Wales....... the latest medical tourism destination for US patients?

A recent news story on CNN attracted my interest when it featured a US patient who travelled to Wales (in the United Kingdom) for sinus surgery to save money. It was headlined “'I can't afford surgery in the U.S.,' says bargain shopper”. It’s an interesting story which shows how the media can sometimes put a slant on a story to create news, but it does highlight some real opportunities for medical tourism providers.

The story (view the CNN video) tells us about Godfrey Davies, an American, who needed sinus surgery. It tells how he “set out on a mission to find an affordable surgeon”, and was appalled at the costs that he was going to incur in the USA. The story was picked up by a multitude of other web sites who took it at face value.

If you view the video, you get one impression. If you dig a little deeper, you actually get to understand the full story and where this patient fits within the medical tourism marketplace.

As a Brit, I found it a bit odd when I viewed the video. My first impression? Here’s a story about an American guy travelling all the way to Wales for surgery....... Why would he do this? And why Wales? But then I dug deeper. It was in fact a story about someone who started life as a “Welsh bloke”, became an “American guy” and went home for an operation. There’s a clue in his name (Davies...it’s a Welsh surname) and in his slightly odd accent (It’s a Welsh accent). Godfrey comes from Wales. It is where his family lives. He’s a UK and a US passport holder. He married an American and became a US citizen in 2002. He doesn't have health insurance in the US because he believes that the quoted premium of $1,000 per month is too much. He says that "with the deductible and co-pay, I would have had to pay more in over three and a half months than coming home to Wales."

So, what can medical tourism businesses learn from this story?

Firstly, don’t take news stories at face value. There’s sometimes an underlying logic to a news story which the media doesn’t always fully expose. It may make the news less newsworthy. In this case, it’s understandable why a Welshman (as opposed to an American) might choose Wales as a medical tourism destination.

Secondly, it highlights one of the key factors in why people select medical tourism destinations. Godfrey Davies chose Wales because it is an excellent cultural match, there is no language problem for him, and he feels 100% safe there. And it’s cheap!

Godfrey went to the BMI Werndale Hospital in Bancyfelin, Carmarthenshire. It is part of BMI Healthcare, Britain's leading provider of independent healthcare with nearly seventy hospitals and clinics nationwide. To give you another example, I myself had a total knee replacement at one of BMI Healthcare’s hospitals near London, The BMI Clementine Churchill Hospital. How much would it cost for a knee replacement in an American hospital? $50,000. How much did it cost me in the UK? £10,000 all in ($15,000). The UK price is cheaper than Korea ($17,800), and not far off the prices that Americans pay in countries such as Thailand ($12,000) and Singapore ($10,800). Given the cultural and language match, and the lower travel cost, if you were an American which destination would you choose?

Thirdly, it’s a great example of the kind of American medical tourists that some medical tourism businesses should be targeting..... people from their own country. Thus, the biggest and most realistic opportunity in the USA for Korea based medical tourism providers is most likely to be Korean Americans. Target the easy win, if you want to succeed.

Fourthly, it supports the argument that the UK might actually be an attractive medical tourism destination for US patients. Despite the different accent, there’s no language barrier! There’s a public healthcare system that delivers excellent outcomes. And there’s a private hospital system that already provides treatment for patients from all over the world who travel to the UK to access healthcare quality and expertise. And...... as Godfrey Davies has demonstrated, you can save an awful lot of money over UK prices.

How much does private treatment cost in the UK?

In addition to Treatment Abroad, we also run various UK health information sites. One of these is Private Healthcare UK. It will tell you all you need to know about private treatment in the UK.

If you want to know what UK private treatment costs go to Private hospital treatment - What does it cost? and select an operation.

And if you’re an American (or a Welshman) and you want to follow in Godfrey Davies' footsteps, you can get a quote for UK surgery by completing the enquiry form for UK private hospital treatment.

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 facts......in 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 .......you 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.