Thursday, October 12, 2006

Medical Tourism

Looks like Singapore is not the only country outsourcing its medical services. Dr Parker blogs about this phenomenon happening in the USA, where healthcare costs are ridiculously high, thanks to high insurance premiums & (IMHO) high litigation rates.

Unsurprisingly, this is creating a lot of unhappiness in the medical community & the patient's union. Quality of care, medical liability & follow-up care, especially in the face of possible complications are issues which have been raised & understandably so.

This particular patient is supposed to go for rotator cuff surgery & cholecystectomy in India. He would also go sightseeing on a two day tour that includes a visit to the Taj Mahal. The cost of the operations would be only 1/5 of that in the USA - a huge savings for his employer. But question is: who is going to take care of him if he develops complications post-op? Will the American insurance company still cover him for any medical care received as a result of such complications?

I know of someone whose brother, suffering from renal failure & undergoing hemodialysis for the past 20 years, decided to travel to China for a kidney transplant. It cost him about $60,000. Apparently he was hospitalised for a week before being sent home. He did develop post-op infection & required ICU care. His original nephrologist here refused to manage this problem, & he had to seek treatment in a different hospital.

Now we all have heard of the dubiosity (is there such a word??) of organ transplants done in China, & how the origins of these organs are rather hazy. (From executed prisoners? Sold by someone in need of money?) But aside from that, is it ethical for a doctor to refuse to give treatment to a seriously ill patient, who developed complications from such a procedure? No, I say. We may disagree with the patient's decision to go through the procedure. But we should not punish the patient by making life harder for him after.

The medical communities in countries where healthcare costs are escalating have to examine all these questions ASAP. Outsourcing is NOT going to go away. Especially in a world where money talks the loudest in most cases.


nofearSingapore said...

Hi aliendoc,
Medical tourism is singled out by our govt as the next big thing. It is understandable as each foreign patient typically comes with one or two carers and the whole lot of them stay for at least a week or two. The economic spin-offs include hotels/F&B and of course healthcare related businesses.
So long as it brings in money, the Health Ministry will support it.
Therein lies the danger. Medical ethical problems of over-treatment, overcharging can easily occur in the pursuit of Vit.M!
All medical institutions ( ie hospitals) and fraternities ( ie sub-speciality organisations) more than ever require men/women of dignity to be involved in gate-keeping to ensure that our profession remain an honorable one.
Hope you know what I mean!

abi said...

Would like to talk to Dr.Huang, iam a healthcare consultant , from chennai, India, working on medical Toursim projects.

Plz mail me at

igakunogakusei said...

I think it's "dubiousness", rather than "dubiosity", but I may be wrong.

aliendoc said...

iggy: I think you are right - thanks!

Dr Huang: Agree with you that healthcare facilities need "gatekeepers". I believe that the govt hospitals have their own ethics committees to look into issues of ethical behaviour. But when it comes to money issues, it probably would not come under their purview. Personally, I think such gatekeepers should not have vested interests in the institutions. They should be advocates for the patients, ensuring that informed decisions regarding their health care are made. This may come with an additional cost to the patient if their is no funding for such advocates.
We also need to look at medical tourism from the other perspective of our own citizens seeking treatment in cheaper countries like Malaysia, Thailand, India or even China! This is already happening though not to a huge degree (yet). Issues like quality of care, continuation of care etc will have to be addressed by our local medical community - SMC? MOH? SMA? Someone will need to step up to the plate. It will be a huge undertaking.