Medical Tourism - should it be banned?

[Vitum Medicinus]

Saw this BMJ article on a bulletin board at my school. Thoughts?

 

Medical tourism should be banned

[EMD]

Saw this BMJ article on a bulletin board at my school. Thoughts?

 

Medical tourism should be banned

There are lots of countries that have difficulty saying "no" 'cause they depend on what Westerners consider garbage; some doctors do make lasting contributions and bring supplies of value.

 

That said, there are a lot of doctors that don't have a good idea of what the situation is like... and don't have a good sense of what is going on in the world. It will continue to happen. As an aside, I don't think it is completely accidental that the disruptive medical tourist in the article was an American. In fact, I think the article speaks volumes about how Americans are often viewed outside of their borders.

[Satsuma]

I would personally love to experience medicine in a developping country for various reasons.

 

I considered doing electives as a medical student. But thus far, I have come up with no good reasons to do it...from a "medicine" perspective. As a second year student, I do not know enough to be of any use to wherever I would go. And I don`t think the medicine I would learn there would necessarily help me practice medicine here.

 

I am not saying the experiences gained there wouldn`t be valuable. But I think it is more valuable on a cultural level.

 

 

So I have personally just decided to do that kind of work later when I can bring more knowledge and skill with me.

 

I remember reading of a retired neurosurgeon who in his retirement travelled through asia teaching neurosurgery skills. To me that sounds alot more useful.

[medicaltourism]

medical tourism provides the treatment opportunity to many patients for different diseases across the world so it should not be banned.

[nosuperman]

medical tourism provides the treatment opportunity to many patients for different diseases across the world so it should not be banned.

 

Care to elaborate without me having to click your link?

[nosuperman]

Oh god they're teaming up!!!

[apache]

I strongly support medical tourism, if anyone cares, it's my health and my prerogative to treat myself in a manner I see fit, and if that involves line jumping by paying 50 g to get what I need in the US or wherever, all the power to me I've just shortened the Canadian line. BTW, the link is broken.

 

Saw this BMJ article on a bulletin board at my school. Thoughts?

 

Medical tourism should be banned

[seeking1]

While the idea of medical tourism seems nice, the reality seems to betray patients, at least from my perspective.

 

Moving around while sick is damaging to oneself and to people whom come into contact with you, unless you have the money to avoid social contact. This aspect of the problem makes implicitly references communicable diseases (i.e. TB, polio, smallpox, etc.). You could easily argue that superior management skills could avoid this problem, although that depends on a centralized care system. Most businesses and governments are nowhere near capable of providing this service.

 

For issues that are chronic in nature, you as a patient are hoping for the best when it comes to the treatment you are receiving. By now, I'm sure most cardio patients know about the condition and how treatment should progress; for them medical tourism may work. It may not work for MS patients, however; sinking money into treatments that, at most, may treat symptoms but not causes may be bad for the patient's life in general. In spite of what some people here may think, money possessed by a patient and family can have a huge impact on health outcomes.

 

No matter what I say, medical tourism will probably still happen, so we should look at regulating it. We don't want random tropical diseases moving into Canada, after all.

[leviathan]

While the idea of medical tourism seems nice, the reality seems to betray patients, at least from my perspective.

 

This aspect of the problem makes implicitly references communicable diseases (i.e. TB, polio, smallpox, etc.).

lol @ smallpox and polio

Why would someone with TB travel to get medical help?

[nosuperman]

I don't see how you could regulate it. It seems to be a matter of autonomy. Whether its unethical, socially or economically harmful etc. to get the service somewhere else, an individual should be the ultimate authority on their own body.

 

Would the government say "no you're not allowed to cross the border and purchase a medical service that you feel to be necessary - you must wait until we provide it, if indeed we chose to provide it." ?? The global economy encompasses every industry, I don't see how medicine - something more personal than the car you buy or the laptop you order - could be excluded from that.

 

If it gets bad enough then I'd wager we'd see some corrective market forces. Either the country providing the product will start charging more or the country providing the consumer will develop a better product.

 

If our medical system cooperated and communicated openly with other countries, they might even be able to tax foreign medical interventions the same way they tax most other foreign-purchased goods and services.

[koft]

I agree it will be extremely difficult to regulate or ban. You can't tell who is going to a 3rd world country for vacation or for medical treatment. However, the main issue i have with medical tourism is those who suffer complications return to their home country for costly management of postop complications. These complications often drain our system vital and limited health care dollars.

 

I am sure you can argue that those are Canadian and should have access to our pseudo-universal health care system.

 

I don't see how you could regulate it. It seems to be a matter of autonomy. Whether its unethical, socially or economically harmful etc. to get the service somewhere else, an individual should be the ultimate authority on their own body.

 

Would the government say "no you're not allowed to cross the border and purchase a medical service that you feel to be necessary - you must wait until we provide it, if indeed we chose to provide it." ?? The global economy encompasses every industry, I don't see how medicine - something more personal than the car you buy or the laptop you order - could be excluded from that.

 

If it gets bad enough then I'd wager we'd see some corrective market forces. Either the country providing the product will start charging more or the country providing the consumer will develop a better product.

 

If our medical system cooperated and communicated openly with other countries, they might even be able to tax foreign medical interventions the same way they tax most other foreign-purchased goods and services.

________

STRAIGHT-4 ENGINE

[Jochi1543]

Sounds like there are 2 parallel discussions going on - medical tourism as in medical students doing electives abroad vs. medical tourism as in patients travelling outside the country to be treated. Regarding the latter, in a perfect world, it wouldn't exist, but in the real world, it does, and rather than chastise people for opting to travel somewhere else for their medical care, we should look at the reasons for that - and the implications it has for our healthcare system at home. I doubt lots of people WANT to go abroad for treatment - there are usually extra risks or inconveniences such as being away from family and friends while recovering, travelling (which can put you at a higher risk of complications e.g. blood clots post-surgery), and medicolegal issues - good luck suing your Mexican "surgeon" who's really a hairdresser.

 

For most people, medical tourism is something they do out of desperation or, if it's an elective procedure e.g. plastic surgery, due to lack of finances to get it done in their home country. If they could access these services at home at the same cost, I doubt many people would consider going abroad. It's obviously a reflection on how healthcare has failed them at home. I know someone whose grandfather travelled to Mexico for a triple bypass because the only alternative here was to die on the waitlist. He had a great experience - in fact, he said he was never treated with as much care and respect in Canada. So if the person has the funds and has researched their physician abroad and feels comfortable with the decision, why not?

 

The other issue is when people travel there and things DON'T go well. I read a story about someone who went to have weight-loss surgery done in Mexico. She developed major infections, perforations, etc, culminating in a 3-month ICU stay here in Canada. I believe the bill was $150,000 or something along those lines. The woman's family has since attempted to sue the surgeon, to no avail - in fact, they have received murder threats. Apparently, the surgeon is the ONLY person on that team who actually had medical training - the "OR nurse" (his wife) is a nail esthetician. But in the end, Canadian taxpayers have had to cover $150,000 in her healthcare expenses because she opted to go for a "budget surgeon" in Mexico - there's lots of highly qualified physicians there, but people will often gamble on their lives to save $3000 and end up going with a quack. But reality is - if she could've accessed the procedure here either through the public or the private system (for a comparable price rather than whatever it costs now - I'm sure it's much more expensive than in Mexico), I doubt she would've gone to Mexico to do it.

 

So the question is - should our local physicians refuse to treat someone like that or make them cover their healthcare expenses? It's tempting to say that. But imagine if things changed and this woman was a refugee from, say, Rwanda, who underwent terrible trauma back home and had lingering disabilities after. Or even just a regular old "skilled worker" immigrant from Eastern Europe who developed adhesions and bowel obstruction after getting their appendix out back home - before moving to Canada. Would we refuse to treat or charge these people then?

[CaffeinatedPonderer]

Canadian taxpayers have had to cover $150,000 in her healthcare expenses because she opted to go for a "budget surgeon" in Mexico

 

She could have likely accessed the procedure "here" - as in the US. Her issue was cost, and even if we offered the same elective surgery, it's unlikely that she would have paid 10x more to have it done here vs. Mexico.

 

Ultimately, unlike a traumatized refugee or skilled worker with a PMHx of complications, it was her voluntary decision to take part in "medical tourism" of the public degree. It should hence be her responsibility to seek information from her local doctors and other members of the healthcare system, and the responsibility of providers to make accessible the possible risks and liabilities - which should include paying out-of-pocket for any complications that result.

 

PS - Who wouldn't love a luxurious hospital suite available for a fraction of the cost?

 

"you can wine and dine by candlelight on gourmet food prepared by a private chef, have the daily newspaper delivered to your door, enjoy 300 thread-count sheets, and have the family visit anytime or even stay with you. In-room fax and Internet? But of course! Access to a concierge, hair stylist, masseuse? You bet. A shoeshine by a GI intern? OK, so there are limits."

http://www.bankrate.com/brm/news/insurance/20040927b1.asp

 

After visiting some of these suites around the world I can attest to their superficial beauty. But under the knife while in the OR, all that I will say is that QoC is suspect.

 

Is medical tourism the right thing to do?

From a capitalist sense, the US seems to think so: https://www.healthbase.com/

Be sure to check out the religous-affiliated testimonial on cost-cutting a triple-CABG here: https://www.healthbase.com/hb/pages/testimonials.jsp