Healthcare elsewhere: the rise of medical tourism

By Gonzalo López Martí – Creative Director
www.LopezMartiMiami.com/

• Healthcare on US soil is way too expensive and bound to become more so in the future.
• It’s just a matter of supply and demand.
• Life expectancy is getting longer.
• Boomers are mostly retired and not planning on kicking the bucket anytime soon.
• Gen-Xers are about to turn the corner.
• Millennials and Centennials are terminal hypochondriacs.
• There’s a chronic disease epidemic in America, as unconfirmed Secretary of Health and Human Services RFK Jr. likes to trumpet from the hilltops to widespread chagrin.
• Social Security is running ever-growing exponential deficits.
• Something’s gotta give.
• Unwinding and dismantling the entrenched edifice of US healthcare to make it leaner and cheaper will not happen without some pressure.
• Internal and external.
• Despite its good intentions, the Affordable Care Act, aka Obamacare, only made it more bloated, opaque, bureaucratic and costly.
• The political will to reform it is simply not there: cutting costs and pushing back against special interests has been known to derail many a Beltway career.
• No living, breathing official, elected or otherwise, would want to go down in history with such an accomplishment sticking out like a sore thumb on his or her record.
• The only way out, I’m afraid, is disruptive private sector innovation.
• In other words: COMPETITION.
• More supply to push prices down.
• Enter medical tourism.
• In Asia it is common practice to cross borders in search of better &/or more affordable medical care.
• Trivia: which Asian country treats the most inbound health tourism patients?
• Thailand.
• The procedure?
• Sex changes.
• We Hispanics are not foreign to the concept.
• The concept of medical tourism, not sex changes.
• We all have a Hispanic friend or relative who forays south of the border to get work done on the cheap.
• It is common practice among Hispanics in California to pop over to Tijuana to see dentists., ophthalmologists, optometrists, orthopedists, you name it.
• We vote and shop with our feet.
• Even when our health is at stake.
• Let me rephrase: especially when our health is at stake.
• Lo & behold, mainstream Americans are following on our footsteps.
• Makes no sense to fly sixteen hours to Asia for a root canal.
• But Costa Rica is only three hours away.
• According to credit & debit card issuer Visa, 11 million Americans travel abroad every year for medical treatments.
• They are usually in their late 40s or older.
• They claim that trying foreign care is worth if the overall savings exceed the $5K mark*.
• Should outbound medical tourism become a commonplace among Americans at large, the US healthcare establishment will kick & scream.
• Lobbying & PR firms in Washington, DC, will do some serious winin’, dinin’ & invoicin’ to try and stop it.
• Expect smear tactics: “Healthcare overseas is sketchy and risky”.
• Mind you, it is not entirely untrue.
• If you are planning on going abroad to get treatment, DO YOUR RESEARCH.
• THOROUGHLY.
• Full disclosure: I have skin in the game.
• López Martí Miami has not one but two clients pushing for medicine without borders.
• One of them is Cleveland Clinic, a revered institution ranked #2 among the best hospitals in America (#1 in cardiology for some 30 years now).
• Cleveland Clinic has a program called GPS (Global Patient Services) catering to foreign patients in search of the highest care available in the planet.
• This target audience is not short of cash: they are high-net worth folks with the ability to pay out of pocket for extremely complex procedures.
• As you might imagine, it is a white glove, concierge service proposition, to borrow terminology from the hospitality industry.
• Pun not intended.
• Our other client in the field of medical tourism is PROMED, a Costa Rican NGO (a cooperative, to be precise) amalgamating efforts by multiple healthcare providers in said country trying to put forward coordinated and concerted efforts to attract international medical tourism.
• See, Costa Rica receives thousands of Americans every year who undergo affordable procedures and treatments: root canals, plastic & orthopedic surgery, Lasik, etc.
• IVF and cardiothoracic interventions are less common but not unheard of.
• Naturally, if you fall with appendicitis, you must dial 911 ipso facto.
• However, if you have the chance to plan ahead with a few months’ time, booking a flight to Costa Rica is a no brainer, financially and vacationally.
• Not sure “vacationally” is a word in the English language but you get the point.
• How is this not a conflict of interest, you might ask?
• Good question: it just so happens that there’s no competition between these two clients.
• Cleveland Clinic is in the inbound medical tourism business.
• Costa Rica is in the outbound medical tourism business (seen from a US POV, that is).
• The overseas patients who fly to see specialists at Cleveland Clinic’s campuses in Ohio or Florida seek ultra-high complexity procedures unavailable in their home countries.
• Conversely, Americans seeking treatment in Costa Rica look for affordable yet reliable care in low complexity fields.
• Cleveland Clinic’s competitors are Mayo Clinic, Johns Hopkins, UCLA, to name a few.
• Costa Rica’s competitors are Mexico, Panama and Colombia.
• For now.
• The landscape will keep changing.
• Disruption will come to the sector one way or another.
• Artificial intelligence, telemedicine (I prefer to call it “remote care”), robotics, you name it.
• The healthcare status quo is on the brink of some drastic change.
• What Uber and Lyft did to the taxi business but taken to eleven.
• There will be blood on the streets.
• Figuratively speaking.
• The cost of healthcare is just too damn high.
• Most procedures in Costa Rica are at least 50% cheaper.
• A good ol’ hip replacement costs north of $30K on US soil.
• In Costa Rica: less than $20K.
• We’re talking about the same exact titanium prosthesis.
• Eventually cultural and legal barriers will fall.
• Sooner or later the dam will break and reality will prevail.
• A friend of mine put it nicely: the US might the best place in the world if, God forbid, you suffer from a rare disease requiring complex experimental treatment.
• Conversely, it ranks pretty low among industrialized and not so industrialized nations if you twist your ankle while pressure washing your patio.
• In the former case, if you are willing to be a guinea pig for Big Healthcare, you might receive the latest, greatest state-of-the-art treatment imaginable, possibly subsidized by professionals wiiling to burnish their resumes and corporations willing to advance science, discover new, cutting -edge medical technology and make a ton of money after the FDA fully approves.
• In the latter case, the big healthcare will treat your swollen ankle like a frickin’ ATM machine.
• Legislation is downstream from politics.
• Politics is downstream from culture.

Is America ready for the globalization of medicine?

• We’ve been doing it for ages: getting healthcare south of the border.
• We as in Hispanics living on US soil.
• Looks like non-Hispanics are doing it too.
• More and more.
• It is a niche.
• For now.
• Its election time and the debate: do we want socialized or private healthcare?
• The naming can be misleading: single-payer, nationalized