Friday, April 02, 2010

The US healthcare reforms and medical tourism

Caroline Ratner at IMTJ has just published a summary of US reaction to the Obama healthcare reforms from the medical tourism sector, so I suppose I had better throw my comments into the mix.

First, let me stress that I am by no means the world expert on the US healthcare reforms! (Does one exist?) But I have been asked by the UK media recently to comment on the reforms and in particular to comparisons with the UK healthcare system. It’s been interesting to watch from afar how a nation is having to deal with both rising healthcare costs and demands for increased expenditure on healthcare.

It’s acknowledged that the USA is one of the most expensive healthcare systems in the world, spending 15.3% of the nation's GDP on healthcare (WHO statistics). This compares to around 8.2% of GDP for the UK and similar for other European countries. Despite the high expenditure, the USA gets atrocious value for money out of what it spends.

Take a look at these comparisons:

The UK spends less than half the amount per capita compared to the USA, but provides a similar number of doctors, more nurses and more beds per 10,000 citizens. Not bad value for the taxpayer's money.

Despite these the healthcare reform debate in the US, the UK NHS has been used as an example of “how not to do it” and at one point those campaigning against the reforms launched a series of television adverts using “tragic” stories from Britain's National Health Service to contest Barack Obama's plans. The reality of the UK NHS is rather different... it works pretty well most of the time and it costs the nation half of what the US spends (as a percentage of GDP). If were a US politician and could wave a magic wand which would transform the US healthcare system overnight to an NHS system of universal healthcare, free (in most cases) at the point of delivery, AND it would cost the country half the money....what would you do. It’s a no brainer. But there are no magic wands.

The perception of the NHS overseas is very different to the experience of the NHS within the UK Here’s a couple of recent, typical quotes from US industry commentators on medical tourism and the US healthcare reforms:

  • “People from UK and Canada is (sic) not looking for treatment outside their countries because of being denied of healthcare insurance or financial constraints, it is because of high cost of care and extensive waiting times for elective surgeries”
  • “ (the reforms) will also potentially create long waiting times for medical procedures which will create situations like in Canada and the UK, where patients travel outside their country because of long queues for important surgeries.

Note the references to the long queues and extensive waiting times in the UK. This kind of uninformed and factually incorrect comment does little for the credibility of the medical tourism industry. It’s political dogma.

Here are the hard facts on UK waiting lists:

  • The average NHS waiting time from referral to treatment is around 8 weeks. It’s often much shorter.
  • Anyone suspected of having cancer has the legal right to wait no more than 2 weeks to see a specialist
  • Anyone referred for elective procedures has the legal right to start treatment within 18 weeks
  • If there is a significant waiting list in your local area, you have the right to exercise patient choice and go to another hospital anywhere else in the country to avoid the wait. (internal medical tourism). You can also compare outcome data, infection rates and many other data online through NHS Choices
  • If you have a serious and life threatening problem, there’s virtually no waiting list. That’s why I’ve only ever met one British heart surgery patient who has gone abroad for treatment. Despite this, I’m regularly amazed by overseas providers or consultancy companies who call me to discuss their plans for attracting British patients overseas for major surgery such as heart bypass.

And here’s some recent “real life” experience.

  • The Web Communications Manager at my company recently celebrated the birth of his first child. Unfortunately, the birth was at 27 weeks so it has not been easy for him or his wife. The child has been in paediatric intensive care for some weeks in a local hospital, and has recently been transferred to Great Ormond Street Hospital in London for heart surgery. Is he happy with the NHS care?....Yes. Has it cost him a penny?.... No.
  • My wife has a recurrent inflammatory problem at the back of her eye. She has regular assessments at the local NHS eye unit, and recently went for a minor procedure. It was urgent, so she didn’t have to wait. She went to the brand new eye state of the art NHS eye unit at Stoke Mandeville Hospital. How long did she wait?..... a week or so. How much did she pay?..... Nothing?

Are British patients flooding overseas for treatment because of “long queues” and “extensive waiting times”? No. The majority of UK medical tourists are not patients requiring elective surgery that they can’t get or will not wait for on the NHS. The reality of healthcare is that patients want affordable (or free) treatment close to home, or within their country. Before they even consider going abroad for treatment, they explore all the avenues for treatment within their own country.The NHS has its faults, of course, but no system is perfect. And would I swap our NHS for the current US model? No, I couldn’t afford it..... either as an individual or as an employer!

So, will the Obama healthcare reforms lead to a massive surge in medical tourism, as some have suggested? No.

Medical tourism will continue to grow as more patients become aware of the possibility of low cost treatment abroad. But we should never forget that what every patient wants is affordable healthcare on their own doorstep.....and travelling for treatment is for many a last resort.


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Anonymous said...

Dear Sir,

Last year Europe Business Association (EBA) held a highly successful medical tourism summit in Malta, with nearly 100 senior figures from 19 countries gathering to discuss the sector.

The second Malta Medical Tourism Summit, 3rd-4th June, 2010 at the Corinthia San Gorg Hotel and Business Centre, St Julian’s, is set to bring together many senior figures within the industry, last year’s inaugural conference attracting nearly 100 decision-makers from 19 countries.

With increasing healthcare costs and pressures on household budgets worldwide, medical tourism and the opportunities it affords, both to patient and practitioner, continues to evolve. This year’s summit will not only mark progress and changes, but outline best practice, new processes and programmes and new thinking which will help medical tourism move forward with confidence.

International speakers leading an interactive forum

Our international panel of expert speakers in the field will be sharing their thoughts and experiences on topics such as:

• The dynamics of the current medical tourism marketplace
• Implementation of cross border healthcare collaborations
• Regulation and accreditation, currently and in the future
• More effective marketing, addressing the issues and capitalising on the opportunities

We very much encourage participative engagement – there’s the chance to listen, learn and formulate your own ideas, but also the chance to share your thinking with colleagues, to work together for better, more productive solutions.

To view the agenda and speaker list as it stands, go to Please note that information will be regularly updated as we confirm speakers leading up to the event itself.

Partnership and sponsorship opportunities

A wide range of cost-effective and innovative partnership and sponsorship options are available to help you make the most of an association with this well-attended and prestigious trade event. In addition to speaking engagements, exhibition stands and branded materials at the conference, we can discuss a range of promotional opportunities which will maximise your company’s engagement with our participant list.

If you’d like the chance to speak at the summit, please contact Rob Young at EBA on +44(0)1865 794362 or email
Alternatively, if you’d like to discuss our comprehensive range of sponsorship packages, or exhibition space during the summit, call +44(0)1865 251211 or email

Redford said...

I think medical tourism is the way forward, I for one do regularly travel to the continent to see a private dentist for a fraction of the cost I'd pay in the UK...

anti aging lifestyle said...

I'm not a world expert on the US healthcare reforms either. But I disagree on the US healthcare reform and medical tourism. I'm still keeping my fingers crossed it won't happen.

Arihant said...

Interesting stats shared and the analysis provides a lot of untapped opportunities in the US/UK healthcare outsourcing industry. What do the others say?