Seeking Healthcare Abroad

In the new world of medical tourism, hundreds of thousands of U.S. residents are going overseas for healthcare

BY JOHN DORSCHNER

jdorschner@MiamiHerald.com

Hammered by lack of insurance and high prices for healthcare, many Americans are looking overseas for care.

No one has exact numbers, but the new Medical Tourism Association, based in West Palm Beach, estimates that hundreds of thousands of Americans are now traveling out of the country for care.

Prime example: Madeline Del Sol of Pembroke Pines. With no insurance, she needed extensive dental work, including an implant, root canals and fillings replaced. South Florida dentists gave her estimates of $11,000 and $13,000.

A Colombian friend suggested she go to Barranquilla, and recommended a dentist. Del Sol was impressed by how warmly she was treated. "I felt like a human being. In the United States, I'm just a dollar sign."

She had a bone implant, two root canals and 13 old fillings replaced for $2,000. The work was superb, she said. "It's probably the best experience I've ever had with doctors."

Still, in the world of medical tourism, it is a matter of buyer beware. Earlier this summer, a woman in Royal Palm Beach died from complications of gastric bypass surgery in Mexico, according to the Palm Beach Post.

Stephan Baker, a cosmetic plastic surgeon in Coral Gables, said he's treated two patients who suffered overseas disasters -- a tummy tuck done in Panama that resulted in a fluid build-up in the abdomen and a tummy tuck done in Costa Rica that ended up with "a pretty significant infection."

Those patients may have saved money on the front end, Baker said, but the resulting problems would have caused them huge post-operative expenses that could have been much more than the savings.

For some years, dental work and plastic surgery have been the primary healthcare reasons for going to Latin America, but with the graying of the baby boomer generation and the number of uninsured climbing toward 50 million, Americans' interest in Latin America healthcare is broadening.

"What's mostly on the increase is the complexity of surgeries, " said Carole Veloso, chief executive of the CIMA San Jose Hospital in Costa Rica.

"People are now actually asking about heart surgery, orthopedics and a lot of gastric bypass surgery or banding" of the stomach.

Veloso said gastric bypass in San Jose can be done for about $7,000, not including travel costs -- a huge reduction over the $20,000 to $30,000 it's likely to cost in South Florida.

CIMA is part of a chain owned by the Dallas-based International Hospital Corp., which is dedicated to maintaining U.S. quality standards at its eight hospitals in Mexico, Brazil and Costa Rica.

While most of its patients are local, CIMA Chief Operating Officer Clifton Orme said the chain is working hard to gain accreditation through Joint Commission International, a sister organization of the group that accredits U.S. hospitals.

Such approval could take several years of preparation. In Latin America, the commission has so far accredited just 11 hospitals in Brazil.

For consumers, another possibility is seeking out an overseas facility with links to the United States. Johns Hopkins, for example, has working relationships with four hospitals and clinics in Latin America. The University of Miami is working to set up its own links, starting with Cartagena, Colombia, where several UM-trained doctors practice.

"There are great physicians everywhere in the world, " said Eduardo de Marchena, director of UM International Medicine Institute. "But it is very difficult to know where you are going to find quality."

Trying to bring order to that uncertain marketplace is the not-for-profit Medical Tourism Association.

Its goals include controlling standards and credentials, protecting "the reputation of medical tourism from disreputable hospitals" and creating "a comprehensive Web portal for people to learn about medical tourism."

"A lot of people are trying to fill this market, " said John F. P. Bridges, a Johns Hopkins professor who is on the MTA's advisory board.

"Far too many of them are dot-com entrepreneurs" seeking a new business. "I call them vultures."

Bridges, an economist, said many details need to be worked out -- guidelines about quality, healthcare information and much more -- but he sees a certain inevitability in moving to a global healthcare system.

"Mexico isn't a third-world country when it comes to healthcare, " Bridges said. "If someone's going to say it's a spin of Russian roulette when you go south of the border, I don't think that's the case . . . Every other market has embraced globalization, why not healthcare?"

Overseas healthcare simply presents consumers with another choice, Bridges said, and they should research doctors and facilities overseas the same way they would in the United States -- looking for credentials, board certifications of doctors and word-of-mouth recommendations.