If you live in South Carolina, that just became a much more viable possibility. And as they say in the health insurance business, so goes Blue Cross & Blue Shield of South Carolina so goes the rest of
heath care insurers.

Medical tourism is not a new concept. People who are underinsured or who have no insurance have been going overseas for everything from heart surgery to hip replacements.

What is a relatively new trend is that health insurance providers are now including coverage at these "partner" hospitals around the world. Evidently, about 11% of all plans now carry that feature. How many more will include it next year is anyone's guess.

Call it Medical Tourism or call it the outsourcing of health care, the story really got legs when BusinessWeek featured an interview with David Boucher, a Blue Cross executive who went to Singapore for his colonoscopy.

In South Carolina, a quadruple bypass costs $122,000 if you're uninsured. To be able to get that [same quadruple bypass] for south of $15,000 at a JCI-accredited hospital with a U.S. board-certified cardiologist, it's an appealing alternative.

Maybe for someone without insurance. But why should someone with insurance go?

Would members with a $250 deductible spend $2,000 for a plane ticket and travel 24 hours to have their hip replaced? They wouldn't. But we are selling a high number of high-deductible health plans—with deductibles from $2,000 to $10,000— [because our] customers are saying: "We want to shift more of a percentage of care onto employees; we want our employees to think there is no free lunch."

Goodness knows the plight of The Shank family reminds all of us that health insurance coverage is not what we always think it is. It is Boucher's statement about the high-deductible plans and their "customers saying they want to shift more of a percentage of care onto employees," that deserves close attention.

While medical tourism may now be an "option," for care, it is not unreasonable to think in the not so distant future that insurers will insist that a surgery is conducted overseas--regardless of the deductible. Just as companies have outsourced call centers and other back office activities, it now seems that health care providers are the next business segment to feel the crunch of outsourcing.

Of course the difference is when back office activities are outsourced the customer doesn't have to leave their home or office. With outsourced health care we're saying, get the passport, get the plane tickets and travel across the world to take care of that knee replacement.

It's not that different than insurers saying you can only have the generic brand of a medication or saying how long they will cover your stay in a hospital for a procedure.

Who doesn't know a woman who had a mastectomy as an outpatient procedure?

In a health care environment that sees a company that made $90 billion last year demand a refund of its payments from a permanently disabled woman who has no short term memory and is devastated every time she hears her son was killed in Iraq, does anyone really think that they won't tell people they have to go overseas for their surgery?

The savings between $122,000 and $15,000 will sooner or later simply be too tempting for the corporate bottom line keepers--even for those people who have the $250 deductible.

Israel is just one country that is gearing up its marketing to welcome overseas patients

So popular has Israel become as a medical tourism destination that its Tourism and Health Ministries have jointly produced a new English-language guide, Meditour, to highlight the medical tourism options in Israel.



According to the guide, Israel not only offers comparable treatment found elsewhere in developed nations, but in some cases, even better care. Israelis for example, have more experience and success in fertility treatments such as IVF, than in any other country, yet they charge less.


A single IVF treatment in the US can cost up to $20,000. In Israel the fees are about $3,250.

There is another reason why insurance companies are probably going to require that all policyholders also hold a passport and that has to do with legal fees.

It's not so easy to sue a hospital and physician in another country when a procedure is botched.

The lawyers can't be happy. Think about this. The trucking company involved in the Deborah Shank case settled for a million dollars -- the attorneys got about 60% of that fee.

A private trust fund is being established for Deborah Shank and no
doubtedly American's generosity will help ensure there is money for her
care.

What about the other Deborah Shank's out there?
Despite my most aggressive Google searching I could not find any similar cases --- I'm sure they are out there and I would like to learn what happened to them.

What makes Deborah Shank's case so heartbreaking is the image of her breaking down and crying every time she learns that her son was killed in Iraq. It is that image, that heartbreak, that she must endure for the rest of her life that makes anyone with an ounce of humanity wonder what was Wal-Mart thinking?

Deborah Shank is a sign of the times. Check your health insurance policy, it is a standard clause --just one most companies didn't bother to pursue. Maybe the public outcry over Deborah Shank will serve as a cautionary tale for other companies demanding their money back.

And, if they can't get their money back from lawsuit settlements well, then they will look for savings elsewhere. Make sure your passport is up to date.

For more on medical tourism.
Ann billoteau parlez vous
Medinnovationblog
Aftercare Lacking In Medical Tourism Experience

Elana blogs about business culture at FunnyBusiness
"Medical Tourism" Is It Worth The Risks For Your Health And Peace of Mind