Low Cost Surgery - Medical Tourism - Travel to Other Countries 

Medical tourism (also called medical travel or health tourism) is a term initially coined by travel agencies and the mass media to describe to the rapidly-growing practice of traveling to another county to obtain health care for significant low cost surgery. Such services typically include elective procedures as well as complex specialized surgeries such as low cost eye surgery, laser eye surgeries, LASIK eye surgeries, joint replacement (knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. The provider and customer use informal channels of communication-connection-contract, with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed. Leisure aspects typically associated with travel and tourism may be included on such medical travel trips.

Contents of low Cost Surgery
History of Medical Tourism for Low Cost Surgeries and Low Cost Eye Surgeries
Description 
Colombia 
Philippines 
India 
Singapore 
Thailand 
Hong Kong 
Risks and rewards 

History of Medical Tourism for Low Cost Surgery
The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism. Spa towns may be considered an early form of medical tourism.

Descriptionof Medical Tourism for Low Cost Surgery
Factors that have led to the recent increase in popularity of medical travel include the high cost of health care or wait times for procedures in industrialized nations, the ease and affordability of international travel, and improvements in technology and standards of care in many countries of the world.

Medical tourists can come from anywhere in the world, including Europe, the UK, the Middle East, Japan, and the U.S. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care.

A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936.

Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery. Colombia provides a knee replacement for about $5,000 USD, including all associated fees such as FDA approved prosthetics and hospital stay over expenses. However, many clinics quote prices that are not all inclusive and include only the surgeon fees associated with the procedure.

Medical tourists may seek essential health care services such as laser eye surgery, LASIK eye surgery or vision correction and other eye surgeries, or cancer treatment and brain and transplant surgery as well as complementary or 'elective' services such as aesthetic treatments (cosmetic surgery).

It is reported that he cost of surgery in Bolivia, Argentina, India, Thailand, Colombia, Philippines or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost US$200,000 or more in the United States, for example, goes for $10,000 in the Philippines and India—and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India or Bolivia and only $200 in the Philippines, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $2,700 in the Philippines or $2,500 in South Africa or $ 2,300 in Bolivia.

To understand the phenomenon of medical travel, we can compare the average costs of cosmetic surgeries between the industrialized nations and Latin America countries where medical tourism and cosmetic surgery tourism are becoming popular, such Argentina, Bolivia, Brazil, Costa Rica, Colombia, Philippines, Mexico. Prices quoted in the table below are from offices affiliated with the ministries of health in the U.S., Europe (France, Spain, Switzerland), Argentina, Bolivia, Brazil, Costa Rica, India, and Mexico.

Low Cost Surgery - Costs of Surgeries in Various Countries

This list will give you an idea which countries will probably be the lowest cost for surgeries.

Match costs below with: USA Europe Argentina Bolivia Brazil Colombia Costa Rica India Mexico Philippines
Rhinoplasty $ 6,000 $ 5,500 $ 2,300 $ 1,200 $ 2,100 $ 2,000 $ 1,500 $ 1,700 $ 1,500
Face Lift $ 15,000 $ 12,500 $ 4,300 $ 2,600 $ 4,500 $ 4,200 $ 2,900 $ 4,500 $ 3,000
Breast Augmentation $ 8,000 $ 7,500 $ 3,700 $ 2,500 $ 3,800 $ 3,400 $ 2,900 $ 3,900 $ 3,400
Breast Reduction $ 9,000 $ 8,000 $ 3,900 $ 2,400 $ 3,600 $ 3,200 $ 3,000 $ 3,700 $ 2,600
Complete Liposuction $ 13,500 $ 11,000 $ 4,500 $ 2,700 $ 4,700 $ 3,800 $ 3,200 $ 4,800
Gluteal Augmentation $ 9,000 $ 9,000 $ 4,000 $ 3,000 $ 4,200 $ 3,800 $ 3,200 $ 4,500

Popular medical travel worldwide destinations include: Brunei, Cuba, Colombia, Hong Kong, Hungary, India, Israel, Jordan, Lithuania, Malaysia, The Philippines, Singapore, South Africa, Thailand, and recently, UAE.

Popular cosmetic surgery travel destinations include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Mexico and Turkey.

In Europe Belgium, Poland and Slovakia are also breaking into the business. South Africa is taking the term "medical tourism" very literally by promoting their "medical safaris": Come to see African wildlife and get a facelift in the same trip. However, perceptions of medical tourism are not always positive. In places like the U.S., where most have insurance and access to quality health care, medical tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out health care; for example, in late 2006, some patients from the Middle East were choosing to travel to Singapore or Hong Kong for health care rather than to the U.S.

While the tourism component might be a big draw for some Southeast Asia countries that focus on simple procedures, India is positioning itself the primary medical destination for the most complex medical procedures in the world. India's commitment to this is demonstrated with a growing number of hospitals that are attaining the U.S. Joint Commission International accreditation.

Singapore positions itself as a medical hub for health care services, medicine, biomedical research and pharmaceutical manufacturing converge. Singapore has made international news for many complex surgeries in specialties such as neurology, oncology, and organ transplants procedures. Currently Singapore boasts the largest number of U.S. Joint Commission accredited hospitals in the region.

In South America, countries such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical skills relying on the vast experience their surgeons have in treating the style-obsessed. It is estimated that 1 in 30 Argentineans have had plastic surgery procedures, making this population the most operated in the world after the U.S. and Mexico. In Bolivia and Colombia, plastic surgery has become quite common. According to the "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more that 70% of middle and upper class women in the country have had some form of plastic surgery. Colombia also provides advanced care in cardiovascular and transplant surgery.

Companies are beginning to offer global health care options that will enable North American patients to access world health care at a fraction of the cost of domestic care, truly low cost surgeries. Companies that focus on 'Medical Value Travel' typically provide experienced nurse case managers to assist patients with pre- and post-travel medical issues. They also help provide resources for follow-up care upon the patient's return. While these services will initially be of interest to the self-insured patient, several studies indicate that the rapid growth of Health Savings Accounts in the U.S. will also drive interest to health care in other countries.

Because standards are everything when it comes to health care, there is a parallel issue around hospital accreditation. Those considering medical tourism may be assisted in making their choices by whether hospitals have been assessed and accredited by reputable external accreditation bodies. In the U.S., JCI (Joint Commission International) fulfills such a role, while in the UK and Hong Kong, the Trent International Accreditation Scheme is a key player. Increasingly, some hospitals are looking towards "dual international accreditation", perhaps having both JCI to cover U.S. clientele and Trent for British and European clientele.

Colombia
Colombia has been treating patients from all over the world for years, especially for cosmetic and eye surgery, including laser eye surgery and LASIK eye surgery. Colombia has also become a recognized provider of advanced cardiovascular and transplant surgery. What often compels persons to seek transplant surgery offshore is not only cost considerations, but waiting lists (such as in the U.S.) or the lack of an organized organ inventory and donor system in the home country. Colombia has such an organ donor and banking system which makes organs available to foreigners with certain legal restrictions. Orthopedic surgeries, such as knee and hip replacements, are done in Colombia with U.S.-made (FDA-approved) prosthetics at a fraction of the cost.

Colombia has many surgeons that have either trained and/or practiced in other countries such as the U.S. and Europe. Salaries for doctors, nurses, and supporting personnel in Colombia are about 20% of U.S. salaries for similar occupations even though they are required to have the same level of education and job skills. Real estate costs related to medical care facilities are also only a fraction of what they are in the U.S.

One advantage of Colombia for those from the U.S. and Canada is ease of travel and close proximity. Colombia offers cheaper airfares from the U.S. and Canada (and some European countries) than other destinations, such as those in Asia, and does not have the visa restrictions of other countries currently in the medical tourism marketplace.

Philippines
The Philippines has been growing as a destination for medical tourism because of world-class physicians and modern technology, with procedures delivered at a fraction of the cost of those in developed countries. The country has excellent hospitals and stand-alone specialty clinics.

India
India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine. The government and private hospital groups are committed to the goal of making India a world leader in the industry. The industry's main appeal is low cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain.

For example, "John Miller, a self-employed, uninsured, middle-aged carpenter from urban North Carolina," needed surgery for acute mitral-valve prolapse, which would have cost him a fifth of a million dollars in his home state. Staab was treated in New Delhi, India, for less than $7,000US by an Indian doctor trained at New York University. Another comparative example involves preventive health screening. At one private clinic in London, a thorough men's health check-up that includes blood tests, electro-cardiogram tests, chest x-rays, lung tests and abdominal ultrasound costs £345 ($574, €500). By comparison, a comparable check-up at a clinic operated by Delhi-based health care company Max Healthcare costs $84.

Escorts Heart Institute and Research Center in Delhi and Faridabad, India performs nearly 15,000 heart operations every year, and the post-surgery mortality rate is only 0.8 percent, less than half that of most major U.S. hospitals.

Estimates of the value of medical tourism to India go as high as $2 billion a year by 2012. India has good, modern medical infrastructure that, in some places, can be comparable to medical infrastructure in the West. The Indian government is taking steps to address other infrastructure issues that can serve as a deterrent to the country's growth in medical tourism.

The south Indian city of Chennai has been declared India's Health Capital, as it nets in 45% of health tourists from abroad and 30-40% of domestic health tourists.

Singapore
Singapore is Asia's leading medical hub, with advanced research capabilities as well as nine hospitals and two medical centers that have obtained Joint Commission International (JCI) accreditation. JCI is the main hospital accreditation agency in the U.S. Singapore hospitals have mainly chosen to accredit themselves through Joint Commission International (JCI), a U.S.-based group. This could be part of the reason why JCI chose to set up its Asia Pacific office in Singapore in 2006.[7] In time, Singapore hospitals may look towards other European or Asian-based hospital accreditation systems in an attempt to broaden their market, as JCI's principal appeal is to the U.S. market, only a portion of the potential global clientele.

SingaporeMedicine is a multi-agency government initiative that aims to develop Singapore into a leading destination for health care services. In 2005, some 374,000 visitors came to Singapore purely to seek healthcare. Many patients come from neighboring countries, such as Indonesia and Malaysia. Patient numbers from Indochina, South Asia, the Middle East and Greater China to Singapore are also seeing fast growth. Patients from developed countries such as the U.S. are beginning to choose Singapore as their medical travel destination for relatively affordable health care services in a clean cosmopolitan city.

Singapore has made news for many complex and innovative procedures, such as the separation of conjoined twins and tooth-in-eye surgery. The successful separation of 10-month-old Nepalese conjoined twins in 2001 put Singapore's medical expertise into headlines around the world. Singapore has since accomplished many more milestones both in Asia and in the world arena.

Thailand
Medical tourism is a growing segment of Thailand's tourism and health-care sectors. Lower labor costs translate into significant cost savings on procedures compared to hospitals in the United States, and a higher, more personalized level of nursing care than westerners are accustomed to receiving in hospitals back home. Over one million people per year travel there for everything from cosmetic surgery to cutting edge cardiac treatment. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006, medical tourism was projected to earn the country 36.4 billion baht.

One patient who received a coronary artery bypass surgery at Bumrungrad International hospital in Bangkok said the operation cost him US$12,000, as opposed to the $100,000 he estimated the operation would have cost him at home.

Hospitals in Thailand are a popular destination for other Asians. Another hospital that caters to medical tourists, Bangkok General Hospital, has a Japanese wing and Phyathai Hospitals Group has interpreters for over 22 languages, besides the English-speaking medical staff. When Nepal Prime Minister Girija Prasad Koirala needed medical care in 2006, he went to Bangkok.

English is widely spoken in Thailand, one reason why it is such a popular tourism destination. Bumrungrad International Hospital makes much of the fact that many of its staff are accredited in the UK, Europe and the U.S. The origins of the U.S. medical system are British, with the American Medical Association acknowledging that Manchester Physician Dr Thomas Percival is responsible for modern medical ethics, and even the founder of Harvard University, John Harvard, was born in Southwark, London. The modern Thai medical system shares in this Anglo-U.S. inheritance, as Prince Mahidol of Songla, the King's father, earned his MD degree from Harvard Medical School in the early 20th century. Prince Mahidol and another member of the Thai Royal Family paid for an American medical education for a group of Thai men and women. Prince Mahidol also convinced the Rockefeller Foundation to provide scholarships for Thai citizens to study medicine and nursing. Funds from the Rockefeller Foundation were also used to help build modern medical training facilities in Thailand. The men and women who studied medicine and nursing as a result of Prince Mahidol's efforts became the first educators for the modern Thai medical system.

Today many Thai physicians hold U.S. or UK professional certification. Several Thai hospitals have relationships with educational facilities in the U.S. and UK (for example, Sheffield Hallam University has links with Bangkok}. The U.S. consular information sheet gives the Thai health care system high marks for quality, particularly facilities in Bangkok. The UK's Foreign and Commonwealth Office web site states "There are excellent international hospitals in Bangkok but they can be expensive".

Thailand has a modern infrastructure, with clean, safe streets. Thailand offers everything from cardiac surgery to organ transplants at a price much lower than the U.S. or Europe, in a safe, clean environment.

However, there is indisputably a major HIV/AIDS problem in Thailand, as acknowledged by the World Health Organisation and dengue is becoming increasingly common.

Thailand has a growing number of hospitals with JCAHO accreditation. Again, international hospital accreditation may be one way for hospitals to demonstrate their worth, and increasingly Thai hospitals competing for business in this sector may need to expand their international accreditation.

Hong Kong
Hong Kong possesses a superb medical infrastructure. A former British colony and now a Special Administrative Region (SAR) within China, it has 12 private hospitals and more than 50 public hospitals. Among the widest range of health care services throughout the globe are on offer, and some Hong Kong private hospitals are considered among the best of their type in the world.

Hong Kong's private hospitals have looked towards a partnership with the UK rather than the U.S. or Australia when it come to international hospital accreditation. All 12 are "Trent Hospitals", having been surveyed and accredited by the United Kingdom's Trent scheme since the mid-1990s. This has been a major factor in the ascent of standards in Hong Kong private hospitals over recent years. The Trent scheme works closely with the hospitals it assesses to generate standards appropriate to the locality (with respect to culture, geography, public health, primary care interfaces etc.), and always uses combinations of UK-sourced and Hong Kong-sourced surveyors. This has lead to a uniquely co-operative approach toward improvement of hospital standards. Some Trent Hospitals have now gone on to obtain dual international accreditation, with both Trent and JCI (and have therefore attained a standard surpassing even that of some of the best hospitals in Thailand and Singapore). Others are looking towards dual international accreditation with Trent and the Australian group.

Unlike Singapore, the Hong Kong public hospitals are yet to commit to external accreditation.

Risks and Rewards of Travel for Low Cost Surgery

Medical tourism carries some risks that local medical procedures do not. Should complications arise, patients might not be covered by insurance or able to seek compensation via malpractice lawsuits, though it should be noted that malpractice insurance is a considerable portion of the cost in the Western countries such as the US that allow doctors to be sued. The most outspoken critics of medical tourism are U.S. malpractice lawyers who see this emerging trend as a threat to their livelihood. Some countries currently sought after as medical tourism destinations provide some form of legal remedies for medical malpractice. However, this legal avenue is unappealing to the medical tourist. Advocates of medical tourism advise prospective tourists to evaluate the unlikely legal challenges against the benefits of such a trip before undergoing any surgery abroad.

Some countries, such as India, Malaysia, Costa Rica, or Thailand have different infectious diseases than Europe and North America, and different prevalences of the same diseases compared to nations such as the U.S., Canada, and the UK. Exposure to disease without having built up natural immunity can be a hazard for weakened individuals, specifically for gastrointestinal diseases (e.g Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress, mosquito-transmitted diseases, influenza, and tuberculosis (e.g., 75% of South Africans have latent TB). International hospital accreditation with Trent or JCI, mentioned earlier, may be of value here when people are trying to choose a destination for their procedure.

Also, travel soon after surgery can increase the risk of complications, as can vacation activities. For example, scars will be darker and more noticeable if they sunburn while healing. Long flights can be bad for those with heart (thrombosis) or breathing-related problems.

However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of any infectious disease, including HIV, TB, and typhoid, there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West.

If your  health insurance policy or health plan does not cover the surgery you need you might consider traveling to another country to get the low cost surgery you need.  Compare costs with surgeons in the United States or your country of residence first, so you get a good picture of what the total costs will be.  Make sure to figure in airfare, room and board, accommodations, food etc.  Be aware of any complications that might arise after you return to your home country and how you're going to handle them.