Medical Tourism Prompts Price Discussions

Published October 1, 2006

Howard Staab, a 53-year-old North Carolina contractor, was healthy in the summer of 2004–or so he thought, until his doctor found a life-threatening heart condition during a routine physical.

Uninsured, Staab had always paid out-of-pocket for medical care. But discussions with the local hospital revealed uninsured patients pay much higher fees than insurers do. Staab faced a $200,000 bill for the heart valve surgery he needed if it was performed there.

In September 2004, Staab got his surgery at a state-of-the-art facility in New Delhi, India. He is part of a growing number of people traveling to other countries in search of low-cost medical care. Staab’s surgery cost $6,700; post-operative lodging and airfare added another $1,500 to the tab.

Critical Voices

“I would do it again in a heartbeat,” Staab said. “The care was far superior to any care I’ve ever had in the States.”

Staab’s own cardiologist supported his decision to seek care abroad and continued to treat him throughout his recovery after his return. But Staab has received negative feedback from a few American physicians.

One of the most vocal critics of outsourcing medical care is the American Society of Plastic Surgeons (ASPS), whose president, Bruce Cunningham, testified in June before the U.S. Senate Aging Committee about concerns over people combining cosmetic surgery procedures with vacations abroad.

Surgery is a serious business, Cunningham noted, adding he thinks patients expose themselves to unnecessary risk if they make price the motivating factor for obtaining surgery in foreign countries.

“In essence, ‘buyer beware,'” Cunningham testified. “Without a complete understanding of the medical standards for the health institution or facility, medical providers, surgical training, credentials, and post-operative care associated with surgery, a patient can be ill-informed–and worse, at significant risk.”

Lower Prices

It’s easy to see why people are tempted to combine travel with surgery: The cost of medical procedures is often much lower abroad. Although medical facilities in low-cost countries are often substandard compared to hospitals and clinics in the United States, there are also highly advanced medical facilities abroad that are specifically built or equipped for medical tourists.

India and Thailand are the two most respected destinations for low-cost medical care. Others include Belgium, Brazil, Costa Rica, Malaysia, Mexico, Poland, and Singapore. is a Web site that connects patients with high-quality medical facilities abroad. Tom Borta, PlanetHospital’s vice president for client relations, noted he is also a client. In January, he had a stent inserted in his heart at a facility in India.

Borta said most clients opt to have their medical procedures performed in India because the quality is high and the cost is the lowest among the countries where sends patients. He said patients’ reported satisfaction is high.

“We have not had a client return from India with a complaint about the quality of care or the surgery,” Borta said. “They have all been really pleased with the doctors, the surgery, and the recuperation process.”

Careful Screening

When potential clients contact, the medical staff reviews their medical history to assess whether they are well enough to travel. Some people may have waited too long to seek care and therefore are not healthy enough to make a long flight to India or Thailand.

Staff members then help clients choose appropriate physicians and destinations for care. The medical records are digitized and placed online to allow physicians in the destination country to easily review the patients’ medical histories. then arranges conference calls between the physician and patient to discuss the procedure.

Once the patient chooses a physician, arrangements are made for the procedure. assigns a case manager from the destination country; the site often arranges travel and lodging as well.

A country manager coordinates any additional requirements such as cell phone service and airport transportation. Case managers attend to all needs that arise while the patient is in the destination country.

Package Deals patients can even choose package deals. For instance, the Web site advertises a breast augmentation and tummy tuck combination package for $9,495. That price includes airfare, meals, surgery, and five days’ accommodation at a clinic and hotel in either India or Thailand. The Indian doctors who perform the procedures are American-board certified.

Someone needing a diagnostic scan can opt to have an MRI done in Brazil, Costa Rica, India, Mexico, Singapore, or Thailand for $200 to $300. A hip replacement can be performed in Argentina, Belgium, India, Singapore, or Thailand for $8,000 to $12,000.

Low-cost havens for plastic surgery have been popular for years. But recently, India and Thailand have begun building high-tech facilities to perform more serious procedures, such as hip and knee replacements or cardiac surgery.

Although insurers currently do not make medical travel part of their provider networks, they may in the future, according to Mercer Health & Benefits, a national consultancy group for human resources managers. Earlier this year, West Virginia’s legislature held hearings on the possibility of including foreign hospitals in its state employees’ health plan network.

Devon M. Herrick, Ph.D. ([email protected]) is a health economist and senior fellow at the National Center for Policy Analysis.

For more information …

Howard Stabb’s story,


Bruce Cunningham’s June 2006 testimony before the U.S. Senate Aging Committee,