Is the global healthcare in crisis?

I am a surgeon as well as a professor in a prestigious school for the global advancement of medicine and healthcare. I dedicated my life in this field to improve the global healthcare practices

I recently read an article about medical tourism and healthcare crisis in medicalstreamline as follows:
Tuesday, July 31, 2007
Why Medical Tourism? A growing 10 Billion Dollar Industry

Medical tourism is the practice of traveling to another country to obtain health care. The provider and patient 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. Services typically include elective procedures as well as complex specialized surgeries such as hip and knee joint replacement, cardiac surgery, dental surgery, and cosmetic surgeries.

Due to the high costs of medical treatment and surgery in the United States, the waiting lists in the United Kingdom, Australia and Canada and the lack of high tech medical procedures in many third world countries, medical tourism is expected to blossom into a ten billion dollar business world-wide. Recognizing this trend governments, large corporations, hospitals, and doctors are flooding the medical tourism market with choices, and prices are dropping in many countries world-wide.

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.

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.

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

As the number of uninsured Americans grows, medical patients are now becoming consumers of medical care in record numbers. Many of these medical consumers are taking part in medical tourism i.e., people who leave the country primarily for medical treatment.

When a medical consumer searches for a provider, they tend to focus on the credentials of the doctor and forget about other important factors. Possibly the most important other factor is the country where the doctor and hospital are located. The country determines many things about the quality of care you will receive.

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

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.

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.

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.

Those involved in medical tourism should seek a hospital in country where government inspections of the hospital are mandated and the standards are high. But just this mandate is not enough. After all the results of the inspections may be known to only a few. Government should also mandate that the results be made public. Such a practice is now law in Germany for German hospitals and other countries in Europe. Wouldn’t the medical tourism consumer want to know the results? After all, hospital infection rates vary widely and give the consumer a good idea about how well the hospital is managed.

Posted by Global at 12:25 PM

Healthcare In Crisis?

Baby boomers are quickly approaching retirement age, and as they do, there are a number of concerns that need to be addressed, particularly in the area of healthcare. Unfortunately, there appears to be no easy answers to the healthcare problems that baby boomers, and the population in general, will face in the very near future.

The United States faces a medical emergency. Costs of the nation’s healthcare system are growing so fast they are out of control. Many employers are dumping escalating healthcare expenses for both employees and their retired workers as fast as they can manage, fearing a loss of competitiveness. Currently, the average American consumes $6,420 worth of healthcare services a year. That’s more than $12,200 a year for the average family. It’s the most inefficient medical system among industrial nations. US healthcare costs have reached $1.6 trillion a year. That’s 15 percent of the nation’s economy, up from 5 percent in 1963. Other industrial nations devote less than 10 percent of gross domestic product to healthcare.

Advancements in medical technology and science means that people are living longer. This does not always mean that there is a high quality of life for those that are living longer though. Many of these people who would have died from a medical condition two decades ago can now live for a long time to come. These people often require a great deal of long-term care, whether it is at home or in a long-term care facility.

Those receiving long-term care at home require nurses to help them with their day-to-day tasks. The following is a quote taken directly from the Medicare website (http://www.medicare .gov/LongTermCar e/Static/ Home.asp)

“Generally, Medicare doesn’t pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn’t pay for this type of care called “custodial care”. Custodial care (non-skilled care) is care that helps you with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring.”

There is also a great deal of talk about whether or not Medicare will even be around in the coming decades. Consider the fact that 28% of the population will no longer be contributing to Medicare via taxes, while at the same time that 28% will be using more of the resources.

Posted by Global at 12:02 PM

which actually states that the healthcare in the United States is in crisis. I need your help. I would like to know your opinion on this behalf.

Thanks,
Philip Allen, MD. Ph.D

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