"Doctors here speak excellent English"

Hospitals in India Woo Foreign Patients
By GANAPATI MUDUR
Published: June 5, 2004
British Medical Journal

This article, part of the British Medical Journal, is a more microscopic view of medical tourism than the artice from the NYT because this one focuses mainly on India. This zoomed in view is a particular interest of mine because my family is from India - and surprisingly enough, when I searched for tourist facilities in India, a prominent hospital in my hometown in India, not far from my relatives' home, popped up.

This article's major points were:

• The three major destination cities in India are Chennai, New Delhi, and Mumbai
• The Indian government hopes that the medical tourism industry will be a $2 billion industry by the year 2012
• The government promotes the industry abroad by telling foreigners of the great opportunities availalbe for health care in India, but when accused of channeling money and attention away from the medical needs of the Indian poor, the government replied that it wasn't "fishing for patients"; it was just promoting opportunites that could be sizable boosts to the economy
• There is an enormous disparity between costs of procedures in the US and their corresponding costs in India: India offers procedures for about 20% of the US' price
• The British NHS doesn't yet support the travel of patients to India because India falls beyond the 3-hour tranfer limit
• Most Western patients who travel to India pay out of pocket
• Many Western patients still don't trust the care they may receive in developing countries, even though the medical outcome is the same or better than that in the US
• The Indian government promises to standardize care in Indian facilities and to make medical tourism a priority

I think the most important issue in this article is that most people travelling abroad pay out of pocket; this fact, combined with the NYT article's assertion that most people travelling abroad are uninsured puts in perspective how desperate the American uninsured really are: they will travel around half the world and pay about $20,000 out of pocket for surgeries! While this makes sense because this is a mere fraction of the cost in the US and because there surgeries are often life-saving, it speaks strongly of the dilemma of the US health care system. Sending patients abroad is certainly not the issue; it is only the superficial gloss of a solution to a much larger problem of lack of access and affordability. It takes a money-driven business in a third world country to offer services to the uninsured that their own communities can't.

Another interesting and very disturbing point was the Indian government's commitment to make medical tourism a priority on the scale as other export trades; if the Indian government spends money on standardizing care and advertising the medical tourism industry, it is indirectly supporting the health care of foreign visitors. At the same time, the Indian government is ignoring the medical needs of a large proportion of its poor population. This makes as little intuitive sense as the above scenario where an American is driven to India to seek health care. While medical tourism is an interesting and complex force, it has a lot of facets below the surface that proponents choose to ignore.