and price in a global market. MTT:How do you move from an environment where there's no price competition to one where there is? JG: Well, first you have to look at what is preventing U.S. healthcare from becoming competitive, the way hospitals in Thailand, India, or Singapore are competing. The difference is that we have a lot of unwise public policies that suppress normal market forces. As a result, for a typical doctor or hospital there is no such thing as a real price. In truth, we're very far away from a real market. What needs to happen are economic, cultural, and legal changes. First, if providers are going to compete on price and quality, everyone needs to change what he or she is doing. And no one is going to change unless there are economic incentives to do so. Second, doctors and hospitals need to change how they think about the product of healthcare. Most doctors today don't think of themselves as competing in a marketplace. In the future they will need to. Finally, we need to repeal laws that prevent competition. MTT:Given how slowly things tend to move when it comes to changing healthcare regulations and laws, what's the downside of the status quo? JG: I think the flow of patients across the border will grow and it will grow fast. Currently there are wealthy people who willingly travel to the Cooper Clinic in Dallas and to other facilities around the country for what I call a super-duper checkup. It's becoming a very common experience. However, once a person commits to climbing on a plane for care, he can go anywhere to receive it. He might go to Guatemala City instead of Dallas and obtain the same quality of care for a fraction of the cost. When you start to think competitively about healthcare, you have to consider all the places that a plane might fly to. The international market place has the potential to become one of the strongest agents of change in the way medicine is practiced in the United States. I think Medicare does not cover medical care outside the country. If the government had any sense, they'd change that. You could save a lot of money if you encouraged seniors, your largest consumers of care, to get care abroad. I think the question is: what's the right public policy within the United States? What's the right way to encourage a competitive market for healthcare? One way to do that is to open up the market for, say, Medicare patients. I think Medicare ought to pay walk-in clinics’ market rates, not Medicare rates. Seniors aren't as desirable at Medicare rates to walk-ins or to urgent care clinics and surgi-centers, for that matter. We also need to change the tax laws to make it as easy as possible for patients to self-insure and manage more of their own healthcare dollars. If you make patients a partner in decisions you'll change their behavior and, in turn, force doctors to compete on price. That's the direction we should be heading. MTT:What's your opinion of the recent proposals from the White House? JG: The approach being taken by the Obama administration is the wrong approach. All the examples of lowering healthcare costs and increasing quality come from supply side. It was doctors and entrepreneurs who created those models. We need to find new ways to encourage the supply side of the market to come up with more of those approaches. The current system is so inefficient and wasteful that providers should be able to find innumerable improvements if allowed to do so. We need more deregulation, not more regulation. We need to make it as easy as possible for hospitals and doctors to repackage and deliver their products in ways that decrease cost and increase quality of care. Right now, their hands are often tied by regulations. MTT:You've talked about the constraints placed on U.S. facilities growing medical tourism. Are there any political constraints operating in other parts of the world? JT: One thing I think that holds back medical tourism in other countries is the politically unpalatable result of having first world patients in a foreign country getting a level care that most of its own citizens cannot afford. That can certainly constrain growth. One place where I don't see that as an issue is Latin America where almost everywhere there's a free healthcare system—but one that is not very good. So they are used to people who can afford better care going outside the free system and buying private care. In Canada or Britain when a Member of Parliament checks into a first-class private hospital it's scandalous. In Latin America that's considered perfectly normal. Beyond that, I don't see too many obstacles—certainly none of the magnitude we face here at home—to other countries really competing on a world level. We just need to make sure we get there, too. About John C. Goodman
Laura Carabello, Publisher of Medical Travel Today to Participate at Service Summit Guatemala 2009 Service Summit Guatemala 2009, scheduled to take place in Guatemala City September 10 – 14, will showcase Guatemala's healthcare services and facilities and offer an invaluable networking opportunity for individuals and organizations looking to expand their reach in this fast-growing destination. Medical Travel Today publisher Laura Carabello will be attending the event and reporting back on efforts to shape the country as a premier destination.
Visa Card Encourages Medical Tourism Growth
Patients Beyond Borders: Thailand Edition to Launch in September
"As one of the original countries to support and promote medical tourism, it’s easy to see why Thailand’s excellent healthcare system and unsurpassed hospitality have positioned Thailand as a robust destination for medical and wellness travel,” says Josef Woodman, CEO of Healthy Travel Media. Thailand was one of the earliest international medical tourism hubs, first as a destination for cosmetic surgery, and in the past decade as one of the leading destinations for patients seeking medical care abroad. Lastyear Thailand welcomed 1.2 million patients from more than 190 countries for a wide variety of procedures. Costs of medical procedures in Thailand are typically 30 to 80 percent lower than those in North America, Europe, and the Middle East. “Thailand has emerged as one of the world’s major destinations for medical services. The combination of first-class medical facilities, five-star hotels and serviced apartments, spas, wellness clinics, and myriad tourist attractions has contributed to Thailand’s popularity,” says Juthaporn Rerngronasa, deputy governor for Marketing Communications, Tourism Authority of Thailand. “We are pleased that our partnership with Patients Beyond Borders will further advance awareness of Thailand as an important destination for medical tourism.” Patients Beyond Borders: Thailand Edition will be available in bookstores and at online retail channels throughout the world. The eBook editionwill be available through Kindle, Sony Reader, ebrary, and Lulu. Booksellers wishing to carry the Thailand Edition should contact Publisher’s Group West, www.pgw.com
A Different Kind of Medical Travel? Editor's Note: This story caught my eye as it involves a couple traveling from their homeland for medical treatment. Conductor Downes, wife die in Swiss suicide Clinic While the intended end result is not what typically qualifies as a success in the industry, it did cause me to wonder if this is a treatment option we'll be seeing more of in the future. Meanwhile on beliefnet.com, writer Hillary Fields expressed that while she has no issue with one's right to travel elsewhere for assisted suicide services, she does find the profit motive and the fees charged by some for the services "abhorrent." Click here to read.
BJOG Release: Doctors Comment On The Impact Of Fertility Tourism On The National Health Service (NHS) In a commentary to be published in BJOG: An International Journal of Obstetrics and Gynaecology, doctors reveal the numbers of women traveling abroad for Assisted Reproductive Technology (ART) treatment and examine their motivations for doing so. Researchers at the Fetal Medicine Unit at the Elizabeth Garrett Anderson Wing, University College Hospitals NHS Foundation Trust in London, analyzed the records of 109 women who had 'high order' multiple pregnancies (defined as having more than two viable embryos at the ultrasound examination before 14 weeks gestation) between February 1996 and July 2007. Within this group of women, 94 (86 percent) disclosed that they had received fertility treatment, a quarter of whom had treatment outside of the United Kingdom. Eighty-nine pregnancies were triplet pregnancies, four were quadruplets and one was a quintuplet pregnancy. The countries where women had their in vitro fertilization (IVF) treatment were varied and included Israel, Germany, Algeria, Cyprus, and South Africa. Researchers found that women who had their treatment overseas were less likely to have had selective embryo reduction compared to those who had treatment in the United Kingdom. The respondents cited several reasons why overseas treatment was sought. These were: the high cost of treatment in the United Kingdom; the ability to have multiple implantations to increase their pregnancy success; the faster speed of treatment; the availability of an ethnically acceptable donor egg; and because they were receiving treatment in their home country. Researchers caution that with freer movement of European citizens within the Eurozone, the number of British women seeking ART elsewhere in the European Union (EU), especially in countries where the practice is less well regulated, may increase. Likewise, researchers warn that the EU's proposed cross-border healthcare directive may mean that member states may have to fund the ART treatment of their citizens obtained in another EU country. There may also be other inherent problems for women when they seek treatment from a different healthcare system such as understanding medical advice in another language and being subject to different informed consent procedures. Researchers note that high order multiple pregnancies have financial implications for the NHS such as additional antenatal and neonatal care and longer hospital stays because of the increased risk of obstetric complications developing throughout the pregnancy and after delivery. Lead researcher, Alastair McKelvey, M.D., says, "We have seen an increase in the number of high order multiple pregnancies (triplets, quadruplets, and above) in women who have received fertility treatment overseas. In a lot of cases, treatment was sought in countries where the practice is more loosely regulated than the United Kingdom, or has no regulation at all. The rigorous consent processes in this country are not practiced in many countries. "We are concerned because these pregnancies are often very high-risk and present the NHS with considerable challenges in the care of mother and babies. Couples are understandably desperate to have children and may think that these treatments are a quick-fix or a good bargain, without considering the potential adverse outcomes. In fact they may not be properly counseled about the risks -- both to the mother and to the babies. These risks are real and potentially serious. There are genuine concerns about complications such as cerebral palsy and even maternal death. "We need international protocols on this urgently, to be agreed upon by the professionals performing the fertility treatment and those caring for the women." Philip Steer, BJOG editor-in-chief, says, "We are witnessing the growth of a new industry in fertility treatment overseas. In some countries, treatment is unregulated and methods are questionable. Women are prepared to undergo treatment because they are desperate to have children, but they may be unaware of the potential dangers of having multiple implants. "We should follow the advice of the British Fertility Society, that is, for single embryo transfer in women below 40 years of age. But for that to be a reality, women must first have access to the three free cycles of IVF, as recommended by the National Institute for Clinical Excellence (NICE). This helps alleviate the pressure to have a successful pregnancy at the first try."
Solid Advice for Medical Tourism Conference Speakers Ian Youngman of The International Medical Travel Journal (IMTJ) recently posted a story of great interest to anyone entertaining a speaking engagement at a medical travel conference. The piece addresses the issue of restrictive speakers agreements. The publisher was kind enough to grant us permission to include a link here:
Treatment Abroad Launches "The Business Success Kit" — How to market and promote medical tourism to the healthcare consumer Treatment Abroad, the leading medical tourism health information Website, has launched a Business Success Kit. This essential “how to” package has been developed to assist its healthcare clients in successfully marketing and promoting their services in this expanding and increasingly competitive industry. Treatment Abroad has a wealth of experience in medical tourism and understands the positive impact a good sales, marketing, and public relations (PR) campaign can have on a business and has created the Business Success Kit to help share its expertise and knowledge of the industry with clients The Business Success Kit brings together in one package many of the “how to” guides that Treatment Abroad makes available to clients as part of the after-sales service it offers.
As competition in the industry grows and increased numbers fight for market share the Business Success Kit is set to become an essential sales and marketing tool for any healthcare provider aiming to attract patients from across the world. Keith Pollard, managing director of Treatment Abroad, explains why they have produced the Business Success Kit. “Over the last five years Treatment Abroad has established a global client base covering 50 countries. We have extensive experience in the medical tourism industry, and we want our clients to share in our expertise and knowledge and help them grow their businesses. We already offer our clients a wide range of after-sales services aimed at helping them succeed in the medical tourism market. We wanted to expand this service so we developed the kit to be used as a “one-stop” package of advice on all aspects of marketing, sales, and PR. “The Business Success Kit will give our clients the information they need to successfully reach potential medical tourists. Marketing and PR are vital to successfully attracting foreign patients, and the implementation of a professional and innovative marketing strategy is essential if a business wants to stand out, attract and retain patients, and be one step ahead of the competition in the crowded medical tourism market place.”
Roscoe To Develop Company's Network Of Contracting Surgery Centers & Hospitals LISLE, Ill., July 21 /PRNewswire/ -- Healthplace America, Inc., the market leader in domestic medical travel, today named Todd Roscoe to the newly created position of chief managed care officer. The appointment was announced by Robert A. Yungk, chief executive officer. Roscoe will develop and oversee managed care operations and provider network development for the company. "As we move forward with the expansion of our products and services for the domestic medical travel market, Todd's expertise and skills in developing and enhancing our existing provider network will be critical," says Yungk. "I'm excited about the capabilities and vision Todd will bring to Healthplace America as we continually identify avenues that will lower costs for our clients and continue to grow the domestic medical travel market in the United States." "I'm pleased to be joining this innovative and dynamic market leader," Roscoe adds. Healthplace America has created a unique approach to help employers, third party administrators, and others manage the high cost of surgery, but there is more we can do to enhance our position in this market segment while strengthening our exclusive network of quality providers." Roscoe has more than two decades of experience managing and directing multi-million dollar managed care and provider contracting agreements. Prior to joining Healthplace America, he was president of Talentum CDH, a health care consulting firm specializing in the development of consumer driven healthcare plans. He also worked for Tenet Healthcare as vice president of Managed Care Operations where he had national profit and loss responsibility for 4,500 managed care contracts generating $4.4 billion in net revenues. Roscoe has performed similar duties for Allied Physicians, National Medical Enterprises, and CIGNA Health Plan. He holds a Bachelor of Business Administration, Finance and Quantitative Analysis, from the University of Cincinnati and an Executive Masters degree in Business Administration from Kennesaw State University, Georgia. About Healthplace America Through its network of high quality surgery centers and hospitals nationwide, Healthplace America created the Healthplace Surgery Benefit(TM), which offers members personalized attention from dedicated personnel who assist them through the entire surgical process, including the collection and transfer of medical records, travel, and accommodations. Healthplace America utilizes Health Grades, Inc., the leading independent healthcare ratings organization, providing quality ratings, profiles, and cost information on its network of contracted surgery providers. The Healthplace Surgery Benefit(TM) program compliments existing employer health plans and provides members with access to quality surgery centers and hospitals across the country that offer low, fixed-rate surgery pricing resulting in significant cost savings for both employers and their employees. World Stem Cell Summit to be held in Baltimore Newswise — This summit will attract more than 1,200 experts from more than 25 countries and across the United States. It will feature more than 100 speakers, including governors, federal officials, and top researchers and scientists and will discuss new federal stem cell policies, scientific discoveries, and human interest stories. This is your chance to meet and talk to all the experts at one location and time with on-the-record sessions, press briefings, and interviews. The World Stem Cell Summit, held this year at the Baltimore Convention Center on September 21-23, 2009, is the only conference that combines this mix of researchers, policy makers, business leaders, and ethics and legal advocates to share, explore, and discuss the latest breakthroughs and advancements in the emerging field of stem cells. Follow the latest on the conference arrangements on the Website and Twitter site. Story possibilities will be posted by participating universities and agencies on the conference news blog. Conference web site: http://www.worldstemcellsummit.com
Thailand Convention & Exhibition Bureau to Sponsor the 2009 World Medical Health Tourism Conference in Phuket Thailand Convention & Exhibition Bureau (TCEB) is set to sponsor the World Medical Health Tourism Conference: A New Way Forward, which will be held in Phuket, Thailand, September 2009. TCEB’s participation and sponsorship in this internationally diverse networking event will aim to promote Thailand on an international scale as a medical tourism destination and a preferred venue for international meeting, incentive, convention, and exhibition (MICE) events. The whole of Phuket Island is getting behind the conference, which will cater to more than 1,200 delegates. Local supporters range from local community groups, tourism operators, and many of the major hoteliers and resort owners, namely Woraburi Phuket Resort, Millennium Resort Patong, The Moevenpick Resort, Karon Beach Resort of Kata Group, Aquamarine Resort, Cape Panwa Hotel, and Andaman Seaview Hotel group. Phuket, dubbed as the medical tourism hub in Asia, is the ideal location to hold the conference because of its infrastructure, capacity to host a massive number of international guests, and the availability of cutting-edge technology and internationally trained medical experts manning their world-class medical facilities. Sometime within the next month the floor plan or layout for exhibitors at the venue, Hilton Phuket Arcadia Resort & Spa, will be published online and application forms will be available for the exhibitors to download from the Web site. Many pre-conference and post-conference activities have been planned for the conference, which early estimates expect to bring a windfall to Phuket of about $10 million over the two-week period. Interested parties are advised to visit the conference website: www.sosmedicaltourism.com for more information. Alternatively, for more information call + (66)76-289-800, to request a printable registration brochure by email sosmedical@sosmedicaltourism.com or sosmedical@ymail.com
Medical Tourism to be Focus of Service Summit Guatemala
Date Set for Healthcare Travel Exhibition & Congress in Dubai: October 27-29, 2009 With the healthcare travel industry poised to play an important part in Dubai's growth strategy, the Institute for International Research (IIR) Middle East, the organizers of the first medical tourism conference in the United Arab Emirates (UAE), which concluded in Dubai, recently have reported high levels of interest from a potentially huge international market. "Research unveiled at the event indicated a global market of around two million medical travelers a year and an industry constrained by hospital capacity and lack of consumer familiarity with medical travel," says Sietske Meerloo, marketing manager at IIR Middle East and organizer of Healthcare Travel Exhibition & Congress. IIR Middle East is also the organizer of the Arab Health Exhibition and Congress, the region's premier event for Middle East healthcare that takes place in Dubai 27-29, October, 2009. “Large numbers of hospitals and clinics around the world are attempting to tailor their health services to cater to medical tourists," Meerloo added. "Several major insurance companies offer a travel component in their policies, and governments are looking closely at policies to take account of the trend." The health care event was officially opened by Haidar Al Yousuf, M.D., transition director at the Dubai Health Authority, who highlighted the importance the Authority is placing on the future of medical tourism. "As we look to develop our domestic health strategy, we also want to develop a joint strategy with our colleagues in the Department of Tourism & Commerce Marketing (DTCM), for the future of health tourism in Dubai," says Dr. Al Yousuf. "The health care sector in Dubai will become an increasingly attractive place for international health care investors, providers, services, facilities, and other health care professionals." PlanetHospital, a California-based leader in medical tourism, used the event as a platform to announce the official opening of its Jeddah Saudi Arabia office to serve inbound and outbound medical tourists from the Arabian Gulf region. "The Gulf has the potential to drive growth in medical tourism," says Mohammed Alarifi, managing director for the new operation. "It is not only a destination from where patients seek medical care abroad but is also becoming a medical tourism destination itself thanks to major hospital developments throughout the region." The American Hospital Dubai also had high visibility at the event. There was "a lot of exchange of experience among colleagues from around the world," says Naser Saleh, director of marketing and sales. “On the conference side, the sessions were very informative." Gary Miller, CEO of Health Travel TV, says the event had been important for them. "We have a unique product, and we’re the only broadcast media here dedicated to this area. I’m coming back to Arab Health in January." Organized in association with the International Medical Travel Association, the Healthcare Travel Exhibition and Congress was supported by the UAE Ministry of Health and the Health Authority of Abu Dhabi. Platinum sponsors were Singapore Medicine. Gold sponsors were the American Hospital Dubai and Dubai Health Authority. For details about Arab Health events, please visit: www.arabhealthonline.com
Healthcare Abroad and Health Tourism
1st International TEMOS Conference
to discuss about quality management, and the potential of health tourism & healthcare services abroad – from the stakeholders’ perspective. Please also visit the Conference Website for registration and further information!
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