Medical Rationing and Medical Tourism

Something a lot of people in this country don’t know is that the various state and federal health care plans for the poor do not cover most poor people or their children. In other words, you may be on unemployment and food stamps, but if your state has a fixed budget for Medicaid, SCHIP and other programs, you probably won’t get health care coverage. In my state the cap has remained in place for years, so in a region (southern Appalachia) where 3 out of every 5 people qualify for state and federal aid because their incomes are below the poverty line, 1.5 of those 3 won’t get any aid at all.

Then there are the “working poor” – those who work as many hours a day as is possible at as many jobs as they can get, but whose income still falls to poverty level or below. These people generally have no health insurance and no state/federal coverage. Not because they choose not to purchase expensive insurance, but because it’s simply not available to them. And on top of this are all those in the “lower middle class” who may have junk insurance through their employers with deductibles so high they simply cannot afford health care, or whose insurers routinely refuse to cover any and all claims.

And on top of that there is the whole rest of the middle class, who have exactly the same problem with their insurance companies – they simply refuse to pay for health care, leaving all but the very rich (who can pay out of pocket) without usable access to health care and one accident or illness away from bankruptcy.

Thus there are entire ‘underground’ networks set up to import drugs Americans can’t afford to buy and their insurers won’t cover (including Medicare/Medicaid), usually from Canada or India. There are also networks designed to help Americans leaving the country in order to get the health care they need, in countries where the costs are far lower and the care much better than what they can get here in the U.S. of A.

When my brother-in-law (who works for the State Department and has excellent government insurance) was informed at his yearly physical that he needed heart bypass surgery, he was in India – a popular destination for medical tourists where the care is good and the costs 1/5 what they are in America. But since he could choose, he opted to have the surgery done in Singapore because they have a new technique that doesn’t involve stopping the heart or using a heart-lung machine (known to cause cognitive deficits). His government insurance would have paid either way, so he took the best option for himself. I figure that if a high-level, well-paid government-insured person knows the health care he can get abroad is better than what he could hope for at home, those of us at the lower levels of the economy (and scheduled to get hit hardest in the recession) should be taking notes!

Medical tourism is something to think about if you need a procedure but can’t get it in this country due to prohibitive cost. If you’ve a few thousand in savings (one way or another) and must have that spinal fusion or hip replacement or bypass in order to function, it wouldn’t hurt to do some homework. There’s an excellent series about a medical tourism journey to India for hip resurfacing ongoing over at Health Care Hacks that is a good place to start.

There is a 5-page feature article in Good Housekeeping examining the options as well, entitled Passport to Cheaper Health Care?. Amy Scher of Health Care Hacks began her series over atWise Bread with I’m Fleeing the Country for Health Care!, and one commenter is the director of America’s Medical Solutions, a medical tourism concierge service run by Americans in India. I suspect there may be similar coordinators in other countries Americans have found can offer cheaper, better health care, so a search is warranted when you’re doing that homework.

If you’re lucky enough to have assets you can make liquid for necessary care – or if your insurer has flatly refused to cover necessary care at all – you might be much better off (and save a bundle) hopping a flight to India or Thailand or Singapore than if you stayed here to suffer-unto-death.

Links:

Passport to Cheaper Health Care?

Health Care Hacks

I’m Fleeing the Country for Health Care!

America’s Medical Solutions

Medical tourism: Need surgery, will travel

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