Healthcare tourism: more than a joyride

The Western middle class dreams of quicker access to better healthcare. This increasingly leads people to travel abroad for medical and dental treatment. Health tourism has emerged partly due to Western systems being unable to handle growing patient numbers, inflating costs and staggering insurance demands. Health tourists are drawn abroad when outdated health systems struggle to curtail expenditure and do not always offer acceptable solutions and when private medical care remains a costly alternative. Consider how key issues of a) waiting time b) procedures & prices and c) reputation & credentials, are redefining global healthcare.

Waiting Time

Serious health problems lead people to seek ways around long waits for treatment. This is a major issue in public hospitals common in Western Europe and Canada. According to the Fraser Institute, reporting results from its annual survey, the total wait time for patients in Canada between referral from a general practitioner (GP) and treatment, averaged across all 12 specialties (and 10 provinces surveyed), grew to 17.8 weeks in 2006 from 17.7 weeks observed in 2005. In 77% of  categories surveyed, the opinion was “actual wait time exceeded reasonable wait time.”

Stage one : The waiting time between referral by a GP and consultation with a specialist rose to 8.8 weeks from the 8.3 weeks recorded in 2005.

Stage two : The waiting time between specialist consultation and treatment fell to 9.0 weeks from 9.4 weeks in 2005.

Stage three : Among the various specialties, the shortest total waits (between referral by a GP and treatment) occurred in medical oncology (4.9 weeks), radiation oncology (5.0 weeks), and elective cardiovascular surgery (8.0 weeks). Patients waited longest between a GP referral and orthopaedic surgery (40.3 weeks), plastic surgery (35.4 weeks), and neurosurgery (31.7 weeks). During the interim, tumors and other problems can escalate.

People statistically seek foreign options for life-threatening cases, but also by choice to reduce discomfort and increase mobility. In some parts of Britain and Canada, elective surgeries like hip replacements, require a waiting period of nearly a year. Quicker, easier access in Bangkok (Thailand) or Bangalore (India) allows patients to get relief in the operating room the day after arrival. Convenience incentives are as appealing as the price and included vacation.

Procedures & Prices

Governments are often unwilling to pay for private, cosmetic and alternative procedures, and affordable insurance coverage has limits. Medical tourism offers procedures at 20-80% lower medical and insurance costs, including hospital stay in private room. Consider travel in Dub ai , Costa Rica, China, Cuba, India, Hungary, Malaysia, Mexico, South Africa or Thailand, where Westerners can afford cosmetic or remedial surgery combined with a vacation. Available procedures are extensive. Prospective patients are encouraged to compare shop. Promotional websites outline menus of available procedures and invite contact for details.

Dental Work

A metal-free, dental bridge worth $5,500 in the U.S. costs around $500 in India. In Thailand, costs for root canal & cap front tooth: 14,000Thb/US$354/ AUD$481/EU284. The Asavanant Clinic in Bangkok offers affordable prosthodontics, restorative, orthodontics, dental surgery and even basic procedures.

Cardiology

Angioplasty runs Cdn$3,000-4,000, and in the US$1,650. Compare Pruthi Hospital in Punjab, India; where angioplasty goes for US$600. Pruthi also offers a menu of cardiac procedures (i.e., pacemakers, valve replacements, cardiology CABG) with significant discounts if you bring a companion to undergo the same procedure.

Heart Bypass

George Marshall, a 73- year old British citizen, didn’t wait 6 months for a heart bypass operation from the British National Health Service (NHS) or pay £19,000 for same operation at a private hospital. Instead, he paid £4,800 for the procedure in India, including a return flight from UK. In India, Research reveals heart bypass procedures average ~US$10,000, in Thailand ~ US$11,000, and in Singapore ~US$18,000. Back in the U.S., it often costs up to $130,000 and waiting in Canada can be disconcerting. Compare gastric bypass surgery in U.S. around $10,000 -$20,000. Abroad, it’s available under US$5,000.

Heart valve replacement & general surgery

Consider the cost of a heart-valve replacement in the U.S. is about $200,000, as compared with about US$10,000 in India (including a vacation). The cost of general surgery in India, Thailand or South Africa can be as low as one tenth cost in U.S. or Western Europe, and often less.

Radiology

Although average wait for Cat scan (CT) is 4.3 weeks in Canada, thousands of Americans go north to take advantage of a new and highly-effective treatment for prostate cancer patients. Ablatherm™ high-intensity focused ultrasound (HIFU) is a non-surgical procedure that uses a precise ultrasound beam to safely and effectively destroy the prostate tissue. Thailand draws many tourists for many radiology procedures: Magnetic Resonance Imaging (MRI) costs 10, 000Thb, (US$200/ EU170/ AUD$265) and multi (64-slice) CT scan costs US$300-600 in Thailand and India.

Opthalmology

Lasik eye surgery may free you from glasses or contact lenses. It’s worth $3,700 in the U.S. and considered cosmetic in Canada (not payable by Medicare). Prices abroad can be as low as U.S.$730. China, Taiwan, and India, are popular destinations for various types of cosmetic eye surgery. A menu of specialty laser eye surgeries in Apollo Hospitals throughout India ranges in price from US$700-$1,900.

Organ Transplants

Need organs? The organ trade thrives in Dubai, Bombay, China, and Singapore. Costa Rica is also quite advanced, where available organ transplants include heart and kidneys as well as bone marrow, cranial sections and livers. In India, open or laproscopic kidney transplants are US$14,500 ( £ 8,400). In India, liver transplant costs are often negotiated on a case-by-case basis. Multiple transplant costs vary widely.

Orthopedics

In some cases, health tourist care is ahead of the west. At Apollo Hospital in Chennai, India, orthopedic surgeon Dr. Vijay Bose had performed more than 400 Birmingham hip resurfacings, while the state-of-the-art procedure was still in the trial stage in the U.S. The total cost of a travel package to Chennai for the operation is less than US $10,000. Back in the U.S., a similar yet, experimental Birmingham resurfacing costs up to $48,000 . Knees giving you trouble? A knee replacement in Thailand with 6 days physiotherapy costs about 1/5 of projections in the U.S. Similar replacements can be done in the Philippines by Western-trained surgeons for as little as US$6,000.

Plastic Surgery

Looking for a full facelift? In the U.S, you’ll likely pay $20,000 compared to US$5,000 in Argentina or $1,250 in South Africa with varied perks. Iranian expatriates now follow trends to flock to Tehran for nose jobs. In that city alone, they choose among over three thousand cosmetic surgeons. Australia is also a popular destination for cosmetic surgery where services can cost less and the climate more agreeable than other Western countries.

One in ten Argentinians opts for plastic surgery. The Plenitas centre offers a team of specialists and vacations which cover not only plastic surgery, but also hair transplants, dermatology, assisted fertilization, dentistry and bariatric surgery (for obese people).

Reputation & Credentials

The quality of service and client referrals, create reputations. Some of India’s most reputable hospitals are Apollo in Chennai, Escorts in New Delhi and Wockhardt in Bangalore, where the world’s first awake coronary bypass with aortic valve replacement was performed and staff experience and published papers draw from over 14,000 successful cardiac surgeries, 15,000 angioplasties and 35,000 Interventional Cardiac Procedures on foreigners . Increasing numbers of hospitals in foreign countries such as Singapore, South Africa, Iran, and throughout southern Asia, are accredited by or are seeking accreditation from the Joint Commission International, the certifying body for international medical facilities. This seal of approval establishes a standard of care that bridges East and West and redefines the global marketplace.

Reputation of overseas hospitals is reflected by the dollars spent on growing business. South Africa drew 270 million Rand (~US$37 million) to medical tourism in 2005 and this is growing. In 2005, India made US$333 million from medical tourism when it’s estimated that nearly a half million patients visited India for medical care. By 2012, India expects medical tourism will yield about $2.2 billion or more per year. Newsweek reported (October 2006) that Bumrungrad Hospital in Thailand treated 400,000 foreign patients in 2005. The Kasikorn Research Centre reported that 1.28 million expatriates visited Thai Hospitals in 2005, generating revenue for these hospitals of around 33 billion baht (U.S$926 million).

Consultant companies have sprung up in Western countries to offer medical tourist packages including details of credentials of physicians who work in foreign hospitals. Specialist in India, Thailand, South Africa, Singapore and other respected foreign hospitals have often trained in Western countries like the U.S., U.K, Canada, Germany, France, Israel, and Australia. They have either chosen to return to their home countries to practice or were unable to obtain visas and licenses to practice where they trained.

Ultimately, aging populations with savings are not the only Westerners who choose to pump money into international health tourism. T he influx of capital represents a level of confidence in the medical professionals and procedures abroad. To benefit from healing vacations, Westerners choose to withdraw money from their economies. These people spread wealth to traditionally poorer nations which have achieved or surpassed international healthcare standards. The result is boosting the economies of medical tourist destinations and reducing stress on Western healthcare practices. It’s also shifting economic power and relocation of professionals in the global picture.

Regardless of the Western country, if a health condition isn’t life-threatening, and patients are wait-listed for procedures governments will fund, patients are apt to wait for free treatment, but for how long? The flow of money and skilled healthcare professionals are redefining traditional borders, nations and cultural barriers. Your money, your health, which country? Your choice.

Not dead yet, not by a long shot

We all reach periods in our lives when events unfold that cause us to question the path we're on and whether it feels right. One such case involved an American university lecturer in New York. Oneday, he opened his door to peer down the barrel of a .38 revolver to see real bullets in its chambers. His life flashed in front of him.

As this lecturer obediently lay on the floor, he wondered silently what the point was to all his formal education, and what life was really meant for if it could end so suddenly. Lucky for him, this drug dealer realized he had the wrong man before he pulled his trigger. The gunman apologized and left. The lecturer grew to feel that stranger was perhaps brought into his life by an angel, who desired that he discover a spiritual seeker inside himself. He felt he was given second chance to add meaning to life, and to meditate on the self. He evolved along a path to become a swami.

During my professional life, in varied roles, I've learned much about history, politics, how the external world works and who controls it. Yet, rarely have I met people who encourage me to explore my inner self. Science and tech developments have dazzled and challenged me yet, I sense they don't transform people. Adults research and collect information to expand the intellect, but this doesn't develop other levels, which they may in fact, disregard. Why is it people increasingly discover a disturbing emptiness amidst an influx of data? Inner worlds of thought and feeling deserve attention. Two people who entered my life remind me I still have much to discover.

One woman who influenced my revelations about life directions had considered the path of a nun, but later evolved to change her mind. Nonetheless, she remains a highly-spiritual person who encourages me to continue writing as a means to explore my inner consciousness. I met her intermittently in a foreign country. She has taught me that nurturing a positive mind can enable me to go beyond the mind, to better understand my inner self. I've learned it requires effort to turn off my thinking and the echo of outside influences. I learned to do that even after she recounted intermittent terrorist attacks close to her home that likely threatened her life.

One man who influenced my most recent revelations offered me a book which discusses the essence of the self. He met me in passing yet, seemed to know me. Later, he conveyed to me in writing that no amount of effort exterted in the wrong direction will attain my goal. He reminded me our true self can be experienced spontaneously, through what seems to be an accidental encounter or, interactions with a person who turns out to be an intuitive friend. This older engineering professor explained his work priorities didn't enable him to devote time he would've liked to his inner development, but he sensed I had other priorities. Not bad intuition for an angel of sorts, who met me for a handful of hours on a plane.

Throughout your life, people you meet enable you to open your eyes to the world around you and see it differently. Is your own self obscured by the thoughts and emotions of dissatisfaction? Imagine a murder took place and the victim was decapitated. If police asked you to identify the body and you asked for a mirror, what would this reveal? You'd realize you needn't look outside you to recognize who you are. You know, without looking into the mirror, that the corpse can't be you. Your sense of the inner world comes from knowing and introspection. Wherever you go, your inner world travels with you. You're not dead yet, not by a long shot.

No rest for the living

Tzu Kung grew weary of study and told Confucius, "I want to find rest."

"There is no rest for the living."

"Than shall I never find it?"

"You shall look forward to the lofty and domed mound of your tomb and know where you shall find rest."

"Great is death! The gentleman finds rest in it, the mean man submits to it!"

"Tzu Kung, you have understood. All men understand the joy of being alive, but not its misery; the weariness of growing old but not its ease; the ugliness of death but not its repose."

How often do you allow negative thinking to shape how you view your circumstances? The main barriers to perceiving your life for what it is are the words you hear and use, the theories you hear, and the conditioning you have been given. In different settings, authority figures in charge have taught you what they think is acceptable or unacceptable behavior. Have you evolved in your own life experience to see beyond their prejudices?

For example, you have learned to work, to devote time and energy to a task or a cause. You have come to realisations about your physical, emotional and other limits. This usually happens when you surpass them and become injured or, when you overstep someone else's boundaries. Each of us has been trained to listen and interpret words. We all have to take in theories about what's acceptable in a given place at a given time with particular people. If you reflect on all this conditioning, how do you evolve to discern your truth? Do you ever rest?

At times, as you sort through your dilemmas, you may borrow answers from people as a strategy to resolve the matter, and move on faster to something else. Yet, over time, you may come to believe other ways of perceiving and judging are not your own, and be left unsatisfied. Thinking may enable this reality to reveal itself to you. At some point, your inner voice must go silent. At this time, you'll know no barriers to improving yourself and realize they never existed. Uncover the truth about your mindset in order to recognize why you head away when answers lie right here.

Not just a superficial exercise

Those people who dream of more sustainable living may be inspired by changes in business practices. For companies that sincerely care, this isn't just a superficial or short-term exercise.  Internal policies are changed and company culture evolves. Certain companies actively take steps to become more environmentally aware. This leads them to recognize the importance of developing more sustainable, eco-friendly practices, and to raise standards for staff and contractor behavior. This influences ecological company reputations and has been shown to positively shape their market shares. Two examples are Patagonia and Land's End which manufacture clothing. Consider some ways these companies have translated their eco-friendly mindset into positive environmental action.

1) They deepen their appreciation of the source. Patagonia launched its 2006-07 environmental campaign on oceans. The company goal is to raise global awareness of human connections to what lies under our seas. Patagonia research and fieldwork compares sea bottom fish-trawling to clear-cutting forests. The company catalogs, retail store and website images reflect 18 months spent with marine scientists, writers, surfers and fishermen, to learn and also teach customers inter-dependence between humans and marine environments is life-preserving. As Patagonia takes steps to translate appreciation of the world into business practices, this company inspires us to become better stewards of the oceans and other waterways.

2) They realize how dependent they are. Patagonia has evolved in its latest environmental campaign to raise awareness of ocean contamination. From plastics and wrappers you observe floating in the harbor to invisible pollutants under the surface, contamination poses a serious threat to marine environments we depend on to survive. Patagonia employees and executive participate in ocean clean-ups and recruit local people to teach them what they can proactively do to make a difference. Patagonia has also donated over 20 million dollars to grass roots environmental activism projects. These organisational projects were reviewed, deemed meaningful, and were otherwise unable to secure corporate or other funding.

3) They take steps to eliminate abuse and restore ecosystems. Land's End staff travel widely to locate partners that offer the best combination of quality, price and service. In developing standards for partners worldwide, Land's End adapts to diverse cultures, encourages workers to be proud of their work, and respect local environments. Compliance with high standards is a prerequisite for becoming and staying a business partner. If Lands' End determines a business partner has violated Standards of Business Conduct, and corrective measure aren't initiated, the business relationship ceases. New rules mean Land's End staff could arrive for unannounced environmental or employee practice evaluations. Land's End has evolved to view relationships with clients, contractors and environments very seriously.

The above examples prompt us all to rethink how well we know the environmental positions and business practices of companies we support. It's a case of reconnecting with the source of your consumption. Ask yourself where it comes from, why you chose it, and whether your beliefs and principles are compatible with your business choices. You're free to change. Its a question of developing critical thinking and environmental awareness.

An analysis of human nature

My first book invites readers to examine different facits of human nature. This is an approach to promote personal growth and improved health and well-being. I systematically explore select human emotions, ambitions and life experiences for the benefit of people who seek to better know themselves and make uplifting self-discoveries. If you choose to take the journey with me, you will simultaneously be on a journey to clarity and increased self-awareness.

Unbeknownst to you, reasons exist for why you make choices and actively or subconsciously shape your life experience. Whether or not you recognize what you're doing and why remains to be seen, doesn't it? Writing exercises can draw out parts of yourself which may have seemed dead or buried. What you may not know on a conscious level will be drawn out of your soul. Develop courage and join me.

How often do you question your range of abilities and the scope of your vision? It may be time to reframe your perception and invite other means of understanding into your life. Writing will serve a purpose you may not have expected. Feelings, a sense of grounding, what you think you know and experience, each only offer you a piece of a puzzle that I'll empower you to connect. If part of you yearns for a new sense of completeness, rest assured, you can learn what it takes to experience and develop this. Join me for a deeper analysis of your own human nature.