Medical tourism very much a niche business

Americans spent $600 million on medical care outside the U.S. in 2009, according to Health at a Glance 2011, a report released Nov. 23 by the Organization for Economic Cooperation and Development.

The amount grew 13% from 2004 to 2009.

"Medical tourism is not mainstream, but it is growing," said Renee-Marie Stephano, president of the Medical Tourism Assn.

The biennial report analyzing statistics on the organization's 34 member countries is available online (link).

Despite this growth, medical tourism has not come close to the projections forecast when it made headlines a few years ago.

For instance, a report on medical tourism issued Oct. 26, 2009, by the Deloitte Center for Health Solutions projected that the number of U.S. patients seeking care abroad would have an annual growth rate of 35%. A survey of 3,000 patients, also in the report, found that in 2009, only 1% had traveled outside the country within the past year to consult with a doctor, undergo a test or procedure or receive treatment. About 9% said they were willing to travel outside the country if they could save 50% or more on costs. Sixty-seven percent were unlikely to travel for necessary care, and 69% said they would not go for elective services.

The Deloitte authors described demand for medical tourism as "tepid."

OECD member countries spent more than $51 trillion on health care in 2009, with $6 billion going toward health-related travel. Of this amount, $2.3 billion was spent by people traveling to the United States for care. The total increased 6.9% from 2004 to 2009.

The U.S. alone spent $2.5 trillion on health care in 2009, according to the report.

During the time measured by OECD, medical tourism came to mainstream attention -- and received its first backlash. For example, Blue Ridge Paper Products in Canton, N.C., shelved plans in 2006 to send some employees to India for care after the United Steelworkers union pointed out that the voluntary option could become mandatory.

Physicians also expressed concern because a small number of third-party payers started providing incentives for patients to travel overseas for care that might be less expensive but of lower quality.

American Medical Association policy states that patients receiving care outside the U.S. must do so voluntarily. Financial incentives should not restrict treatment or referral options. Before travel, local follow-up should be coordinated and financing arranged for that aspect of care. Insurance that pays for medical-related travel also should pay for follow-up care when patients return home. Patients should be informed about the risk of combining surgical procedures with long flights and vacation activities (link).