With the skyrocketing costs of health care, the issue of health travel or “medical tourism” has been generating lots of buzz in the media. Within the last few weeks, stories about health travel have hit the pages of publications like US News & World, the New York Times, and the Wall Street Journal, detailing how health travel offers people high quality health care at a price far more affordable than the US. It’s a benefit without boundaries – meaning, the cost savings are for anyone who wants them, including the thousands of insured who are nevertheless facing higher premiums, reduced coverage, and higher out-of-pocket deductibles and co-payments.

While much of the press has focused on exotic locales like India, Mexico is actually the most common destination for Americans traveling for health care. Last year alone more than 50,000 Americans traveled to Mexico seeking everything from heart surgery, hip replacement, cosmetic dentistry, cosmetic surgery procedures, preventive screenings and even homeopathic health treatments. Mexico is widely recognized for its number of leading gastroenterology (weight loss) surgeons.

In its study Medical Tourism: Consumers In Search of Value, Deloitte estimates the number of medical travelers is expected to reach 6 million per year in 2009. The growth is not surprising – the typical medical traveler receive outstanding quality health care at significantly lower cost over U.S. pricing.

For example, in Mexico, weight loss surgery ranges from $6,000-$11,500 vs. the $25-35,000 price tag in the U.S. Hip replacement is $10,000-$12,000, compared to $60,000+ in the U.S. A $100,000 angioplasty in the U.S. is $25,000 in Mexico – featuring a surgeon who regularly spends at least three months of his operating time in the U.S.

Mexico offers the additional benefit of having direct flights from many U.S cities, and most surgeons are fluent in English as well as Spanish. The hospitals that welcome medical tourists are sleek, modern affairs featuring amenities such as patient suites, sushi restaurants and a medical traveler concierge, while even newer, more sophisticated hospitals continue to be built.

Do your research to find the medical tourism company that best suits your needs. There are companies that guide patients through the process of getting medical treatment abroad, handling every detail of your trip – from insurance to financing, arranging for air travel, accommodations, appointments, transportation to and from your procedure and even keeping you in touch with friends and family.

Acronyms have always dominated the practice of medicine and one of the older ones is RVS or Relative Value Scale. Simply stated, although far more complicated in reality, the RVS sets the fee structure that physicians will be paid by insurance companies and agencies such as Medicare and Medicaid. A lesser known acronym is RUC which represents the real power behind the RVS. This entity, the Relative Value Scale Update Committee (RUC), evaluates physician’s procedures and makes recommendations to the CMS or better known at the Centers for Medicare and Medicaid Services. These reimbursement recommendations are almost always followed, i.e., ninety percent of the time. More alarmingly, they almost always favor dramatic increases for specialists rather than primary care physicians…six times more frequently.

Why is this disparity so important one might ask? It is terribly important for a whole host of reasons. These include:

The compensation disparity between specialist and primary care docs widens geometrically. Specialists now earn $135,000 per year and $3.5 million during a career more than a primary care doctor;

• Clearly, with this type of incentive, many more docs are becoming specialists and eschewing the field of primary care;
• The PCP base is shrinking at exactly the time we need it most;
• The new Health Care legislation is heaping 37 million more Americans into the health care system and they all need a PCP

Income disparities shape medical student specialty choice Specialty and geographic distribution of the physician workforce: what influences medical student and resident choices? March 2009. Accessed January 4, 2010

It is not just “Houston” that has a problem…it is the American health care system and all Americans. Soon the waiting time for a PCP appointment will lengthen to dangerous intervals. Overworked and underpaid docs will be the norm and that isn’t good for anyone.

One solution is concierge medicine or often referred to as Direct Care. A Direct Care practice denotes an experienced primary care physician who limits his or her practices to 300 to 400 patients and works for an annual fee rather than accepting insurance payments. This allows patients to receive the care they need and deserve and PCP to practice medicine in a thorough and safe manner while achieving a reasonable earnings level.