Texans do Indian Surgery

Texans do Indian Surgery

Nancy Koehler's Indian hip operation cost $9,000.

Byron Harris reports

Nearly one out of four Texans does not have health insurance. Not being able to buy prescription drugs is one thing.
But for those who need serious surgery, the problem is worse. For some people who have to go under the knife but can't afford American medical bills, the solution is India. Last November, Nancy Koehler shared the plight of many Americans. Every step she took needles of pain shot from her disintegrating hip. "It hurts constantly. It's very difficult to sleep at night," she said. She needed hip replacement surgery. But she couldn't afford health insurance, and didn't have the tens of thousands of dollars it would cost to pay for it out of her own pocket.

She decided to go to Bombay, where many Americans are going for expensive high-quality surgery. After a year of research on the internet, she found the clinic of Dr. Ahmeet Pispati, a British-trained surgeon who for the last several years has resurfaced hip joints with a procedure only recently approved in the United States.

Hips consist of a ball at the top of your thigh bone, and a socket, that the bone fits into.

Historically, in the United States surgeons have cut off the ball of the hip and replaced it with a solid metal ball and a new socket. In hip resurfacing, instead of cutting off the bone, the surface of the hip ball and the socket are replaced.

"I feel so good. I'm not going to have any problems," says Koehler.

Eight weeks ago Ms. Koehler made the trip to Bombay to have her hip resurfaced.

Looking back, she's says her Indian experience is far better than the United States. She knows what she is talking about. Eight years ago, when she still had health insurance, her other hip was replaced in the United States, by an American surgeon.

"The Indian hip is far better," she says. Her American hip dislocated twice requiring her to have a second painful surgery. And then there's cost.
In today's dollars her American hip could cost as much as $40,000.
The Indian hip, with hospital stay, rehab and plane ticket, cost less than $9,000.
Is India for everybody? Not necessarily, says Dr. Nariner Monga. Indian by birth, he's practiced in the U.S. for 31 years.
"I'll have to check out very thoroughly, which institute the surgery's going on and after making sure that it is in good hands then I won't feel uncomfortable," he says. Today, Nancy Koehler uses a cane only because it's her doctor's orders. She talks with him via e-mail every day. And compared to the twin devil of health insurance and painful surgery, her Indian hip has been a walk in the park.

Sun and surgery Vancouver

24 Hours Vancouver - News: Sun and surgery Vancouver

By IRWIN LOY, 24 HOURS

Robert Stuart Smith walks without pain these days, but that wasn't always the case. Last year, the Vancouver realtor was told he'd have to wait up to two years for routine surgery.

"I was getting pretty crippled with my knee," the 72-year-old explains now. "I felt there had to be a better way."

So Smith did some research and found a B.C. company that would arrange for him to get the surgery at a private hospital in India. Immediately.

Smith couldn't say no.

"I respect the system in Canada," he says. "But there are options, so I looked at the options."

Faced with sometimes lengthy waits for health services, more and more British Columbians like Smith are also exploring their options, and a few companies have sprung up to meet their needs.

Burnaby's MedSolution is one of them.

"It's just now getting to the point where people are so fed up with having to sit and wait for 18 months in agony until they get the services they need," says spokesman John Knox. "People want to get on with their lives and they want to do it as fast as possible."

OUTSOURCED CARE

"Medical tourism", as the fledgling industry is being called because of its often-exotic destinations, has so far avoided the heated public versus private health care debate.

But some within the industry have already lobbied provincial and federal governments to look at medical tourism as a publicly-funded health care option.

In the U.K., lobbyists want the National Health Service to "outsource" some of its patients abroad. In a system that already delivers some health care through private insurance, the cost savings can be a convincing argument.

Here in Canada, patients can apply to provincial health ministries to seek funding approval for out-of-country surgeries, although it is not often granted.

Knox admits it's potentially a contentious issue.

"Should the government be paying people to get stuff done outside the country?" Knox asks. "Well, if it can't be done at home in a timely manner, I think a lot of people would feel that it should."

For now, Knox says the industry is taking a wait-and-see approach.

"We're heading into the election and from our point of view, we want to see how the cards line up after Jan. 23," Knox says. "Then we're going to be taking a look at who's running our health-care system and whether or not there's any room to pursue those kinds of talks."

THE NEXT STEP?

If recent polls are accurate, the Conservatives might well be the ones running the system. Its platform, like the Liberals, seeks to establish wait-time guarantees under a fully public system.

But if nothing's available within that time, patients can be transferred between provinces - or in some cases, and unlike the Liberal platform, to the U.S.

Such a plan would seem to leave the door open for health ministries to pay for out-of-country treatments. But Conservative health critic Steven Fletcher insists it's unlikely.

"I can't envision a scenario where to fly someone halfway around the world can be helpful to a patient quality-wise or cost-wise," Fletcher says.

But private hospitals in countries such as India likely disagree.

Whereas patients could shell out $40,000 for a hip replacement in a U.S. hospital, for example, the same procedure would cost less than $6,000 in India, according to MedSolution.

Even with airfare added on to the price, it's hard to argue there aren't potential cost savings for a health care system that's forever in need of extra funds.

In fact, the Punjab Chief Minister, Amarinder Singh, already met with Liberal Health Minister Ujjal Dosanjh on at least one occasion last year to lobby on behalf of his region's medical tourism industry, according to Indian media reports.

Dosanjh, who did not respond to several interview requests, has said the meeting was a "courtesy" and is not interested in pursuing the matter.

Medical tourism in Phillipines - INQ7.net editorial

Medical tourism - INQ7.net: The medical tourism program launched last week may yet help relieve the brain drain in the health professionals sector and at the same time earn a lot of dollars for the country. But the program has to be well managed to ensure that it does not adversely affect the health program for poor Filipinos and result in the exploitation of people ready to sell parts of their body for money.

Health Undersecretary Jade del Mundo has said that the program would put the Philippines on the world stage of medical tourism. India, Thailand, Malaysia and Singapore are ahead of the Philippines in medical tourism, but it should not be difficult for the country to catch up, given the competent health professionals it has, its international image as a caring and compassionate nation and its very reasonable and competitive medical rates. Also a plus is the fact that most of our health professionals are proficient in English.

A heart bypass here costs only about P500,000, or about half the price abroad. A kidney transplant costs P3 million, or less than half the rate in other Asian or Western countries. Even cosmetic surgical procedures are cheaper here. For example, blepharoplasty, which widens the contours of Asian eyes, would cost about P500,000 in Japan and South Korea, but only P150,000 in the Philippines.

Medical tourism has a dual purpose: people would visit another country to get medical treatment and enjoy a vacation in the process. This new kind of tourism promises to be a lucrative dollar earner for the Philippines. Dr. Joseph James Joaquino, a plastic surgeon, said that in Thailand in 2004 the medical tourism industry drew 600,000 foreign tourists and earned nearly $500 million for the country.

Tourists would be ready to pay high professional fees, and so doctors, nurses and other medical professionals who are thinking of working abroad could be convinced to stay in the Philippines. Later they could pool their savings and set up clinics and hospitals of their own. Other doctors and nurses already working abroad could be enticed to return to the country if they could earn better pay so that they could be near their families at the same time.

The medical tourism program could also help promote indigenous medical and therapeutic practices, such as "hilot." This type of Filipino massage has therapeutic benefits and, properly promoted, could compete with the world-famous Thai massage.

There are certain caveats, however. The Alliance of Health Workers, through a spokesperson, said that the program, which would offer world-class health care to foreigners, could aggravate the neglect of poor Filipino patients. Millions of them now have to content themselves with substandard treatment and obsolete equipment in government hospitals and clinics.

Another danger is that the program could result in the “mutilation” of hundreds, if not thousands, of poor Filipinos who would sell kidneys and other vital organs for big sums of money. In 2003, 420 kidney transplants were done locally. About 250 of the kidneys came from donors not related to the recipients, and most of the donors were paid. The selling of kidneys is a booming business in Rizal Park, Bacood and Baseco compound in Manila, Novaliches in Quezon City and Addition Hills in Mandaluyong, according to Dr. Angeles Tan Alora, a bioethics expert.

What if the donors who are left with only one kidney each later suffer kidney failure? Would not the government and society spend more to solve the new problem?

What makes medical tourism an attractive program all over the world is the money. Del Mundo, citing figures from the International Trade Center Geneva, said that the global medical tourism industry earns about $20 billion a year. The Philippine government expects to earn $300 million in the first year of operation of the medical tourism program and $1 billion a year for the next five years.

If the program does stem the brain drain in the health professionals sector and brings in the tourist dollars, well and good. But safeguards have to be taken to ensure that it does not result in the neglect of poor Filipino patients and in the exploitation of poor people who might be enticed to give up some of their vital organs in exchange for dollars.

India ideal destination for SAARC patients: Expert - Health News - Webindia123.com

India ideal destination for SAARC patients: Expert - Health News - Webindia123.com: India ideal destination for SAARC patients: Expert
Hyderabad | January 19, 2006 7:36:25 PM IST

India has become an attractive destination for liver transplants for patients from countries of the South Asian Assocation for Regional Cooperation(SAARC) and the Gulf according to M R Rajasekhar, Fellow in Abdominal Organ Transplation, USA.

Liver transplantation cost about Rs one crore in the US and RS 90 lakh in the UK, but only Rs 20 lakh in India.

Dr Rajasekhar, has set up the country's first Hepatobiliary Surgery and Multiorgan transplant unit at the Indraprastha Apollo Hospital, New Delhi.

In view of the cost advantage, patients from Pakistan, Bangaladesh as also from Palestine and United Arab Emirites, prefer India, Dr Rajasekhar, who has specialised in live donor, cadaver donor, adult and pediatric liver transplants, said, here today.

While more than 60,000 patients succumb to liver failure in India every year, few actually get the benefit of liver transplant due to cost factor as also low awareness about the procedure, Dr Rajasekhar, said.

He said screening for Hepatitis B, and Hepatitis C virus before blood transfusion as also vaccination of both children and adults for hepatitis-B was needed.

He said, ''Reducing alcohol conumsption and disincentives to reduce alcohol consumpiton will go a long way in reducing incidence of chronic liver disease and liver cancer.'' Though there was no vaccination available for Hepatitis -C, which was emerging fast as the commonest cause of liver failure in the country, Hepatitis-C was curable in 50 per cent of the patients, he added.

RIMS seeks super speciality crown : 19th jan06 ~ E-Pao! Headlines

RIMS seeks super speciality crown : 19th jan06 ~ E-Pao! Headlines: "On being questioned on the frequent clashes and scuffle between patients' parties and doctors on duty and RIMS security personnel, Professor Fimate said that the need of the situation is mutual respect for each other.

“We are doing our best to serve the patients and the people are co-operating.

However there are times when patients' parties violate the rules and regulations of the hospital,” said the Director.

This shows that there are a range of cultural issues facing Indian hospitals as they attempt to recreate themselves as medical tourism institutions.

To help avoid any unpleasant stand off between the staff of RIMS and patients' parties, unarmed guards are deployed at the hospital, said Professor Fimate and lamented that the people still have not over come their habit of spitting on the wall.

Such habits are strictly prohibited at all the big hospitals across the world, said the Director and added that a little civic sense on the part of the public will go a long way helping the employees keep RIMS clean."

IOL: Philippines launches medical tourism campaign

IOL: Philippines launches medical tourism campaign

January 13 2006 at 05:19PM

By Oliver Teves

Manila - Officials launched a campaign on Wednesday to promote so-called medical tourism in the Philippines in an effort to grab a slice of the multi-billion dollar industry.

In a programme to formally promote the archipelago as "islands of wellness," Health Secretary Francisco Duque III said government agencies and private clinics and hospitals will strive to make the Philippines the "new hub of wellness and medical care in Asia".

He said the country was gearing up to compete directly with other Asian countries that are years ahead in the industry.

'New hub of wellness and medical care in Asia'
Medical tourism, which combines both health care and travel and leisure, last year generated more than $1-billion (about R6-billion) in revenues for Thailand, India and Malaysia, Duque said.

"We believe that the Philippines can tap into the remaining huge market potential and generate this kind of amount once we take off in the next five years and thereon push ahead," he said.

He said "it's not too late" for Filipinos to catch up with other Asians.

"I think we still have very many worthy qualities as health care providers, and our medical and surgical capabilities are quite comparable, if not superior," he said.

He said the government also hopes the campaign "will be an attractive strategy to reverse the current outward migration of our professionals, prompt new doctors to stay and lure back our health workers who had international training".

'We still have very many worthy qualities'
Health Undersecretary Jade del Mundo said the medical brain drain, which has seen doctors take higher-paying jobs abroad as nurses, "could bring us to the brink of a health crisis".

As an added benefit, the growth of medical tourism could generate enough revenues for the country to improve overall health care by increasing the number of hospital beds for the poor and making expensive advanced medical equipment available to them, Duque said.

He said the components of the new program include medical, surgical and dental care, health and wellness, traditional and alternative health care, long-term tourism and the establishment of international retirement and medical zones.

The prices of medical and surgical procedures in the Philippines are 30 percent to 50 percent cheaper than elsewhere, he said. A coronary bypass costing about $50 000 in the United States is only about $25 000 in the country, with comparable clinical expertise and facilities, as well as complication and success rates, he said.

Elizabeth Nell, a programme director at the department of tourism, said the Philippines will target medical tourists from the United States - particularly the large Filipino-American community - along with Europe, Australia, South Korea, Japan and Pacific island states.

Vietnam as Medical Tourism Destination??

: "A growing number of foreigners are flocking to Viet Nam for medical tourism even though the industry, which has been promoted in Thailand, Singapore and the Philippines, is new to the country, the British Broadcasting Corporation (BBC) said in a recent report.

The radio broadcaster reported that Viet Nam has become famous through the world for its traditional medicine such as acupuncture, with a large number of skillful doctors, including Dr. Nguyen Tai Thu, a world-renowned acupuncturist.

Many leaders and officials of foreign countries have been treated successfully by Vietnamese specialists in that Asian traditional medical procedure.

Viet Nam’s Central Acupuncture Institute receives many foreign tourists annually, the BBC said, adding that some hospitals in Viet Nam have been equipped with state-of-the-art instruments that can provide high-quality medical treatment services at a competitive cost.

However, according to the BBC, the number of foreign medical tourists to Viet Nam does not live up to the country’s potential because of its poor marketing activities and shortage of doctors fluent in foreign languages"