Medical Tourism On The Increase

medical tourism

Medical Tourism

On The Rise Due To Higher US Hospital Costs And Health Insurance Premiums

There are people that love to travel for a variety of different reasons.  Some love history, architecture and art.  Others love outdoor activities and visit different places on the globe for that reason alone (the fairly recent trend of ecological tourism comes to mind).  But how about traveling for health care?  Over the past few years a phenomena come to be known as medical tourism has come about, involving people who travel to other (read less expensive) jurisdictions for various kinds of medical care.  Usually this has involved Americans mainly who seek out not only elective plastic surgery, but other kinds of things such as hip replacement and cancer treatment as well. Indeed when one considers that many US medical insurance plans might only cover perhaps 70 or 80 percent of certain medical costs, the co-payment or out of pocket costs that many Americans must pay is quite substantial.  And considering the much less expensive costs for the same (if not better) kinds of health care treatment abroad, it is no wonder this phenomena of tourism for medical care has come about.  In fact, in many cases, health care in very upscale private hospitals or clinics abroad could actually cost less than the out of pocket deductible or co-pay amounts incurred in the US.  It is not unusual for people partaking in this kind of medical care to report that they got a vacation out of it, got excellent medical care, and saved money all at the same time.

For those of you that live in a country with so-called free national health care (nothing is free my friends, someone is paying for this via tax money even if it is not you), you may find this idea foolish.  But, for Americans especially that have been suffering through exponentially higher and higher medical costs over the years, and the advent of the recent US version of national health insurance, also known as Obama Care, the idea is both very relevant and has been on the rise in popularity (or should I say necessity?).  But what about this so-called free national health insurance (and or national health care) already in place in some countries?  My grand-father used to say you get what you pay for, and when government is involved it has been my experience you usually do NOT get what you pay for, even if it is not you directly paying for it.  Many of our European clients especially have reported stories about relatives being placed on a 6 month waiting list for cancer treatment after being diagnosed.  Six months? Can you imagine?  It almost seems they want you to kick the bucket so they do not have to pay for the treatment (and save money).

The myth and ruse often portrayed by the medical lobbies in the US and in Europe also is that health care abroad is sub-par and maybe even dangerous.  Mental images of witch doctors out in the bush preforming medical cures with rusty knives and voodoo incantations is the stereotype they would prefer you believe.  But the truth is actually quite different.  Which is to say that medical care and treatment elsewhere, can be modern, up to date, with better and more personalized service, and certainly less costly than treatment in the US.  Some recent statistics indicate that heart valve repair surgery in the US costs US$170,000 on average (and these are numbers from 2012, so the costs are probably even higher now) but the very same treatment in a modern private clinic abroad could cost as little as US$22,000.  Obviously costs vary by hospital or clinic and even country (in terms of average local costs) but the point to be made is that the US especially has some of the highest health care costs in the world.  The question is why?  Considering that private health care, facilities, equipment and medications are available and equal to if not better abroad, it makes you wonder.

The top two destinations for people seeking quality medical care abroad has been Thailand and India.  I have had about 3 client so far that have been patients at the best private hospital in Bangkok (the same hospital the King of Thailand uses) and they claim they have never been treated so well in any other hospital inside the US.  India reports that they have been getting 500,000 visitors each year for medical treatment alone.  Those numbers sound high, but then again, maybe not.  However, there is a place much closer to home (for US residents anyway) and I am referring to The Dominican Republic.  The Dominican Republic you say?  Yes.

While many people only think of the Dominican Republic as a place for Caribbean beach resorts and even ecological tourism as one more recent phenomena, truth be told there are a number of very modern, private and relatively inexpensive private hospitals or clinics in Santo Domingo.  And I will give you a very real life example of costs.  Even the public hospital system has a private clinic division and they offer what they call the executive program.  And one of the services they offer is a complete workup. Here is how it works.  You show up at 5:30AM in sweat pants and or gym clothing and you will be in a very nice reception area with a group of other people doing the same thing.  You will be there until about 11:30AM and they do give you breakfast (although no pancakes with sausage but rather yogurt, fruit, toast, cereal, juice and coffee).  They will administer various kinds of tests including full blood work, cholesterol, chest x-ray, ultrasound to check organs, and an exercise EKG stress test as well (they have the same up to date equipment as in the US).  When you are done you will finish up in a consultation with a physician (that speaks English) and you will return about one week later to pick up your test results all bound into a spiral book, which you will review with the physician in his office together.  So, what is the cost for all this?  Are you sitting down (you had better sit down)?  The equivalent of about US$800, or at least that is what I paid about 2 years ago.  Considering the exercise EKG stress test ALONE can cost anywhere from US$1,000 to US$5,000 in the US ( claims the US national average is US$3,800 for this test), the entire battery of tests I mentioned is less expensive than just the stress test alone if done inside the US.  And many people in the US with insurance need to pay about US$200 to $400 our of their own pocket just for the EKG stress test alone (with insurance paying the other US$3,000 or whatever amount).  So, you can quickly imagine and calculate what all the other combined tests and related co-pay would cost in the US.  In other words, it is not hard to believe or imagine that the cost for this program in the Dominican Republic could actually be LESS than what you might pay out of pocket for co-payments in the US even with health insurance.

And this leads us the next most commonly asked question by our clients regarding health insurance.  Can you obtain very affordable private health insurance in the Dominican Republic?  Yes is the answer.  There are a number of very good and very solvent private insurance companies in the Dominican Republic that offer health insurance plans, and global expat health insurance is available as well.  Just keep in mind that in some cases, the health insurance policy will only be available to legal residents (and of course citizens) which is yet another benefit for you to apply for residency in the Dominican Republic.  So, what does it cost?  Well, we have a number of clients aged 50 and above that have some of the best health insurance plans available (including dental) and they are paying about US$1,500 per year in insurance premiums (that was not typography error, I did write per year and NOT per month).  If you want to explore health insurance options in the Dominican Republic I can suggest you contact Mr. Pedro Andujar, Cell Phone 829-710-8066, who speaks English and someone that has been helping our clients with insurance for well over 10 years now.

The next most commonly asked question by clients regards a referral for a good English speaking dentist and in this regard I can recommend Doctor Annie Rosa, who has an office in the Naco section of Santo Domingo.  I have known Annie for years and she is a very nice lady that cares about her patients and she has a very modern, comfortable and up to date office to rival any modern office in the US or Europe.  Her specialty is oral rehabilitation but of course she does all the things you would expect a dentist to do (cleaning, fillings and so on).  She probably is closest thing to a painless dentist I have ever found.  Contact Dra. Annie Rosa via her cell phone: 809-610-4561 or email:

Author's Note:  None of the above mentioned people have paid me any renumeration to mention them, nor do I have any other kind of renumeration agreement for any clients that decide to utilize them.  Although I must disclose that in some years past Pedro has sent over a bottle of wine at Christmas time, but that was more out of friendship rather any other reason.

In summary, while medical tourism is nothing brand new, there is another recent and new found interest in foreign or world-wide health insurance as the next progression in this medical care phenomena.  Which is to say that there has always been supplemental health insurance plans for expatriates or so-called travel insurance for any emergencies as well.  But what we are now seeing is something very different, and it has been spurred on by the recent US nationalized health insurance programs being promoted in the US (assuming you can get onto the web site to sign up, that is).  Stated more plainly, Obama-Care is pushing small business owners and individuals in general to obtain health insurance outside of the United States, and in correlation, seek medical treatment abroad as well.

Obviously such an idea becomes a problem when the topic of medical emergencies (requiring immediate treatment) comes into play.  However, routine medical check-ups, dental work (cosmetic and otherwise), various surgeries that can be planned in advance (hip replacement, knee surgery, etc., etc.) are all things that cost less abroad – and the premiums for private medical insurance abroad reflect that as well.  Pick your own physician, hospital or private clinic without having to beg the government to approve a medical procedure.  And we are talking about private first rate & modern clinics or hospitals as well.  In summary, not only are many government policies, taxes, and financial mismanagement pushing people to secure their wealth and assets abroad, but now their own health needs as well.  Is it so surprising?

About The Author: This article was written by John Schroder of Ascot Advisory Services.  John's firm has been helping clients in the Dominican Republic for the last 17 years with residency application services, naturalized citizenship filing, banking assistance and legal services pertaining to real estate (title transfers, legal representation at closing, sales contract review).  You can contact him by telephone at 809-756-1917 or click the about the author link above to reach a contact page to send an email directly.

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