People who oppose sweeping health care reform often try to score easy points with some variation of this statement: “American health care is the best in the world. People come from all over to see the doctors in the United States.” The reasons people come here, we are told, are shorter wait times, superior technology, and better-trained doctors.
The problem is, this is not entirely true. According to Medical Tourism: Consumers in Search of Value, a report recently published by the Deloitte Center for Health Solutions, the number of Americans leaving the United States to get medical treatment far exceeds the number of foreigners coming in. In 2007, 750,000 Americans traveled abroad for medical treatment, while only 400,000 foreign patients sought care in the U.S. This means health care now joins a host of American industries that add to the U.S. trade deficit – that is, we buy more units of medical treatment in other countries than other countries buy from us.
Deloitte predicts that the trend towards outbound medical tourism will continue in coming years. At the current rate of growth, there will be 6 million outbound trips by 2010, while inbound medical visits will only reach about 450,000. Thus, as the pundits extol the worldwide appeal of our great health system, U.S. citizens are voting with their feet, choosing international care in greater and greater numbers.
None of this necessarily implies that the quality of U.S. medicine is going down. Foreign countries are beating us on price. The cost savings can be significant: According to Deloitte, a knee surgery in the U.S. that costs $4,686 as an outpatient procedure averages $1,398 abroad, including travel costs. A $6,500 hysterectomy costs about $2,100, and a $2,600 cataract surgery $1,282 abroad.
Nor is there any reason to think these disparities will decrease any time in the future. While it is true that foreign prices could rise under the pressure of the falling dollar and burgeoning airline ticket prices, health care costs in the U.S. have also been rising at double digit rates in recent years. All signs point to a widening price gap.
It would be a mistake to dismiss this trend as the price sensitivity of a small group of consumers. Every year, almost a million Americans are leaving the country, bypassing our entire health care system, to find treatment abroad. In doing so they incur significant risk. If your knee surgery goes bad after you come back from Thailand, who is going to clean up the mess? If I have a major medical procedure, I want the doctor who performed it living nearby, in case I have problems down the road. Patients who travel around the world to get surgeries take this gamble because they have been priced out of the American system. They are going elsewhere because the American system does not meet their health needs.
For a nation that believes in the power of free markets, America can be myopic when it comes to health care costs. Health care, no matter how high the quality, is of no value to people who can't afford it. Saying America offers the best health care in the world if you have unlimited resources is not the same as saying America has the world's best health care.
Call medical tourism the free market at work if you want. I call it system failure. But either way, the facts of medical tourism quash the myth that our health care is the envy of the rest of the world. At least 750,000 Americans a year say otherwise, and put their own money behind their convictions.