THIS WEEK IN MEDICAL TRAVEL TODAY
Volume 3, Issue 23

by Amanda Haar, Editor

Greetings,

Well, we've done it. The industry has managed to capture the attention of perhaps the greatest media prophet of all time: Oprah Winfrey (see INDUSTRY NEWS).

While the piece provides a nice overview of the industry and price comparisons, I think the reader comments are perhaps more revealing about how far we have and haven't come. From, "I had no idea there was a term created for those traveling for health care" to, "Definitely worth considering" reveal the broad spectrum of understanding that exists in consumers' minds.

In this issue we also have a PERSPECTIVE piece penned by Judy Dugan of ConsumerWatchdog.com. While appreciative of the value proposition that medical travel offers consumers, Dugan feels that consumers, insurers, and the government should all proceed with caution when wading into these new waters.

If you’re an employer, be sure to note the link to the right of this letter for the Value-Based Design 2009 Survey sponsored by the The Center for Health Value Innovation. Click through to participate or read more about it under INDUSTRY NEWS

As always, we welcome your comments, story ideas, and press releases.

Amanda Haar, Editor
ahaar@cpronline.com

SPOTLIGHT:Bob Repke, Global Medical Conexions

Editor's Note: Global Medical Conexions is a medical travel group with interesting roots. Launched in 2007, the company combines the experience of seasoned insurance professionals and a transplant network specialist for a unique understanding of the needs of global medicine. Medical Travel Today spoke with Bob Repke of Global Medical Conexions to learn more about the company's origins and goals.

Medical Travel Today (MTT): Let's start with some background on Global Medical Conexions. When and how did you get started?

Bob Repke (BR):  Our company was started in 2007. The decision to develop a global business model came out of discussion we had with a group from Bangkok who are involved in the business of medical evacuations. They have contracts with several embassies and international companies, essentially managing the transportation and medical care for people who get sick in the southeast Asian region. Patients are brought to Bangkok for treatment, and then returned to their assignment or their home country.

The group saw the possibility of extending their services to patients traveling from the United States  and wanted to explore what was then referred to as medical tourism. Their best point of entry appeared to be through the health insurance industry, and through an associate of mine they found their way to me.

I've been in the insurance business for over 30 years, the majority of which has been on the re-insurance side. I developed group health and benefits practice for General Reinsurance Corp with lots of involvement internationally through our subsidiary Cologne Life Re.  I also worked with Employers Re as their West coast manager for both Treaty and Direct lines. This helped me develop a broad perspective on the health care business and the many ways to manage risk from both an employer and carrier perspective.

We met with the group from Bangkok, Medical Destination Thailand, discussing the possibility of offering the services of high quality medical providers to U.S. patients; an intriguing idea reinforced by a personal visit to Bangkok confirming the quality and value of available health care services.

Through our discussions on medical travel, it began to make sense to offer a global medical option to employer groups. The option to travel outside the United States could be viewed as an added benefit in a group health plan.

From our reinsurance and alternative risk background, we saw that this would make the most sense when offered as part of an employer-based self-funded plan. The reason we chose self-funded plans is because they're ERISA-based with the employer becoming the insurer of record and therefore able to design benefits and choose the networks to create a unique broad-based health plan for their employees.  The opportunity for our firm is to work with the employer and their administrator to further enhance the self-funded health plan.

That's a very simplified explanation of how we started Global Medical Conexions (GMCX).

MTT: Can you identify the "we" in Global Medical Conexions?

BP: Certainly. We have four partners in Global Medical Conexions, myself, Nigel Wallbank, Ricardo Faerman, and Ariel Basse.

Nigel Walbank was the CEO of the largest independently owned transplant network in the United States, Strategic Health Development Corporation.  Nigel's background is particularly strong in the area of medical management and records transfer, which is key to successful transplant management.  The global patient requires a competent medical case manager to see to the effective and confidential transfer of medical records and proper follow up when they return to the United States. Nigel brings that strength to the table along with the ability to access the most effective way to service our client base.

Ricardo Faerman is from Buenos Aries where he is the CEO of an Argentinean life and health insurance carrier.  His knowledge of Latin American insurance business, health care providers, and general business practice is key to our developing strong relationships throughout this region. 

Ariel Basse is our attorney and Chief Operation Officer.  

MTT: Are you operating out of the United States at this time?

BR: Actually we have three corporations: GMCx US, GMCx Latin America, and GMCx Thailand.

MTT: Do these locations represent your provider network area?

BR:  To a large extent.  Our network now extends from Bangkok and New Zealand in the East.  And includes providers in Argentina, Brazil, Panama, Cost Rica, Mexico, Israel, and Miami.

We have a limited number of providers and have tended to choose countries that are very consumer-friendly. We come down on quality side first. If you look at our list of principles, they are quality, service, and price in that order. Our destinations reflect that as much as anything else.

We've visited all the hospitals personally and met with their senior management. All of the facilities are accredited by the Joint Commission International (JCI), the International Society for Quality in Healthcare (ISQua), or the equivalent. The doctors are largely board- certified and many trained in the United States.

We're also focusing on a limited number of procedures, the ones that makes sense. For example, we'd say no to an organ transplant but yes to a mechanical issue, such as knee or hip replacement, heart bypass, etc.

MTT: It seems like you have a good framework in place. How are you currently developing the business?

BR:  Our principals have many years in the group health and self-funded health plan arena.  We are in a relationship-based business and when we see a positive development in our business, we don’t hesitate to share with our associates.  At this point, we are talking with many insurance carriers who in turn work with self-funded plans. We work together to deliver the global value to their clients.  In addition, we are working with consultants, third party administrators, brokers, and others involved with employer-based plans.

MTT: How has the concept been received?

BR:  The response has been very enthusiastic. By and large people are going out of their way to introduce us to their clients. We’ve only seen pushback in two areas.

One, the recession. Employers aren't looking to spend any more money and some are happy with the status quo.

The other issue is health care reform. The attitude is very much one of "wait and see." However, for those folks there is some movement. The brakes aren't completely off but they get that reform won't have that much effect on this option. It still makes sense.

MTT: I'm curious. How has the conversation changed over the past two years? Are more people aware of medical travel and which types of employers seem most interested?

BR:  We did a lot of education in 2008 and the first part of this year—what is it, how it works, what's the differentiator with Global Medical Conexions.  That last part is still essential.

An employer’s staff is one of their more important assets. If an employer is entrusting their staff to us, we make sure that they feel confident in the process. We provide full-on concierge service—from getting their passport, meeting them at the airport, driving them to the hotel and to the doctor, etc. We're happy to repeat that part of the conversation any time.

As for who is interested, I'd say the larger employers are. If they can apply this approach to 10 people as part of a larger group, it shows both value and a quality improvement for the patient with true cost reduction for the plan.

MTT: Where in the model does Global Medical Conexions earn its keep?

BR: There are really two revenue streams for us. First, an access or PEPM fee when using our network and the option of purchasing our warranty product.
We feel these are the best approach for maximum cost transparency.

I’d welcome the opportunity to discuss our model further with any of your readers. I can be reached at rrepke@globalmedconex.com.

About Bob Repke

Bob Repke has worked in the field of reinsurance for over 25 years.  Starting in 1982, he managed and led all Treaty, Facultative and Direct Reinsurance lines for Employers Reinsurance Corporation in the Western United States. In early 1991, he started and led the Healthcare division at the General Reinsurance Corporation. Upon the acquisition of Cologne Re, he co-founded and shared the leadership of the GenRe and CologneLifeRe International Council.

In 2001 he founded IC West Insurance Services, which works with U.S. carriers as well as Lloyd’s underwriters, specializing in employer stop loss, reinsurance, and product development.

Most recently, he co-founded Global Medical Conexions, Inc., an International Select Provider Organization. As president of GMCx, Bob works to bring international options to employers, employees, and individuals seeking medical care outside the United States.
He is past chairman of the Integrated Benefits Institute, past Board member of the Western Protectors Insurance Company and is currently on the Board and Executive committee of the Self Insurance Institute of America. Bob resides with his family in San Francisco, and is an active member of the Olympic Club and Golden Gate Yacht Club.

SPOTLIGHT:Uwe Klein, M.D.

Uwe Klein, M.D., founder, Health Care Strategy International

Editor's Note: The pieces are falling into place for the European Medical Travel Conference 2010 scheduled to take place in Venice, Italy in May. Medical Travel Today recently caught up with chairman and organizer of the event, Dr. Uwe Klein, to learn how the event has evolved and what's on top for this year.

Medical Travel Today (MTT): Tell us a bit about your background and how you came to be involved in medical travel. 

Uwe KIein (UK): I studied internal medicine and occupational health in Germany and Canada. I then worked for SIEMENS implementing numerous projects in prevention and expatriate care. This led to a lot of travel around the world in which I evaluated the health care conditions in countries where the company had projects. I later became a consultant on cultural change and strategy development and then a freelance consultant and trainer for soft skills, including intercultural issues. In 2005 I returned to medicine and began offering consulting related to medical tourism marketing and business development. Most of my early work centered on German-Arab relations (Middle East).

Today, I work as a consultant in the field of international health care specializing in hospital development, recruiting, marketing of health care services, and treatment scenarios for international patients. My clients include clinics, governments, municipalities as well as individuals. I also offer training and coaching for intercultural projects.

In addition, I manage or support the organization of congresses in medical tourism and international health care issues, serving, at different times, as organizer, chairman, moderator, and even speaker.

MTT: I understand the European Medical Travel Conference (EMTC) was first held in 2008. How has the event evolved since that time? What significant changes have you seen in terms of numbers and types of exhibitors as well as attendees?

UK:  Let me start by explaining how the first event came together. In 2006 I attended a medical tourism fair in Moscow along with a professor from Germany. We both made observations about how wild, unorganized, and also unethical the market was in certain ways.

As we discussed it, we raised the question of which power or authority would be able and willing to exert a pressure on development of standards in quality, case management, and transparency. I came up with the idea to create a congress as the platform where the players could come together and talk about the future direction of this new industry.

What was as that day a bit of a joke, because no event was visible so far in Europe, became a viable project three months later and, in fact, the first congress was held in 2008.

From the beginning, the event was designed to be hosted by different European countries each year. In 2008 the event was held in Munich, Germany, and in 2009 we were in Budapest. In 2010 we'll be in Venice, Italy.

At our first event we had 320 attendees. In 2009 the number ticked up slightly to 300 participants for Budapest. That doesn't seem like much of an increase, but we were pleased because the event occurred at the height of the global financial crisis.  We considered any increase at all to be exceptional.

We're expecting around 450 participants for the 2010 event.  The market players are very much interested and growing.

MTT: How have the topics changed and what do you anticipate this year’s big issue or issues to be?

UW: We anticipate there to be three key focus points this year: 

1. Two-Way Transatlantic Medical Travel: That is first the idea of U.S. patients discovering Europe and Germany as a major destination because the combination of quality, patient and travel safety, and still reasonable pricing (compared to U.S. averages) outperforms other regions. This also incorporates the idea of European Union (EU) nationals traveling to the United States for specialist treatments. We'll be looking at both.
2. EU Patient Mobility Act: This legislation will trigger a lot of re-thinking on case management, cross-border solutions, insurance innovation, health care cost etc. We'll be looking to sort out the barriers and conflicts.
3. Cruise Ship Medical Tourism: This will be the hit of next year's developments. Cruise ships in the Mediterranean Sea and in other areas may bring more and more medical treatment facilities on board and cooperate with land-based specialist hospitals. How that works, will be explained at the conference. I expect a lot of business development in this field.

MTT: How did you come to choose Italy as this year’s host country?

UW: Italy has been a little bit quiet in the area of medical tourism in the past few years. However, in the region of Venetia they have a total of over 50 million overnight stays in the high season, so they are, in fact, the largest tourist destination region in all of Europe.

Turning only one percent of the tourists into health tourists or medical travelers would mean a big leap for Italy to close a gap with other countries that currently dominate the market.

Plus, Italy has given medical tourism significant strategic attention, which means that the political backup is fully there.

There are good reasons for market stakeholders to have a closer look at the country and to network with hospitals and providers in the region.

MTT: How is the event coming together thus far? 

UW: It's a bit early to say. The Website has been up for only two weeks, and we've just started the sincere marketing effort. However, we have an impressive panel of excellent speakers who are all recognized stakeholders and thought leaders in the market. Happily, most of those people came to us looking for the opportunity to be involved.  We feel this is a good start and shows that the event is coming together at the right time with the right issues at in the right place.

MTT: I understand that at EMTC 2010 you are planning to host a forum of the various medical travel associations that currently exist. What's the purpose of that forum and the hoped for outcome?

UW: There are a number of players and interests in the medical tourism industry that are after big and quick money. Meanwhile, there are also a number of associations trying to impose standards on the industry. But if the JCI, or a similar entity, or medical associations with legitimate medical professionals, are not involved, then we create the opportunity for commercialization of everything that will do nothing to create or ensure patient safety.

As I've watched the various associations assuming competitive, and in some cases, adversarial roles, I wondered how is it non-profit organizations can be in a competition with another? This approach doesn't mesh with their stated missions.

I'm hoping to bring the associations together to talk to each other about how to cooperate, how they want to set standards, and which representatives of the various national medical tourism association would they trust to take care of the bigger issues like patient safety and facilitator education.

MTT: How do you feel the EU Directives will impact the industry? Are they harmful or helpful or neither?

UW: The EU directives are still under development, but as this is going on, cross-border health care scenarios are already a reality in Europe. For the complete liberalization of the markets there are still many steps to be taken. But the directive will exert a push for cost efficiency, quality, service, and patient safety for years. We are working on bringing up a suitable organization or association in Europe to become the binding link and glue for the health care service markets.

MTT: What might the timeframe for their adoption/passage be?

UW: It is released step by step, and nobody knows how fast the politicians will push it, but I personally believe that even though it's already started, this will take five more years.

About Dr. Uwe Klein
Dr. Uwe Klein studied internal medicine and occupational health in Germany and Canada. He implemented numerous projects in prevention and expatriate care at SIEMENS. After 1995 he became a consultant on cultural change, corporate strategy, and communications, focusing on knowledge management and e-learning. Since 2005 he has worked in the field of medical tourism as a consultant and launched the European Congress on Health Tourism in 2009. He is currently preparing for the 2010 event slated to take place in Venice, Italy (http://www.emtc2010.com/).

His consultancy firm Health Care Strategy International (http://www.healthcsi.de/) collaborates with international health care companies, hospitals, governments, and associations to network for quality solutions in international health care and medical knowledge management.

He is also president of Hippokratia e.V., a non-profit organization promoting transparent business models and quality supervision in medical tourism by non-commercial institutions.

INDUSTRY NEWS

BridgeHealth Reaches One Million Member Milestone for Travel to Surgical
Centers of Excellence Via Contracted TPAs, Insurers, and Employers

DENVER, Co. – November 5, 2009 – Following two years of steady corporate growth since its founding in 2007, BridgeHealth Medical, Inc. (www.BridgeHealthMedical.com), the nation’s premier provider of medical travel services to high quality surgical centers of excellence at significantly lower rates, today announced reaching a major benchmark:  Over 1,000,000 lives under management by Third Party Administrators (TPAs), employers, insurance carriers, program administrators, and Limited Benefit Plans are being introduced to the BridgeHealth network of surgical Centers of Excellence.  By incorporating BridgeHealth into their portfolio offerings, these leading business channel partners offer members and individuals a way to control claims costs on major surgeries while giving employees access to high quality health care.

“This is a major milestone for BridgeHealth because it means that well-respected, national health care administrators and carriers see great value in offering this innovative specialty travel network,” says Arthur Laffer, Ph.D., noted economist and creator of the Laffer Curve, economic advisor to President Ronald Reagan, and member of the Board of Directors of BridgeHealth. “While these entities may be inundated daily with multiple program opportunities, they now value and prioritize what BridgeHealth has to offer.  Collectively, they have chosen to dedicate time, effort and resources to introduce this plan enhancement to their constituents as a realistic way to blunt anticipated cuts to employee health benefits.”

BridgeHealth offers worldwide access to quality accredited hospitals and qualified physicians, bringing affordable coverage to small and large businesses alike. Individuals benefit from the end-to-end coordination of high quality, lower cost procedures -- both domestically and abroad -- that help reduce costs across-the-board for consumers, employers, and insurers.

Victor Lazzaro, Jr., CEO of BridgeHealth Medical, Inc., explains, “Channel partners regard the BridgeHealth offering as a clear differentiator in this highly competitive benefits marketplace, with many seeing a medical travel option as a positive way to help combat large year-over-year rate increases for plan sponsors. In a tough economy, this type of benefit is very appealing.”

He says that the number of health care administrators and carriers in the BridgeHealth pipeline grows steadily, with respected organizations now recognizing that the medical travel option means real savings on claims, value to employers and employees, and a market differentiator for the program sponsor.

“While this benefit can be added off-cycle, we have significant interest from plans to be ready for a January 1, 2010, effective date,” he continues.  “Our channel partners are anxious to deliver a right now solution for their clients’ healthcare costs where those plans can save 30-80 percent on surgical case fees and share some of those savings back to employees to go toward their out-of-pocket costs.”

According to Bruce Flunker, CEO of Employee Benefit Consultants of Milwaukee, WI, “We selected BridgeHealth as a partner because they mirror our own organization’s position at the leading edge of quality improvement and cost control within healthcare choices for our employer clients.  Access and experienced support for employees to travel to surgical centers of excellence has become a reality within US healthcare channels; we are actively rolling this option out as an improved choice for members covered under their company plan.”

Allied National, Inc., a third party administrator of fully insured plans for individuals and small employers, is offering the BridgeHealth program as a standard feature to all of its policyholders. Bill Ashley, CEO, notes, “They will now have an opportunity for greater choice and cost-efficient health care without compromising on quality. In particular, we believe this program will be extremely valuable to our clients with high out-of-pocket plans.”

As BridgeHealth validates market momentum, Sam Havens, former CEO of Prudential Healthcare, director and business development catalyst for several leading-edge health care technology firms, and a member of the Board of Directors for BridgeHealth, concludes, “The BridgeHealth domestic network is a premier option for surgery, offering consumers increased quality, choice of providers, cost savings, and patient education – the key elements of every proposed health care reform package. BridgeHealth is also filling a need on the international side by integrating agencies and hospitals with data to support the medical travel advantage.”

About BridgeHealth Medical
BridgeHealth Medical (BridgeHealth) is the premier provider of medical travel services to high quality surgical centers of excellence at significantly lower rates, founded with a vision “to create a trusted bridge to the world of medical care.” BridgeHealth offers both U.S. domestic and international networks and serves health plans, insurance carriers, employers, third party administrators, individuals accessing benefits via voluntary benefits plans, health and affinity card programs or Consumer Directed Health Care Plans (CDHP), and individual consumers seeking medical travel options.  Visit www.BridgeHealthMedical.com

Oprah.com Features Medical Travel

Editor's Note: I think we can safely say that medical tourism has arrived.  The latest issue of Oprah.com features a "Global Guide to Medical Tourism," which features a brief overview of medical travel and pricing comparisons for the most popular features. Click here to view the story.

World Egg Bank Launches Medical Tourism Program With World's Largest
Egg-Donation Fertility Clinic

PHOENIX, Nov. 2 /PRNewswire/ -- The World Egg Bank (TWEB), an international
agency for the donation of human eggs to infertile women, announced a
first-of-its-kind partnership with a European fertility clinic to provide
American women with in vitro fertilization (IVF) of donated frozen eggs at or
less than the cost of staying home for such treatment.

The exclusive partnership is between TWEB and IVI in Alicante, Spain, the
world's largest IVF center for frozen donated eggs. It boasts one of Europe's
highest success rates and maintains 18 clinics throughout the world.

Egg donation treatment at IVI will cost the same or less than an IVF cycle in
America using fresh donor eggs, and about the same as one using frozen donated
eggs - including the cost of a vacation in Spain.

"This provides not just an economic alternative for American patients," said
Diana Thomas, president and CEO of TWEB, "but is also well suited to intended
parents who enjoy foreign travel."

Now a common solution for infertile women who wish to bear children, egg
donation can be accomplished with fresh donated eggs, which requires both
donor and recipient to coordinate carefully timed procedures in the same city.
Frozen eggs, however, can be shipped nationally or internationally and thawed
for transfer.

In contrast to American fertility clinics, approximately two-thirds of IVI
patients use frozen donated eggs. In contrast, egg freezing accounts for a
fraction of American IVF cycles and is still considered experimental by some
fertility specialists.

TWEB maintains one of the world's largest egg donor registries, with donor
biographies online. More about IVI is available at http://ivi.net/en and
http://www.theworldeggbank.com/tweb2/IVI/AboutIVI.aspx

About The World Egg Bank
TWEB was formed in February 2009 as a merger of two companies, X and Y
Consulting Inc., an egg donation agency founded in 1996 by Diana Thomas, and
Cryo Eggs International, founded in 2004 as the first commercial source of
frozen human eggs in the world. In 2005, the first child born of a frozen egg
bank was born under the care of two of TWEB's doctors and founders. TWEB's
scientific team includes Jeffrey Boldt, M.D., and Michael Tucker, M.D., the two
scientists who pioneered egg cryopreservation technology.

Companion Life Adds Dental Tourism Option to Help Policyholders Save

Columbia, S.C. – Companion Life Insurance Co. has teamed up with a leading medical travel facilitator to offer its dental policyholders preferred pricing on travel and treatment at dental clinics outside the United States.

Traveling abroad for credentialed dental care, also known as dental tourism, helps policyholders maximize their dental benefits. Prices at the international clinics average 60 to 80 percent less than in the United States, so Americans can save thousands of dollars on extensive dental care -- even after factoring in travel costs. Members’ dental benefits will help cover treatment costs at the overseas clinics.

Companion Life is including the international treatment option in all of its dental programs nationwide, effective immediately. It is offering the value-added service through Companion Global Dental (www.CompanionGlobalDental.com), a division of medical travel facilitator Companion Global Healthcare Inc., based in Columbia, S.C.

Companion Global Dental will arrange travel, make dental appointments, provide round-trip customer service, and even facilitate the scheduling of tours to volcanoes, rainforests, coffee plantations, and other attractions for Companion Life members visiting any clinic in its network. The network currently includes three state-of-the-art clinics, all located in Costa Rica, that have completed Companion Global’s credentialing process.

“We believe we are the first national dental insurer to provide international travel and care as a value-added option on all of our policies,” said J.C. Preas, Companion Life’s vice president, field marketing. “This option will allow our members to get the dental treatment they need at a credentialed facility, to save significantly on out-of-pocket costs, and even combine an exciting vacation with their dental treatment.”

Companion Global Dental’s network providers are MP Adult Dentistry of Costa Rica, Meza Dental Clinic, and Prisma Dental Clinic. All the clinics have English-speaking staff members, utilize the latest in technology, and have years of experience in treating American patients. All offer ground transportation to and from the airport.

“Companion Life members who travel to our clinics will save money and have an amazing travel experience, and they will not have to settle for a lower standard of care,” said Phil Midden, Companion Global Dental’s operations manager. “Many of the dentists in our network trained in the United States and are members of American dental associations.”

Companion Life offers dental plans – small group, large group and voluntary – to employer groups with two or more employees. For more information, call 1-800-753-0404.

About Companion Life
Headquartered in Columbia, S.C., Companion Life Insurance Co. (www.CompanionLife.com) has specialized in employee benefits since 1971. The company markets life, dental, disability, accident, and specialty health insurance products through a network of independent agents and brokers, general agents, and managing general underwriters. Companion Life is licensed in 45 states and the District of Columbia. It holds an A.M. Best Rating of A+ (Superior).

About Companion Global Healthcare
Based in Columbia, S.C., Companion Global Healthcare Inc. (www.CompanionGlobalHealthcare.com) provides medical travel assistance to clients who seek treatment at any of its 24 network hospitals and three dental clinics around the world. The company serves as a single launch point for appointments, travel arrangements, case management coordination services upon return to the United States, medical travel insurance, and help with filing insurance claims.

The company serves uninsured and underinsured individuals, as well as employers and insurance companies that include the Companion Global Healthcare network in their benefit plans. Employer groups interested in restructuring their benefit plans to include Companion Global Healthcare’s network and services should call 1-800-906-7065.

RNL BIO Rescues a College Student from Autoimmune Hearing Loss

SEOUL, South Korea, Nov. 4 /PRNewswire-FirstCall/ -- RNL BIO Co., Ltd,
(www.rnl.co.kr) a leading biopharmaceutical company specialized in adult stem
cell therapeutics announced today that it treated an American college student
who was suffering from autoimmune hearing loss, and she gained her hearing back
in two months after treatment.

Chloe Sohl, an 18-year old college student who majors in music at the University
of Arizona suffered from autoimmune hearing loss since the age of 15. Although there is no known cause of her diagnosis, it is a serious disease that slowly damages the organs. Chloe's father, Bertram Sohl, M.D., is a director of Obstetrics and Gynecology at St. Mary's Medical Center in Long Beach, Calif.,  and her mother, Veronique Jotterand, M.D., is an ophthalmologist and vice chief of staff at Miller Children's Hospital in Long Beach, Calif.

Even though Chloe's parents are medical doctors, they felt helpless and devastated about their daughter's progressive condition. They tried every possible medication, but Chloe's condition got worse. The only options they had were for Chloe to use a hearing aid and take medication to slow down her autoimmune system. Tai June Yoo, M.D., a professor from the University of Tennessee,  medical advisor of RNL BIO, and specialist in immune diseases, explained that if Chloe continued to take strong medication like Methotrexate and Humira, there would be a good chance for further serious complications without guarantee of improvement. Her doctors even recommended that Chloe receive a Cochlea implant that could enable Chloe to hear some sound, but would  destroy the middle ear.

Ever since Dr. Sohl met Dr. Jeong Chan Ra, president and CEO of the firm, they began to see hope in Chloe's hearing. Dr. Ra established RNL Life Science in California to promote stem cell banking and to introduce the benefit of stem cell therapy through medical tourism. He held a seminar on April 20, 2009, with 30 doctors from Southern California on the topic of adult stem cell therapy in San Pedro, Calif. Among the attendees was Dr. Sohl, who was stunned at RNL BIO's achievements in stem cell therapeutics.  The principle of adult stem cell therapy is actually simple because it utilizes the natural healing ability of our own body.

"Every part of our body already contains stem cells that play a key role in maintaining and repairing our own structural and functional system,” explained Dr. Ra. “Due to aging, the amount of stem cells decrease and that's why the time and ability to recover from cellular damage slow down and chronic and degenerative symptoms develop as time goes by. The principle of our stem cell treatment is to make enough stem cells and to bring them back to the patient's own body. Surprisingly, we found that stem cell therapy has great potential to treat autoimmune diseases."

Earlier this year, RNL BIO treated patients with atopic dermatitis. Other autoimmune disorders have also been treated in addition to atopy. Many stem cell researchers have demonstrated that mesenchymal stem cells modulate the immune system and suppress inflammation as a major therapeutic effect. Chloe's hearing loss falls into this example. This treatment was supposed to soothe any hypersensitive immune response and repair damaged organs so that she might hear again.

Dr. Sohl was very interested in having  his daughter receive stem cell treatment, but his wife was skeptical. Chloe's physicians even discouraged Chloe from receiving stem cell treatment. However, they opted  for the treatment for Chloe, given RNL BIO's successful outcomes.

Chloe said, "I felt very good about it. I felt very optimistic. I've had IV's every month since I started to lose my hearing. It was good because I knew this could work unlike the other ones.”Currently, stem cell transplant is not allowed in some countries like the United States, some European countries, and South Korea unless it garners market approval through clinical trials.

Chloe had to travel outside of the United States and to Japan or China where RNL established stem cell clinics. More than 2,000 patients with various diseases have been treated with stem cell therapeutics through RNL BIO since 2008.

Chloe visited Dr. Won, a plastic surgeon in Los Angeles to harvest her fat tissue around her belly button last June. The  tissue was sent to the laboratory RNL BIO in Germantown, Md., where they isolated stem cells, put them in a liquid nitrogen shipper, and transported them to RNL BIO in Seoul, Korea. It took a month to expand her stem cells to a sufficient amount
for  treating her hearing loss. Chloe's family planned a trip to Korea during their summer vacation. At last, on July 27, 2009, they visited Korea for two weeks. The stem cell treatment took place in Japan -- 600 million cells were administered by three injections with 5 day intervals. The cells were injected into her veins and auditory system.

Chloe's hearing was tested two months after the procedure was completed on October 16, 2009. The results were spectacular. The left side of her ear improved 50 percent from not being able to hear at all. The right side of her ear gained almost complete hearing.

Dr. Jotterand stated,  "It’s  been a 180 degree turnaround. She's just enjoying life and enjoying being a freshman at the university. She's having a great time, and it's wonderful to see.”

Chloe's parents invited Dr. Ra and other members of RNL BIO to their home in Long Beach to celebrate. They expressed their gratitude and felt as if they’d  received a gift of miracle. They also promised to support RNL BIO's by promoting stem cell therapy in the United States.

Dr. Ra stated, "Through this great discovery and research of adult stem cells, I am committed to create and develop therapies that will not only prevent diseases, but ensure a better quality of life for all."

Thailand's Medical Tourism Growth Rate Continues to Increase

NEW YORK, Nov. 6, 2009 -- In 2004, the Royal Thai Government organized a strategy for developing Thailand into the medical hub of Asia. Today the Tourism Authority of Thailand (TAT) (http://www.seeyouinthailand.com/) and the Department of Export Promotion (DEP) has estimated two million medical tourists will arrive in Thailand for health care services in 2010, an annual growth rate of 14 percent for the sector, ahead of the country's gross domestic product (GDP).

Research and Markets reported in 2008 that Thailand conducted more medical check-ups and treatments for international tourists than any other country in Asia. Thailand provides some of the world's best medical treatment services and facilities, and many visitors claim that Thailand’s care providers' "warmth and understanding was a valuable part in the treatment and speedy recovery" (Tourism Authority of Thailand). The average cost of health care services in Thailand is approximately 1/5 of prices in the United States or Europe. Taking this estimate into consideration, it is even more significant that in 2008,
foreign patients generated an estimated $6 billion USD for Thailand. One international medical travel journal stated that the Royal Thai Government has provisioned a five-year
plan that aims to double this revenue by 2014.

A major international accounting and consulting firm estimated 1.5 million Americans traveled abroad for health care services in 2008 and forecasted an annual global market
expansion of more than 20 percent going forward to 2012. Thailand is prepared to meet this growing demand by excelling in the medical care it delivers on a daily basis to patients from over 190 countries at affordable rates.

People are taking a medical trip to Thailand for health checks, dental and cosmetic surgery, or other medical treatments or routine maintenance. Tourists can undergo and
recover from many non-invasive procedures during a typical two-week holiday in Thailand. "Patients Beyond Borders: Thailand Edition" by Josef Woodman, CEO of Healthy Travel Media, just released on Monday, is a guidebook that offers an in-depth overview of Thailand's international hospitals, selected health travel agents, nearby recovery and guest accommodations, spas, and area travel information so that medical tourists know which places to go in Thailand to get their world-class medical treatments.

With the accelerated growth of Thailand into becoming Asia's medical hub, considerable opportunities in related fields are being created. The medical device sector, for instance,
is continuing growth due to demands for new and upgraded medical machinery and devices. Thailand is also gaining recognition for its research and
clinical trials of advanced medicine and stem cell treatments. As Thailand's medical tourism industry continues to grow, its health care industry will grow in leaps and bounds as well.

About the Tourism Authority of Thailand

The Tourism Authority of Thailand (TAT) (http://www.seeyouinthailand.com/) was established in 1960 by the Royal Thai Government to be specifically responsible for tourism promotion. In 1965, TAT opened its first overseas office in New York. Since then, TAT has established 21 offices in different parts of the world including the Los
Angeles office. TAT aims to provide the best Thailand traveling information to the public and media members as well as work closely with our travel partners to develop new deals and packages.

Value-Based Design Survey Now Open

The Center for Health Value Innovation has asked Buck Consultants to survey employers regarding their experiences in implementing a Value-Based Design.

The survey explores the various insurance plan designs, plus the incentives and
disincentives that employers are incorporating into their total benefits today.  Understanding the successes, challenges, and experiences of employers across the
United States will help drive the new wave of innovation for improved health and
economic outcomes. 

To participate in the survey please click here.

The questionnaire will take no more than 10 minutes to complete and all participants will receive a complimentary copy of the compiled survey results (estimated February 2010).

PERSPECTIVES

Editor's Note: The following Op-Ed commentary by Judy Dugan, research director and a health policy advocate for Consumer Watchdog, was published in The Los Angeles Times on Tuesday, November 3, 2009, and is included here with author permission.

Judy Dugan Consumer Watchdog

Medical Tourism: Outsourcing Your Health

Pitching lower costs, 'international hospitals' are trying to make inroads into the U.S. health care system. But are they just a remedy for insurance companies?

At a luxury hotel conference center in Century City last week, "international hospitals" from Singapore to South America set up half an acre of colorful display booths in an attempt to attract more business from American insurers and employers. Glossy brochures and videos offered hip replacements, cancer treatments, and cardiac care in Turkey, Thailand, or Costa Rica. Send a patient and a companion on business class, the basic pitch went, and we'll give them deluxe private rooms, a concierge, and a driver. You'll still save half or more of the U.S. cost — tens of thousands of dollars.

The name for this is medical tourism. It's not a phrase that has come up openly in the national debate on health care reform. But the medical tourism industry has its hopes set on embedding the globalization of health care in standard health insurance packages. At the convention in Century City, meeting rooms buzzed with sessions on how to sell insurance companies and major employers on the idea.

If the reforms being decided in Washington don't clearly reduce costs for health care and insurance — and right now they're headed in the wrong direction — American workers may find themselves facing "incentives" for overseas surgery that border on coercion.

Medical tourism is known today as a path to lower-priced plastic surgery, dental implants or laser eye surgery, and a last resort for the middle-class uninsured who can scrape together $50,000 for a liver transplant in India, but not the $200,000 it would cost in the U.S. The business end of medical tourism, however, sees major growth potential in the already insured.

But there is a problem: no public data on quality and little recourse for injured patients. Despite the industry's assertion that it offers U.S.-quality care, there is no backup to that claim. A new U.S.-based accreditation system for international hospitals adds some reputational sheen but doesn't let patients compare results of, for instance, cardiac bypasses. Patients are often faced with signing airtight waivers that free providers from liability for negligence or error, starting with the paid "facilitators" who arrange travel, visas, lodging, and hand-holding during the process.

For insurers and employers looking at a $45,000 hip replacement in the U.S., the lure of a $5,400 hip replacement in India -- even with $10,000 or $12,000 in travel and lodging costs added on -- is hard to resist. So what if there's a lack of public, comparative data on outcomes, complications, and long-term recovery?

Hospitals in the Third World pay a fraction of U.S. salaries. A doctor in the Philippines, for instance, makes far less than a U.S. nurse. In nations including India, Thailand, and Mexico, government intervention steeply reduces drug and other costs. Hospital construction costs are low, and physical safety requirements such as earthquake-proofing are generally absent. Hospitals for the international trade don't have to care for indigent patients. And, because the deeply ill aren't candidates for a 15-hour pre-surgery plane trip, the overseas hospitals skim off healthier patients needing less complicated -- and expensive -- care. This could leave U.S. hospitals and medical professionals to treat the sickest patients -- and raise U.S. costs even more.

Here are a few early indicators of insurer interest: the Blue Cross Blue Shield Website touts "Blue Cross' Companion Global Healthcare," a wrap-around travel planner and network of overseas providers, selling to individuals and to employers in South Carolina. In California, Blue Shield and HealthNet offer plans for employers of Mexican immigrants that cover treatment in Mexico. And United Health Group, the parent of PacifiCare, sent a speaker to the medical tourism conference to advise on how to get employers to include overseas surgery in health plan networks.

In 2008, West Virginia legislators considered a proposal promising state employees a waiver of all co-payments and deductibles, payment of all travel expenses for the patient and a companion, a week of "free" sick leave and a rebate of 20 percent of savings if they chose overseas surgery. The measure didn't pass. But except for the rebate, it's close to what an Anthem WellPoint pilot program offers and what a few smaller U.S. companies are trying out.

When overseas surgery goes well, the insurance company -- or an employer with a self-funded health plan -- ends up with a fatter profit and a satisfied patient. If the surgery doesn't go so well, or a long flight home generates a deadly post-surgical blood clot, the patient has little recourse.

Overseas surgery or cancer treatment is as drastic as cost-cutting gets, putting the whole burden of risk on the patient. Yet Congress is heading toward a bill that forbids cost efficiencies such as direct government drug purchasing or Medicare-style price-setting. Medicare-for-all never even got serious consideration.

That's why medical tourism should be under a microscope now, before employers and insurance companies decide it's part of their own cost — and profit — solution.

About Judy Dugan
Judy Dugan is research director and a health policy advocate for Consumer Watchdog, a nonprofit, nonpartisan consumer advocacy organization in Santa Monica.

VOLUNTOURISM: HIV/Aids Opportunities

One of the benefits of travel is experiencing other cultures in other countries around the world. Travel allows you to embrace the freedom of flight and learn from others on the other side of the world. It opens the mind, body, and soul to a new way of living. But for 22 years, people living with HIV/AIDS were banned from travel... until now.

President Barack Obama overturned a travel ban earlier this month to lift the 22 year-old U.S. travel and immigration ban on those living with HIV/AIDS, a move applauded by travel industry groups and health care organizations. The U.S. regulation prevented non-U.S. citizens living with HIV from entering the country and HIV-positive people from  becoming permanent U.S. residents – except under exceptional circumstances. The news traveled to the other side of the world - HIV agencies in Australia, Asia, and the South Pacific welcomed Obama's end to the “discriminatory” policy.

“At an international level, it will help ease the stigma associated with HIV and encourage people to get tested and receive treatment,” said ACON chief executive officer Nicolas Parkhill. ACON is an Australian-based corporation that promotes the health and well-being of the gay, lesbian, bisexual, and transgender community. “This will significantly improve HIV prevention efforts here in Australia and especially in many Asian and Pacific countries where HIV transmission rates continue to escalate.”

In the meantime, medical volunteers are working around the world to help those living with HIV/AIDS. African countries have been hit hard by the HIV/AIDS epidemic and volunteer groups including Waltz Volunteer Inc., provide voluntourism opportunities for medical professionals.

The programs aim to raise awareness of the disease through education and access to medical care. Medical professionals specializing in treating the HIV/AIDS virus work with children in African villages to educate and counsel, and provide education on safe sex, HIV testing, and basic hygiene practices. This particular program is available to volunteers in Kenya, Tanzania, Uganda, Rwanda, Cameroon, and South Africa.

Health care professionals agree that education is the first form of defense against contracting the HIV/AIDS virus. Volunteer groups including Global Cultural Solutions and Experiential Learning offer AIDS Awareness programs aimed at educating communities in impoverished areas about the AIDS epidemic.

The Global Cultural Solutions program allows volunteers to craft their own two-week program, based on the community where they are placed. Volunteers don't have to have a medical degree, but they  must have an understanding of the HIV/AIDS virus. Volunteers visit schools in Ghana and hold workshops and support sessions for women, children, and families.

While education is the key to prevention, medicine is the key to survival for those living with the HIV/AIDS virus. Doctors Without Borders/Médecins Sans Frontières (MSF) began treating people living with HIV in the 1990s and now operates HIV/AIDS programs in 32 countries including Ecuader, Peru, China, Cambodia, India, and dozens of countries throughout Africa. MSF provides treatment to more than 100,000 HIV-positive patients- including 7,000 children, but a recent report shows that some countries have stopped treating HIV-infected patients. Countries in Uganda and cities throughout South Africa are backing away from previous treatment coverage, which has resulted in an estimated 3,000 deaths since the beginning of the year. 

Now that the travel ban has been lifted, those living with HIV/AIDS will enjoy a bit more freedom to roam the world, and may even find it easier to receive treatment in other countries. However, 67 countries still enforce travel restrictions on people with HIV/AIDS. HIVTravel.org lists countries with and without travel restrictions, including countries with short- and long-term travel restrictions. In the meantime, voluntourism efforts to increase the education around HIV/AIDS continue and with an open travel plan, it just might make it easier for those suffering with the virus to get the medical attention they need. 

About Melanie Nayer

UPCOMING EVENTS

Healthcare Abroad and Health Tourism 1st International TEMOS Conference
November 15-17, 2009 in Cologne / Germany

TEMOS is pleased to announce the 1st International TEMOS Conference on “HEALTHCARE ABROAD AND HEALTH TOURISM” in Cologne, Germany from November 15-17, 2009.
 
The main objective is to bring together the parties and markets of:

• Health insurance companies and payers from Germany and Europe
• Hospitals and medical facilities from all over the world
• International facilitators, health tourism operators and telemedicine providers

to discuss about quality management, and the potential of health tourism & healthcare services abroad – from the stakeholders’ perspective.
 
To push these conference topics we have the pleasure to introduce several international experts as members of the TEMOS Conference Advisory Board, for example:

Health insurance: Dr. Franz Benstetter, Head of Operational Services Munich Health, Munich Reinsurance Company.

Medical facility: Dr. Kalyan S Sachdev, M.D., Chairman and founder of Privat Healthcare Group, member of the governing Board of Indian Spinal Injuries Center.

Telemedicine: Prof. Dr. Michael Nerlich, M.D., Head of the Department of Trauma at the University of Regensburg Academic Medical Center Surgery, President of the International Society for Tele' and eHealth (ISfTeH).

Science & Economics: Prof. Dr. Wolfgang Goetzke, Director of gewi-Institute for health economics, Co-founder of the Fresenius University in Cologne, Coordinator of the regional initiative “Health Cologne” and “Health Region Cologne Bonn”.

Click here to find additional members of the Advisory Board.

Please also visit the Conference Website for registration and further information!

Register now via the Online Registration Form and benefit from the early bird rates!
 
Please contact info@temos-conference.com or the conference hotline +49–2203–601 3000
for any questions regarding the International TEMOS Conference.
 
Exhibitors can increase their profile by choosing between several attractive sponsoring options for this event. Please get in touch with us to learn more about your opportunities.
 
Please note: You can ideally combine the attendance of the TEMOS conference with a visit to MEDICA®, the world’s largest exhibition for ' technology, which is held in the neighboring city of Duesseldorf from November 18-21, 2009.

National Newspaper confirms support for Health & Medical Tourism Show
The Independent Newspaper has confirmed support of the forthcoming Destination Health exhibition, which is set to take place on 17 - 18 April 2010 in London.
Destination Health is a brand new exhibition designed exclusively for people planning to travel abroad for all types of treatments.

If you are involved in any aspect of health tourism, then you should be exhibiting at Destination Health.

For everything from heart disease to hip replacements, breast implants, and medical spas, Destination Health is dedicated to every area of health tourism. It brings together thousands of patients and medical providers under one roof and offers an exclusive platform to meet people who are ready to invest in their personal health, body image, and well-being.
Whatever the size or nature of your business, if you want to promote and increase awareness of your health and medical travel services in a focused and dedicated environment, you should be at Destination Health.

To find out more, visit the Destination Health website or call us on + 44 (0) 20 8230 0066 or email sales@destinationhealth.co.uk

European Medical Travel Conference Slated for May 5-7, 2010

The European Medical Travel Conference 2010 in Venice, Italy, is the ideal platform to meet European and international partners and benefit from the latest thinking on medical travel. It runs from Wednesday, May 5 to  Friday, May 7.

The style of the conference has evolved from that of previous European Congresses... in Budapest in 2009, and in Munich in 2008. It is a compelling mix of business, science, and practical experience.

Attend: Previous major congresses on Medical Travel and Health Tourism in Europe have attracted over 300 participants. We’re expecting even more for EMTC 2010.
Check out the benefits of being a participant in EMTC 2010.

Exhibit: We have 500 sq. m. for the exhibition during the conference, which will accommodate about 30 stands. Take advantage of the special rate of €1,300 until December, 31, 2009.

Contribute: Good speakers are a valuable part of the conference. The organizers invite you to become a speaker and offer compensation commensurate with your contribution.
Download the speaker application form

Sponsor: Support Europe’s premier medical travel event and maximize your company profile.

Email chairman@emtc2010.com for more details.

Asia Medical Tourism & Wellness Congress @ Kuala Lumpur, Malaysia May 13-14, 2010

Kuala Lumpur, Malaysia will be hosting an international event next year in Berjaya Times Square. Medical Tourism & Wellness Congress (GLOW 2010) will be an international trade exhibition running concurrently with a multi-stream conference session.

GLOW 2010 will gather senior-level decision makers across the health care, wellness, and corporate executive sectors from around the world to brainstorm on issues concerning their industry.

The objectives of the Congress are:

• To bring together our clients who are senior decision makers in major organizations across the region (100 - 150)
• To provide an exciting neutral platform for vendors/solution/service providers to position themselves effectively
• To conduct marketing/ advertising and promote brand awareness
• To conduct business development activities to a targeted focused audience
• To network and benchmark with professionals as well as other vendors and solution/service providers

GLOW 2010 will bring together our clients who are key corporate professionals in the medical, spa, and wellness sectors across the Asia Pacific and Middle East region to provide an exciting platform for vendors and solution providers to position themselves effectively. We estimate in excess of 100 to 150 senior-level decision makers for the exclusive conference in addition to walk-in trade visitors of over 1,500 for the exhibition.

A wide variety of sponsorship opportunities are available. Visit http://www.glow2010.com/ to learn more.

Central and Eastern Europe Medical Tourism and Healthcare Summit  
May 17-18, 2010, at the Aristos Hotel, Zagreb, Croatia

Medical Tourism in Central and Eastern Europe has been increasing rapidly. The region as a whole offers a variety of affordable treatments and procedures within easy reach of most travelers.

Global Engage, in partnership with Global Health Consulting of Croatia, is pleased to announce this international summit, which will bring together and showcase facilitators, providers, and medical organizations from across the region including Croatia, Bosnia and Herzegovina, Macedonia, Serbia, Bulgaria, Romania, Hungary, Slovakia, Slovenia, Czech Republic, Poland, Lithuania, Latvia, Estonia, Ukraine, and surrounding countries to meet and network with senior level delegates from all over the world.

The Central and Eastern Europe Medical Tourism and Healthcare Summit will include an exhibition area, workshops, and a two-day conference agenda featuring an international speaker panel focusing and sharing their experiences on current issues affecting medical tourism and health care in the region and the world in general.

A further dedicated conference stream will focus on dental medical tourism providing an educational platform for dentists in the Central and Eastern European region to develop their business internationally and attract foreign patients to their practices.

There will be adequate time provided for networking and forming collaborations with potential partners over business lunches, drinks reception, and a gala dinner and the opportunity to visit local medical facilities.

Attend as a delegate or if you prefer to gain increased exposure for your company or organization please enquire about our exclusive exhibition, sponsorship, and marketing options.

To view further details of the conference agenda, speakers, sponsorship, and registration details please visit - http://www.globalengage.co.uk/central_eastern_european_medical_tourism_summit.html

Or to discuss your participation in more detail contact Steve Hambrook (Conference Director). Tel +44 (0) 1865 811 189 or email steve@globalengage.co.uk